What is lithium?

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Lithium is a mood stabilising medicine. Taking lithium helps you have more control over your emotions. It helps you cope better with the mood swings of bipolar disorder. It is not addictive.

If you have a mental health problem, talk to your doctor about whether a medicine is right for you. Lithium is just one option.

How does lithium work?

Lithium is a mood stabiliser, but the exact way that it works is not known. Lithium may work by changing the levels of chemicals such as serotonin in your brain.

What forms of lithium are available?

Lithium carbonate is the active ingredient in lithium tablets.

You may be prescribed a slow-release form of lithium tablets. Slow-release tablets must be swallowed whole with water. They keep the level of lithium in your blood more steady.

What is lithium used for?

Lithium is used to treat certain mental health problems, such as:

• mania (feeling highly excited and overactive)
• hypomania (like mania, but less severe)
• bipolar disorder, where your mood changes between feeling very high (mania) and very low (depression)
• schizophrenia
• some types of depression

It may take several weeks to months for lithium to start working.

The amount of medicine that you need varies from person to person. Your dose may depend on:

• your age
• your general health
• other medicines that you take

If lithium helps you feel better, your doctor may prescribe it for months or years, or even lifelong. It's important to continue treatment, even when you feel well. Lithium is not a cure, but may help control symptoms and prevent relapse while you are taking it.

What are the possible side effects or risks of lithium?

Short-term side effects

You may have some short-term side effects when you start taking lithium. These side effects often improve or disappear after a few days or weeks.

Short-term side effects may include:

• mild nausea or diarrhoea
• feeling thirsty
• frequent or increased amount of urination (wee)
• tremor (shaking hands)
• changes in your sense of taste

Long-term side effects

Some side effects may continue or develop. Possible long-term side effects include:

• feeling very tired
• weight gain
• 'brain fog' or feeling confused or forgetful
• thinning hair
• thyroid problems
• kidney problems

If any side effects are worrying you, see your doctor.

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Lithium toxicity

The amount of lithium you have in your blood needs to be just right. If the level is too low, it won't work properly. If it's too high, it can cause serious side effects. Dangerously high levels of lithium in the body is called 'lithium toxicity'.

Signs of lithium toxicity include:

• stomach pain, vomiting or diarrhoea
• increased muscle weakness, shaking or twitching
• confusion, severe drowsiness or dizziness
• trouble walking or slurred speech
• feeling very thirsty
• blurred vision or ringing in the ears (tinnitus)
• swelling of your face, mouth, or tongue — this may cause trouble breathing or swallowing

In very severe cases, high lithium levels can lead to seizures, coma or even death.

You may develop lithium toxicity if you:

• take too many lithium tablets at once
• combine lithium with some other medicines — especially non-steroidal anti-inflammatory medicines (NSAIDs) and some blood pressure medicines
• get very dehydrated — for example, if you have a fever, vomiting or diarrhoea
• don't have enough salt in your diet

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How do I take lithium?

It's important to take lithium exactly as your doctor and pharmacist tell you. You should:

• take lithium with food to prevent stomach pain
• eat and drink normally — don't follow a low salt diet
• drink plenty of fluids in hot weather and during exercise, to avoid dehydration
• take care if you are driving, as lithium can make you sleepy
• follow your doctors' instructions about having lithium blood tests — the results will help get your dose right

Do not stop taking lithium suddenly. Always talk to your doctor before making any changes to your medicines.

Tell your doctor if you:

• are taking any other medicines or supplements, as they may interact with lithium
• have any heart or kidney problems, or have been told to reduce your salt intake
• are pregnant, planning to become pregnant or breastfeeding
• are worried about the side effects of lithium

If you miss a dose, ask your doctor or pharmacist what to do. You can also check the consumer medicine information (CMI) leaflet that comes with your medicine.

Before you take any new medicines, check with your doctor or pharmacist whether they are safe to take with lithium. This includes over-the-counter (OTC) medicines, vitamins and other supplements that are available in supermarkets or health food shops.

If you take lithium and are planning a pregnancy, pregnant or are breastfeeding you should speak with your doctor about the risks and benefits of taking lithium during these times.

When should I see my doctor?

If you take lithium, you will need to see your doctor regularly. Your doctor will arrange blood tests to make sure you are not taking too little or too much lithium.

Once you find the dose that is right for you, you may only need to see your doctor every few months. However, you will need to see your doctor more often if you are unwell or have any new symptoms.

Your doctor will monitor your mood and your general health. They will recommend blood tests to check your:

• lithium levels
• kidney function
• thyroid function
• parathyroid function

Some people who take lithium for long periods gain weight. Talk to your doctor about managing your weight.

Females who take lithium may need to change to other medicines while pregnant. Discuss your medicines with your doctor before becoming pregnant.

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Resources and support

You can also call Lifeline on 13 11 14 — 24 hours a day, 7 days a week.

Call the Poisons Information Line on 13 11 26 if you think you have taken too much lithium. There is no need to wait until symptoms appear.

For advice and to get connected to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating times.

See healthdirect's medicines section for more information about lithium, or read the consumer medicine information (CMI) leaflet that comes with your medicine.

You can learn more about the different treatment options for mental health problems on the SANE Australia website.

The Black Dog Institute has information to help you understand bipolar disorder.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

Find information in many other languages about medicines for bipolar disorder, including lithium.

Aboriginal and/or Torres Strait Islander peoples

Find an Aboriginal Community Controlled Health Organisation (ACCHO) in your area.