People are often frightened when the doctor raises the possibility of lithium treatment – it conjures up all kinds of images from the media and Hollywood of dark, dangerous institutions and wild kinds of symptoms. Patients often look surprised when I mention it – saying, “but isn’t that for only really crazy people?” It is unfortunate that lithium has gotten such a bad rap, because it is one of our best tested, longest used (since the 1960s), and most effective interventions for bipolar disorder. Here’s a list of its many benefits:
- It treats mania.
- It treats depression.
- It can reduce the cycling of both mania and depression.
- It’s the only medication that’s proven to reduce the risk of suicide in bipolar disorder.
There was a long period of time in recent history when doctors were leaning toward using the newer medications to treat mania and bipolar disorder, but as experiences with those medicines have revealed a number of difficult side effects, psychiatrists are moving back to the old standby – lithium. While lithium has its own side effects, they are well defined and can often be reduced or eliminated with adjustments and modifications to dose or other straightforward interventions. Following are the most common side effects:
- Stomach problems
- Weight gain
- Frequent urination
- Kidney damage
- Liver damage
- Foggy thinking
- Fatigue
- Tremor
Lithium wasn’t cooked up in a multimillion-dollar lab. It is a naturally occurring salt that just happens to calm the nerves and, when used under a doctor’s supervision, has manageable side effects for most people. Because it is often effective in managing both “poles” of bipolar – mania and depression – it is one of the rare medications that is truly a mood stabilizer for many people.
One of the biggest challenges with lithium is that blood levels (the concentration of lithium in the blood) must be maintained in a very narrow range. If your lithium level dips below its therapeutic level, the drug isn’t effective. If it rises too high, the drug can become toxic, and severe lithium toxicity can lead to death. So remember:
- Always take the prescribed dose. Appropriate doses can vary widely from person to person – even people of similar weights. The blood level is the important number in the case of lithium. So don’t worry if your dose is very different from someone else you know?
- Make sure your doctor prescribes regular blood tests to check your lithium levels – at least every few months (more regularly when you first start taking it). The “right level” is typically between 0.6 and 1.2 mmol/litre but every lab has a slightly different range. And while most people require a level in this range, some people do well in a lower range.
- Your doctor may also order additional blood and urine tests particularly to check on your thyroid and kidney functions.
- Lithium levels can rise as you lose fluid, so be wary of hot weather and vigorous exercise, and limit your consumption of diuretics, including coffee and alcohol.
- If you experience diarrhea, vomiting, dizziness, lack of coordination, blurred vision, or other signs of lithium toxicity, contact your doctor immediately. If you can’t reach your doctor, head to the nearest emergency room.
Warning: On the Web or at your local health food store, you may hear of a form of lithium purported to be safer: lithium orotate. The theory behind this claim is that the chemical compound delivers lithium to the brain more efficiently than lithium carbonate, the standard compound, so it requires less lithium in your bloodstream to be effective. However, no studies currently show that lithium orotate is effective in treating mania or depression. Taking the recommended dose of lithium orotate probably won’t harm you but it also won’t help.
If you’ve taken lithium for bipolar disorder or are a doctor who has prescribed it, please share your experiences, insights, and observations.
Related Posts
- New Series: Bipolar Medication Spotlight
- Bipolar Medication Spotlight: Depakote (Valproic Acid)
- Feeling Like a Guinea Pig?
- Bipolar Medication Spotlight: Lamictal (Lamotrigine)
- Do You Feel Stigmatized by Your Bipolar Medications?
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16 Responses to “Bipolar Medication Spotlight: Lithium” (Pingbacks/trackbacks not shown below)
Tiana at 5:28 pm on
July 18th, 2008
I have been taking lithium for less than a month now, but so far my experience with it has been significantly better than my experiences with Lamictal, Abilify, and Geodon. All of the aforementioned medications came with horrible side effects (for me) and helped my moods very little. With lithium, my moods and energy level have improved so much. I am so grateful that I can function now!
I know two people who have died from kidney failure due to lithium toxicity and one who is waiting for a kidney transplant. These people were all monitored regularly for toxicity…
No thanks to lithium.
I also happen to know a lot of folks who have been off meds for a long time who take lithium orotate safely and have had no episodes in years…
If you’ve taken lithium for bipolar disorder or are a doctor who has prescribed it, please share your experiences, insights, and observations.
I didn’t see that part. I took lithium years ago. It made me tremble, and I was covered from head to toe in very scaly psoriasis.
I also developed horrible acne which has left me scarred 20 years later.
I was also extremely depressed the whole time I was on it and it made me gain 40 lbs…the brain fog was horrible. I was monitored and kept on what I was told was a low dose…
You can be sure I think it’s a wonderful drug…
Andrea at 5:13 pm on
July 20th, 2008
A friend had a grave plot picked out the week prior to starting LithaLife, a lithium orotate supplement. After two weeks taking the pills, she was looking for a husband. After four weeks, she enrolled in classes. She says lithalife saved her life.
how can you say lithium orotate won’t, help with such authority??
that there are no studies proving that it helps does not mean it does not help.
I wish psychiatrists listened to people’s experiences…since I’ve started listening to alternative voices and trusted MULTIPLE anecdotes since there were no studies to be had, I’ve chosen very effective alternatives and I’m almost med free…
Meds effectively ended my life in terms of quality. I’m finally getting it back.
Joe Kraynak at 8:55 am on
July 21st, 2008
My wife was recently hospitalized for a severe manic episode twice - once for three days followed by a five-day respite followed by a ten-day stay. The second-tier meds she was using to control her mania didn’t work.
During the second hospitalization, the doctor started her on lithium and lowered the dose of risperdal she was taking. (He also had her stop taking her antidepressant - Wellbutrin.)
After about 5 days, I noticed a dramatic improvement. At the end of her ten-day stay, she was able to come home and get back in the swing of things. Lithium was truly remarkable.
She has experienced some weight gain (not nearly as much as when she had taken Depakote or Zyprexa in the past.) To help, the doctor decreased the amount of risperdal she is taking.
Yes, lithium toxicity is very real and very scary, but so is mania. We’re very fortunate, so far, to have the lithium work so well at the low-end of the therapeutic range. Lithium liberated my wife and our family from the shackles of bipolar.
I truly hope your wife remains healthy and stable but if she’s only been on Lithium since “recently” I don’t think we know yet what the outcome will be.
I did the med merry go round for 20 years and am now almost off meds and the quality of my life is much better….
I took 37 different drugs in that period of time. I had short periods of times where I thought I was doing better and that such and such a drug was the wonder drug…ultimately it became clear meds were being used to clear up other meds side effects ad nauseum.
I’ve gone natural with an excellent orthomolecular psychiatrist that also uses various energy healing techniques. Some may think it sounds like hocus pocus, but my brain is finally clearing and I’m virtually off all my meds…
I see people going into the life I led for 20 years and I cringe…the mainstream pharma funded world of psychiatry is hard to avoid. And it takes a conversion of sorts to get out from under their spell.
I do hope the best for you…some people some of the time actually stabilize on meds, but as a consumer myself and a psychiatric social worker professionally I’ve become completely disenchanted with drugs and traditional psychiatry.
Have any of you people who take lithium oratate ever heard of the placebo effect?
Kimiana,
your sarcasm is charming…
Maybe these people I know who have been stable for years never had bipoar…it is grossly over diagnosed…I wouldn’t have a problem with that interpretation.
But given I know some of these people had severe difficulties, became sicker on conventional meds and got relief when they took lithium orotate (not alone but with a nutritional regime that includes healthy diet and other supplements)
you know that most anti-depressant success is placebo? this is documented in the literature. those people tend to relapse and “poop-out” of the antidepressant is blamed…how do you explain years of stability on lithium orotate, unless of course there never was a disorder???
My doctor made me choose one of three drugs to take: lithium, Lamictal, or Seroquel. I looked up all three. Seroquel had terrible somnolence and weight gain problems. As for lithium, I felt as though I didn’t have the time to have my blood levels monitored for toxicity. Lamictal seemed like the better choice.
I have heard that lithium has helped some people but it’s not for everyone. It’s the same choice with Seroquel. Either people have chosen to gain weight and conquer their illness or have bypassed the drug and gone a different route. For a lot of people, it comes down to whether your physical health or your mental health is more important. There is no psych drug that is free of side effects.
stillo at 6:29 am on
July 29th, 2008
I don’t beleive Lithium is doing anything for me at all, i take 1 gram a day and i am more depressed now than i have ever been, i am just waiting for my next appointment with my pdoc and i will be waving goodbye to this awful drug
Stillo
Michele at 2:56 pm on
August 2nd, 2008
I take both lithium,lamictal and colonzopam for treatment of bi-polar I sustained after hitting my head during a traffic accident (I was not aware one could receive bi-polar as a result to hard blows to the head and there were 5 degrees of bi-polar) It IS NOT ONLY GENETIC. My Dr, has been doctor of the year since 1996 and is head of the psychiatric unit at a large accredited hospital. The only side effect I have had with lithium was when I accidently overdosed (thought I had not taken my meds. yet I already had) I took the same dosage again. It was not fun. I was shaking, could not walk or talk and felt like I was going to pass out. Sleep took away all the symptoms…with the help of burnt toast & peanut butter (same as charcoal) Other than that one instance, I have never had a problem with lithium. I also think lithium and lamictal compliment each other.
Jimmy Stevenson at 9:59 pm on
August 16th, 2008
Hi everyone,
I suffer from psychotic bipolar I (I have also been diagnosed with schizo-affective disorder a time or two).
I take (3) 300 mg capsules of Lithium Carbonate a day at bedtime (900 mg total a day). I have to say that I love lithium. Before starting on Lithium, I was on Abilify. I love lithium over Abilify. With Abilify I just did not feel like myself.
When you are trying to excel in today’s competitive environment, and you have to talk to co-workers on a daily basis, and you don’t “feel like yourself”, how can you get ahead and excel? You can’t, at least not for me. Now I know that for some people Abilify and other meds are great and work well for them. That is great. And that is the big trick for brain meds - everyone is different - you have to find the right meds and the right combinations of meds which work well for you.
But for lithium, I “fell like myself”, I have a lot of energy, I don’t get upset towards others around me, and it keeps me out of depression.
Now when I get under a lot of stress, or when I get an “unplanned-for-stressor” which hits me by surprise, then I supplement the lithium with Zyprexa. Zyprexa is specially formulated for all the different types of ghosts, goblins, demons, and bogie monsters. I.E., it eliminates all forms of delusions and hallucinations. I manage all this with the help of a caring significant other who tells me, “I think tonight maybe you should take a 5 mg dose of Zyprexa.”
She helps me out a lot this way.
This way, I know that I stay safe and that those around me stay safe. I manage my meds.
You can too!
Good luck,
Jimmy Stevenson
PS - I weigh 230 pounds, my lithium blood work usually comes in around “.7″, on the .6 to 1.2 scale, so I am healthy with lithium.
Janet at 11:11 am on
August 18th, 2008
My mother has taken lithium for over 30 years now. It is truly a God send for manic depression! Before her doctor put her on lithium she was in the lock up ward of the psychiatric wing at Methodist Hospital in Houston. She had been there for a couple of months. She was on the depressed swing of a bipolar episode and not coming out of it no matter what medication they tried. They had even done shock treatments on her and nothing was working. The doctors told my father to find a State Hospital to put my mother in and have her committed. In a last ditch effort her doctor tried Lithium and she snapped out of it within a matter of a few short days. She has lived a normal, happy life on a maintenance dose of 300 mg/day of Lithium for the past 30 years. She won’t leave home without it! You better believe that I sing the praises of Lithium to everyone I know!
Ask a Question or Post a Comment:
I have been taking lithium for less than a month now, but so far my experience with it has been significantly better than my experiences with Lamictal, Abilify, and Geodon. All of the aforementioned medications came with horrible side effects (for me) and helped my moods very little. With lithium, my moods and energy level have improved so much. I am so grateful that I can function now!
I know two people who have died from kidney failure due to lithium toxicity and one who is waiting for a kidney transplant. These people were all monitored regularly for toxicity…
No thanks to lithium.
I also happen to know a lot of folks who have been off meds for a long time who take lithium orotate safely and have had no episodes in years…
If you’ve taken lithium for bipolar disorder or are a doctor who has prescribed it, please share your experiences, insights, and observations.
I didn’t see that part. I took lithium years ago. It made me tremble, and I was covered from head to toe in very scaly psoriasis.
I also developed horrible acne which has left me scarred 20 years later.
I was also extremely depressed the whole time I was on it and it made me gain 40 lbs…the brain fog was horrible. I was monitored and kept on what I was told was a low dose…
You can be sure I think it’s a wonderful drug…
A friend had a grave plot picked out the week prior to starting LithaLife, a lithium orotate supplement. After two weeks taking the pills, she was looking for a husband. After four weeks, she enrolled in classes. She says lithalife saved her life.
how can you say lithium orotate won’t, help with such authority??
that there are no studies proving that it helps does not mean it does not help.
I wish psychiatrists listened to people’s experiences…since I’ve started listening to alternative voices and trusted MULTIPLE anecdotes since there were no studies to be had, I’ve chosen very effective alternatives and I’m almost med free…
Meds effectively ended my life in terms of quality. I’m finally getting it back.
My wife was recently hospitalized for a severe manic episode twice - once for three days followed by a five-day respite followed by a ten-day stay. The second-tier meds she was using to control her mania didn’t work.
During the second hospitalization, the doctor started her on lithium and lowered the dose of risperdal she was taking. (He also had her stop taking her antidepressant - Wellbutrin.)
After about 5 days, I noticed a dramatic improvement. At the end of her ten-day stay, she was able to come home and get back in the swing of things. Lithium was truly remarkable.
She has experienced some weight gain (not nearly as much as when she had taken Depakote or Zyprexa in the past.) To help, the doctor decreased the amount of risperdal she is taking.
Yes, lithium toxicity is very real and very scary, but so is mania. We’re very fortunate, so far, to have the lithium work so well at the low-end of the therapeutic range. Lithium liberated my wife and our family from the shackles of bipolar.
I truly hope your wife remains healthy and stable but if she’s only been on Lithium since “recently” I don’t think we know yet what the outcome will be.
I did the med merry go round for 20 years and am now almost off meds and the quality of my life is much better….
I took 37 different drugs in that period of time. I had short periods of times where I thought I was doing better and that such and such a drug was the wonder drug…ultimately it became clear meds were being used to clear up other meds side effects ad nauseum.
I’ve gone natural with an excellent orthomolecular psychiatrist that also uses various energy healing techniques. Some may think it sounds like hocus pocus, but my brain is finally clearing and I’m virtually off all my meds…
I see people going into the life I led for 20 years and I cringe…the mainstream pharma funded world of psychiatry is hard to avoid. And it takes a conversion of sorts to get out from under their spell.
I do hope the best for you…some people some of the time actually stabilize on meds, but as a consumer myself and a psychiatric social worker professionally I’ve become completely disenchanted with drugs and traditional psychiatry.
Have any of you people who take lithium oratate ever heard of the placebo effect?
Kimiana,
your sarcasm is charming…
Maybe these people I know who have been stable for years never had bipoar…it is grossly over diagnosed…I wouldn’t have a problem with that interpretation.
But given I know some of these people had severe difficulties, became sicker on conventional meds and got relief when they took lithium orotate (not alone but with a nutritional regime that includes healthy diet and other supplements)
you know that most anti-depressant success is placebo? this is documented in the literature. those people tend to relapse and “poop-out” of the antidepressant is blamed…how do you explain years of stability on lithium orotate, unless of course there never was a disorder???
My doctor made me choose one of three drugs to take: lithium, Lamictal, or Seroquel. I looked up all three. Seroquel had terrible somnolence and weight gain problems. As for lithium, I felt as though I didn’t have the time to have my blood levels monitored for toxicity. Lamictal seemed like the better choice.
I have heard that lithium has helped some people but it’s not for everyone. It’s the same choice with Seroquel. Either people have chosen to gain weight and conquer their illness or have bypassed the drug and gone a different route. For a lot of people, it comes down to whether your physical health or your mental health is more important. There is no psych drug that is free of side effects.
I don’t beleive Lithium is doing anything for me at all, i take 1 gram a day and i am more depressed now than i have ever been, i am just waiting for my next appointment with my pdoc and i will be waving goodbye to this awful drug
Stillo
I take both lithium,lamictal and colonzopam for treatment of bi-polar I sustained after hitting my head during a traffic accident (I was not aware one could receive bi-polar as a result to hard blows to the head and there were 5 degrees of bi-polar) It IS NOT ONLY GENETIC. My Dr, has been doctor of the year since 1996 and is head of the psychiatric unit at a large accredited hospital. The only side effect I have had with lithium was when I accidently overdosed (thought I had not taken my meds. yet I already had) I took the same dosage again. It was not fun. I was shaking, could not walk or talk and felt like I was going to pass out. Sleep took away all the symptoms…with the help of burnt toast & peanut butter (same as charcoal) Other than that one instance, I have never had a problem with lithium. I also think lithium and lamictal compliment each other.
Hi everyone,
I suffer from psychotic bipolar I (I have also been diagnosed with schizo-affective disorder a time or two).
I take (3) 300 mg capsules of Lithium Carbonate a day at bedtime (900 mg total a day). I have to say that I love lithium. Before starting on Lithium, I was on Abilify. I love lithium over Abilify. With Abilify I just did not feel like myself.
When you are trying to excel in today’s competitive environment, and you have to talk to co-workers on a daily basis, and you don’t “feel like yourself”, how can you get ahead and excel? You can’t, at least not for me. Now I know that for some people Abilify and other meds are great and work well for them. That is great. And that is the big trick for brain meds - everyone is different - you have to find the right meds and the right combinations of meds which work well for you.
But for lithium, I “fell like myself”, I have a lot of energy, I don’t get upset towards others around me, and it keeps me out of depression.
Now when I get under a lot of stress, or when I get an “unplanned-for-stressor” which hits me by surprise, then I supplement the lithium with Zyprexa. Zyprexa is specially formulated for all the different types of ghosts, goblins, demons, and bogie monsters. I.E., it eliminates all forms of delusions and hallucinations. I manage all this with the help of a caring significant other who tells me, “I think tonight maybe you should take a 5 mg dose of Zyprexa.”
She helps me out a lot this way.
This way, I know that I stay safe and that those around me stay safe. I manage my meds.
You can too!
Good luck,
Jimmy Stevenson
PS - I weigh 230 pounds, my lithium blood work usually comes in around “.7″, on the .6 to 1.2 scale, so I am healthy with lithium.
My mother has taken lithium for over 30 years now. It is truly a God send for manic depression! Before her doctor put her on lithium she was in the lock up ward of the psychiatric wing at Methodist Hospital in Houston. She had been there for a couple of months. She was on the depressed swing of a bipolar episode and not coming out of it no matter what medication they tried. They had even done shock treatments on her and nothing was working. The doctors told my father to find a State Hospital to put my mother in and have her committed. In a last ditch effort her doctor tried Lithium and she snapped out of it within a matter of a few short days. She has lived a normal, happy life on a maintenance dose of 300 mg/day of Lithium for the past 30 years. She won’t leave home without it! You better believe that I sing the praises of Lithium to everyone I know!
