Lithium: What It Does and How to Use It Safely

Lithium is one of the oldest and most effective medicines for bipolar disorder. It helps prevent manic and depressive episodes and, importantly, lowers the risk of suicide. If your doctor suggested lithium, you probably want clear, practical advice — not jargon. Here’s what matters most.

How lithium works and who it helps

Lithium stabilizes mood by changing how brain cells communicate and handle certain chemicals. Doctors commonly use it for acute mania and long-term maintenance in bipolar I disorder. It’s not a one-size-fits-all drug: some people respond very well, others less so. Response can take days to weeks, and full benefit for mood stability often appears over several weeks.

Two common forms are lithium carbonate and lithium citrate. Doses are individualized — your doctor will start low and adjust based on blood levels and symptoms.

Monitoring, blood levels, and safety checks

Regular blood tests are essential. The typical target range for maintenance is about 0.6–1.2 mmol/L, but your clinician may aim lower or higher depending on your situation. Tests include lithium level, kidney function (creatinine), and thyroid function (TSH). At first, blood checks are frequent: after a few days, then weekly until stable, then every 3 months or as advised.

Why tests matter: lithium has a narrow therapeutic window. Too low and it won’t work; too high and it can be toxic. Even small changes in kidney function, diet, or other medicines can shift levels.

Watch for these early side effects: mild tremor, increased thirst and urination, nausea, and mild weight gain. Many side effects settle over time or with dose adjustments.

Know the warning signs of toxicity: severe vomiting or diarrhea, confusion, slurred speech, coarse tremor, drowsiness, or coordination problems. If any of these appear, get emergency care and a blood lithium level right away.

Common drug interactions: avoid or use caution with NSAIDs (ibuprofen, naproxen), some diuretics (like thiazides), ACE inhibitors, and certain antibiotics. These can raise lithium levels suddenly. Tell every prescriber and your pharmacist that you take lithium.

Simple daily tips: keep fluid and salt intake steady (don’t crash diets or start new extreme workouts), take doses at the same times each day, and carry a list of your meds. If you lose fluids from illness (fever, vomiting, diarrhea), contact your doctor — dehydration can push lithium into the danger zone.

Pregnancy and breastfeeding require special discussion. Lithium can increase certain risks in pregnancy but stopping it also risks relapse. Talk with your psychiatrist and obstetrician early if you plan a pregnancy or become pregnant.

Bottom line: lithium works, but it needs respect. With the right monitoring and small lifestyle choices, many people use it safely and get reliable mood control. If you have questions about dosing or side effects, call your prescriber — quick action prevents most problems.