Learning about lithium

Originally Published: December 8, 2006
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Dear Alice,

What is lithium, and what does it do to you?

Dear Reader,

Lithium is a medicine that has been around since the 1950s. In 1970, the U.S. Food and Drug Administration (FDA) approved its use in humans. It comes in both tablet and liquid forms.

Nowadays, lithium is most often prescribed to treat symptoms of mental illness such as mania (very elevated mood) and depression. It's also used to stabilize mood for people with bipolar disorder and to help people struggling with schizophrenia. (Check out the Related Q&As for more info on bipolar disorder and schizophrenia.) Other uses for lithium include treating certain blood and impulse control disorders.

Scientists still aren't completely sure how lithium works. They do know it acts as a salt in the body, and it seems to work inside the brain to regulate neurotransmitter production and function. (Neurotransmitters are chemical messengers in the brain and nervous system.) Specifically, lithium seems to zero in on glutamate, a neurotransmitter that's been connected to depression and mania. Lithium also works to increase production of white blood cells.

Health care providers say it takes lithium between one to three weeks to start working enough for patients to notice an improvement in their symptoms. People taking lithium are required to periodically check their blood levels of the drug. This is because the drug must be kept at a certain level in the body for it to work properly. If the level goes too high or too low, unpleasant (and sometimes dangerous) side effects are more likely to occur.

Like any medication, lithium has known side effects. These side effects are more common at the start of therapy, but they usually subside as therapy goes on:

  • weight gain
  • dry mouth, increased thirst, and urination
  • nausea and diarrhea
  • impotence and lowered libido
  • fine hand tremor
  • altered taste perception

More serious side effects may be a sign that blood lithium levels are too high, and the dose may need to be altered. These include:

  • visual impairment
  • severe fatigue
  • muscle weakness, twitches, tremor, and unsteady gait
  • mental confusion and slurred speech
  • seizure
  • heart arrhythmias
  • loss of appetite
  • coma
  • hypothyroidism

Keep in mind that prescriptions are written on a case-by-case basis, and people respond differently to lithium. Given this variability, it's always good for people who are currently taking or thinking about taking lithium to talk honestly and openly with their health care provider about their personal concerns and treatment goals.