David Baxter PhD
Late Founder
Bipolar Medication Spotlight: Lithium
by Candida Fink MD
July 22, 2008
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:
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:
by Candida Fink MD
July 22, 2008
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.
- Stomach problems
- Weight gain
- Frequent urination
- Kidney damage
- Liver damage
- Foggy thinking
- Fatigue
- Tremor
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.
