When your doctor tells you or someone close to you to start taking lithium, it's normal to feel a little apprehensive and curious. Especially when it comes to a mood-regulating medication, we often have a lot of questions. But the best way to stay healthy is to be fully informed about this medication. So today, let's talk briefly about lithium, what it does, and what you need to be careful about when using it.
What kind of medicine is Lithium?
Simply put, lithium is a medication used to treat conditions like bipolar disorder . Certain chemicals in the brain (called neurotransmitters) help control our mood, behavior, and thoughts. Lithium works by balancing the activity of these chemicals.
Although it is mainly used for bipolar disorder, your doctor may sometimes prescribe it for other conditions. So if you have any questions about this, ask your doctor.
The most important things to tell your doctor before starting medication
Before you start taking lithium, it's important to tell your doctor if you have any of the following conditions. This is very important for your safety.
| Situation that may apply to you | Description |
|---|---|
| Diseases in the body | Heart disease, kidney disease, thyroid disease, parathyroid disease, Brugada Syndrome, breathing difficulties, current infection. |
| Salt and fluid levels in the body | If you have lost water from your body due to laxatives or excessive sweating (dehydration), if your blood potassium or sodium levels are low, or if your blood calcium levels are high. |
| Diet | If you are on a low salt diet. |
| Pregnancy and breastfeeding | If you are pregnant, trying to get pregnant, or breastfeeding. |
| Allergies | If you are allergic to lithium or any other medicine, food, or dye. |
How should I use this medicine?
This medicine comes as a solution and should be taken by mouth. It is very important to take it every day, at the right time, as prescribed by your doctor .
To measure the amount of medicine, use a special measuring device (oral syringe, spoon, or dropper) designed for this purpose. Do not measure with ordinary household teaspoons , as they cannot measure the exact amount. This can cause the dose to fluctuate.
If you experience stomach upset, take this medicine with food. Most importantly, never stop taking this medicine unless your doctor tells you to.
Overdose: If you have any suspicion that you have taken too much of this medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Department (ETU) of the nearest hospital. Treat this as an emergency.
Also remember, this medicine is prescribed for you only. Never share it with anyone else.
What if I miss a dose of medicine?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take double or extra doses.
Other medications that may interact with lithium
Lithium is a drug that can interact with other medications, so it is important to tell your doctor about all the medications you are taking.
Never take lithium with these medications:
- Cisapride
- Dronedarone
- Pimozide
- Thioridazine
These medications can also interact with lithium:
This list is not complete, but if you are taking any of these medications, tell your doctor .
- Things that contain caffeine
- Medications such as Carbamazepine
- Other medications for conditions such as depression and anxiety
- Some medications for high blood pressure
- Migraine medications (e.g. Sumatriptan)
- Diuretics - medicines that remove water from the body
- NSAID painkillers (e.g. Ibuprofen, Naproxen)
- Medicines given to relax muscles during surgery
- Herbal products such as St. John's Wort
Therefore, give your doctor a complete description of not only all medications, vitamins, and herbal products you are taking, but also if you smoke, drink alcohol, or use other drugs .
Things to be especially careful about when taking medication
- Regular medical check-ups: See your doctor regularly to see if your condition is improving. It may take several weeks for the full effects of the medication to show.
- Salt and water: This is what someone taking lithium needs to be most careful about.
- The amount of salt (sodium) in your body directly affects the effectiveness of this medicine and the risk of side effects. Therefore, eat a diet that contains salt as usual. Do not use salt substitutes.
- Drink plenty of water. It is best to drink at least 8-12 glasses of water a day. Avoid caffeinated drinks like coffee, tea, and cola.
- If you have diarrhea or are sweating a lot (e.g., during exercise or in hot weather), drink extra fluids. This will reduce the risk of lithium toxicity.
- Exercise and heat: Be careful not to become dehydrated when exercising, using a sauna, taking hot baths, or on very hot days. Call your doctor if you have a high fever or persistent diarrhea.
- Driving: This medicine may make you dizzy, drowsy, and have difficulty making decisions. Therefore , avoid driving or operating machinery until you know exactly how this medicine affects you.
What side effects might I experience?
Like any medication, lithium can cause side effects. Some are serious, some are common.
| Side effect/symptom | Description |
|---|---|
| If you have these symptoms, tell your doctor immediately. | |
| Lithium toxicity | Severe diarrhea, vomiting, tremors, loss of balance, uncontrolled eye movements, ringing in the ears, muscle weakness, slurred speech, and memory loss. |
| Serotonin syndrome | Agitation, confusion, rapid heartbeat, muscle stiffness, excessive sweating, high fever, convulsions, vomiting, diarrhea. |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Other serious symptoms | Heartbeat irregularities, chest pain, excessive thirst and frequent urination, severe headache, blurred vision. |
| If these symptoms persist or are bothersome, tell your doctor. | |
| Common side effects | Dizziness, fatigue, nausea, a subtle tremor in the hands. |
Take-Home Message
- Always take lithium at the exact dose and time prescribed by your doctor. Never stop taking the medicine or change the dose without your doctor's advice.
- Inform your doctor about all other medications, vitamins, and herbal products you are taking.
- Drink plenty of water daily, especially during hot weather and when exercising, while eating a salty diet as usual.
- If you experience symptoms of lithium poisoning, such as severe diarrhea, vomiting, confusion, and tremors, seek medical advice immediately.
- This medicine is for you only. Never share it with others.
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