Lithium Withdrawals or Relapse?
According to research published by the National Center for Biotechnology Information (NCBI), it has long been considered that lithium therapy could be abruptly stopped because it was guessed that lithium salts did not induce lithium withdrawal symptoms. However, several open and controlled studies have shown that lithium discontinuation was linked with possible withdrawal symptoms and rebound effects.
Lithium withdrawal symptoms have been described in some individuals. Still, it is difficult to differentiate them from depressive or manic symptoms because no specific somatic lithium withdrawal symptoms have been observed. The most significant risk related to lithium discontinuation is the early recurrence of bipolar illness. Mainly, it has been shown that the risk of manic recurrences is increased in the first weeks after discontinuation of lithium medication. This risk is higher than predicted by the natural history of the manic-depressive illness.
Relapses can happen even when lithium is stopped only for a few days. Sudden discontinuation of lithium is associated with an increased risk of recurrence. The root cause of this rebound effect is still unknown. In clinical practice, lithium discontinuation has to be gradual when possible. Also, studies are needed to identify when the risk of lithium withdrawal syndrome develops after starting lithium medication. It is also essential to establish more precise clinical guidelines for lithium discontinuation.
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The Dangers of Stopping Lithium Suddenly
Stopping lithium suddenly can have severe consequences, especially for individuals with bipolar or other mood disorders. It can trigger a rapid onset of manic or depressive episodes, leading to a worsened mental health condition and increased risk of self-harm or suicide. Therefore, it is crucial for individuals taking lithium to consult with their healthcare provider before making any changes to their medication regimen and to follow a plan for tapering off of lithium if discontinuation is necessary to ensure safety.
Common Lithium Withdrawal Symptoms
Recent research coins the term “SILENT” to describe the Syndrome of Irreversible Lithium Effectuated Neurotoxicity. These are lithium carbonate neurotoxic side effects that don’t go away even though the drug is discontinued. The most common symptom of SILENT is cerebellar dysfunction, a form of brain damage affecting the cerebellum. The cerebellum coordinates gait balance and can affect motor movements and speech, as seen in Parkinsonism, muscular dystrophy, dementia, and other conditions.
Similarly, other side effects that emerge during treatment with lithium carbonate, such as renal impairment, may not go away even after stopping lithium.
Common side effects of lithium withdrawal include:
- Heightened anxiety.
- Sleep disturbances.
- Return of mania, bipolar, or other original symptoms.
- Increased suicidal risk, which is lessened with slow and gradual lithium withdrawal.
Physical Symptoms of Lithium Withdrawal
Lithium Withdrawal Physical Symptoms
Lithium withdrawal can lead to various physical symptoms, including:
- Tremors or shaking.
- Muscle weakness.
- Increased thirst and urination.
- Weight gain.
- Flu-like symptoms (aches and chills).
- Changes in heart rate or rhythm.
These symptoms can vary in intensity and duration depending on the individual and their circumstances. Working with a healthcare provider to manage lithium withdrawal safely is essential.
Emotional Symptoms of Withdrawal from Lithium
Emotional and Psychological Lithium Side Effects Withdrawal
Emotional and psychological lithium withdrawal side effects may include:
- Mood swings.
- Difficulty concentrating.
- Suicidal thoughts (in severe cases).
These symptoms can vary in severity and duration, and it’s essential to seek professional guidance and support when discontinuing lithium to manage these emotional and psychological effects.
Common Side Effects of Lithium
According to the US Food and Drug Administration (FDA), signs of lithium toxicity include vomiting, diarrhea, tremors, ataxia (clumsiness, loss of coordination), drowsiness, and muscular weakness.
Other common side effects include weight gain, cognitive impairment, impaired kidney function, hyperthyroidism, and hypothyroidism. Below are several possible side effects of lithium; we have categorized them for clarity. Along with many others, these side effects are listed on the FDA drug label.
Lithium Carbonate Side Effects
Gastrointestinal and Renal
Side Effects Lithium Gastrointestinal and Renal
- Nausea, vomiting, diarrhea.
- Weight loss.
- Weight gain.
- Increased urination.
- Increased thirst.
- Abdominal pain.
- Dry mouth/ excessive salivation.
- Kidney toxicity (may lead to kidney failure).
- Incontinence of urine or feces.
Musculoskeletal Adverse Effect of Lithium
- Tremors, tics, twitches.
- Cogwheel rigidity.
- Startled response.
- Uncontrolled tongue movements.
- Ataxia (clumsiness, loss of balance, difficulty walking).
- Hyperreflexia (reflexes become over-responsive).
- Muscle weakness.
- Swelling of ankles or wrists.
- Painful joints.
- Tightness in chest.
Cognitive Side Effects Reasons to Quit Lithium
- Memory loss.
- Mental confusion.
- Poor concentration.
- Loss of alertness (warnings given for those operating heavy machinery or driving).
- Slurred speech.
- Blackout spells.
Ocular/Aural Lithium Symptoms
- Blurred vision.
Other Conditions and Disorders
Other Lithium Side Effects
- Leukocytosis (elevation in white blood cell count).
- Hypothyroidism (underactive thyroid).
- Hyperthyroidism (overactive thyroid).
- Gout (a painful form of arthritis linked to high uric acid levels in the foot).
- Goiter (enlargement of the thyroid gland, inflammation/swelling of the neck).
- Parkinsonism, dystonias, and other movement disorders.
- Sodium depletion.
- Protracted sweating.
- Dental caries.
- Vertigo, dizziness.
- Lithium carbonate usage in pregnancy is potentially associated with congenital disabilities, specifically in heart malformations known as Ebstein’s anomaly.
Lithium Long Term Side Effects
Long-term use of lithium may lead to various side effects, including:
- Kidney problems, such as reduced kidney function.
- Thyroid issues, such as hypothyroidism.
- Weight gain.
- Increased thirst and urination.
- Hand tremors or shaky hands.
- Memory problems or cognitive changes.
- Skin problems, such as acne or rashes.
- Hair loss or changes in hair texture.
- Frequent urination at night.
- Electrolyte imbalances.
Too Much Lithium Side Effects
Excessive lithium levels, often due to overdose or improper dosing, can result in severe side effects. Here’s a simple list of potential symptoms of too much lithium (lithium toxicity):
- Confusion and cognitive impairment.
- Severe hand tremors or shaking.
- Frequent urination.
- Excessive thirst.
- Muscle weakness.
- Nausea and vomiting.
- Irregular heartbeat.
- Coma (in extreme cases).
Lithium toxicity is a medical emergency; if you suspect you or someone else is experiencing these symptoms, seek immediate medical attention.
What is Lithium?
Lithium (lithium carbonate) is an antimanic agent, a mood stabilizer prescribed to treat mental health conditions, including depression, bipolar disorder, and schizophrenia. Lithium works to treat affective disorders by reducing abnormal activity in the brain. According to the National Institute of Health (NIH), lithium is available as a capsule, immediate-release and extended-release tablets, and liquid solution consumed orally by mouth. Brand names for lithium include Lithobid and Eskalith.
For bipolar disorder treatment, also formerly known as manic depression, lithium can be used alone or in combination with other drugs such as the following:
- Ativan, Valium, or Xanax: Benzodiazepines for anxiety and panic attacks prescription.
- Seroquel, Risperdal, or Haldol: Antipsychotics for schizophrenia and bipolar disorder.
- Paxil, Lexapro, or Zoloft: SSRI antidepressants for anxiety and depression.
Lithium is typically prescribed as a maintenance treatment between manic episodes in individuals with bipolar disorder. To effectively contain manic and depressive repetitions of bipolar disorder, lithium should be administered to keep a blood concentration of 0.60–1.20 mEq/L.
Understanding the Use of Mood Stabilizers
What are Mood Stabilizers?
Mood stabilizer medications are drugs prescribed to treat manic and depressive psychiatric conditions. Mood-stabilizing drugs are most commonly prescribed to treat bipolar disorder in individuals.
Bipolar disorder affects how an individual feels emotionally and functions mentally and is characterized by extreme energy levels and emotional changes. Mood stabilizers lessen the mood swings of this manic depression or help control the mood swings from happening.
The effects of mood-stabilizing drugs include:
- Relief from depressive episodes, or low energy levels, despair, sadness, hopelessness, and feelings of low self-worth.
- Prevention of seizure activity.
- Relief from manic episodes or extreme energy, anxiety, irritability, poor judgment, impulsivity, and risk-taking behaviors.
- A more stable emotional state and more manageable, predictable behavior.
According to the National Institutes of Health (NIH), bipolar disorder affects 3.9% of adults in the US. Moreover, individuals struggling with bipolar disorder have a higher rate of abusing alcohol or drugs, getting into fights, engaging in impulsive behaviors, shoplifting, and taking risks than individuals without bipolar disorder.
Other Examples of Mood Stabilizers
Common Mood Stabilizers
The oldest mood-stabilizing drug and the most commonly used is lithium, a chemical element that restricts the actions of the muscles and nerves.
Lithium is a potent, potentially toxic drug that can cause serious side effects when chemical levels get too high. Individuals taking this medication must be monitored carefully and receive regular blood tests to ensure they are getting the accurate dose of the drug.
Other common examples of prescription mood stabilizer pills include:
- Carbamazepine (Tegretol, Equetro).
- Divalproex or valproic acid (Depakote, Depakene).
- Lamotrigine (Lamictal).
- Gabapentin (Neurontin).
- Topiramate (Topamax).
These prescription drugs regulate brain activity, preventing overstimulation from minimizing the intensity of bipolar mood swings. Mood stabilizer pills are usually prescribed with an antidepressant and other drugs that help manage moods.
Doctors also use mood stabilizers to treat:
- Schizophrenia and its related depressive episodes.
- Some types of seizures, as mood stabilizers, are anticonvulsants.
- Alcohol and drug abuse and addiction and its associated depression and anxiety.
Lithium Overdose Lethal Effects Explained
A lithium overdose can have lethal effects and is a medical emergency. Excessive lithium levels in the bloodstream can lead to severe toxicity, potentially causing life-threatening complications. These include heart rhythm disturbances, kidney failure, seizures, and coma. In extreme cases, untreated lithium overdose can result in death, underscoring the importance of prompt medical intervention if overdose symptoms are suspected. If you or someone you know has taken too much lithium, seek immediate medical attention.
Symptoms of overdose may include the following:
- Muscle weakness.
- Loss of coordination.
- Blurred vision.
- Ringing in the ears.
- Frequent urination.
- Heart block.
- Hyperthermia (temperature elevation).
- Hypotension (decreased blood pressure).
A lithium overdose is a medical emergency, and emergency services like 911 should be contacted immediately if a lithium overdose is suspected.
Lithium Drug Black Box Warning
The black box warning for lithium is a caution from the FDA about potential risks when taking this medication, especially for mood disorders. It highlights the possibility of harmful side effects, including kidney problems, and the need for careful monitoring during treatment to minimize these risks. This warning reminds healthcare providers and patients to follow safety guidelines when using lithium to ensure its safe and effective use.
Mixing Alcohol and Lithium Warning
Is it Safe to Mix Lithium and Alcohol?
Drinking alcohol while on lithium is not safe. For individuals on lithium, alcohol may decrease the benefits and increase the adverse effects of the medication.
Because lithium is commonly prescribed to people with bipolar disorder, it is not recommended to combine alcohol with lithium because ethanol, the main ingredient in alcohol, also causes mood-altering effects. Both of these drugs impact the central nervous system (CNS). When alcohol and lithium interact, they can counterbalance each other. Someone who mixes the two may find that their mental state gets worse as a result.
There are other concerns with mixing alcohol and lithium. One of these is the fact that alcohol is dehydrating. Because alcohol dehydrates the body, it can lead the amount of lithium in the blood to rise and become toxic. People on lithium are advised to maintain a balanced diet, which can be interrupted by alcohol. Because of how heavily lithium affects sodium levels in the blood, it’s essential to be vigilant with salt consumption.
Lithium use is also associated with an increased risk of hypothyroidism. Drinking alcohol also harms thyroid levels. Other illicit drugs, including marijuana and cocaine, can cause dangerous interactions with lithium. Individuals with substance use disorders should not be prescribed lithium.
Alcohol and Lithium Withdrawal Side Effects
Can You Drink Alcohol on Lithium?
Alcohol abuse complicates the management of bipolar disorder and other mood disorders. Drinking impairs judgment, making the user more impulsive and prone to injury or risky behavior.
Lithium and alcohol also increase the risk of suicide. The risk of suicide is nearly doubled in people with bipolar disorder who abuse alcohol compared with people who don’t. Because alcohol and lithium affect the central nervous system, taking them together can increase side effects. Some of the side effects that can be amplified by combining alcohol and lithium include:
- Trouble concentrating.
- Cognitive problems.
- Trouble with judgment.
- Coordination problems.
- Liver Damage.
- Nausea and Vomiting.
- Joint and muscle pain.
Treatment for Lithium and Alcohol Abuse
Alcohol and Lithium Withdrawal and Abuse Treatment
Individuals struggling with bipolar disorder have a high prevalence of comorbid alcohol use and abuse disorders. In contrast, chronic alcoholism may heighten the presence and severity of bipolar disorder symptoms. As such, many individuals may be prescribed lithium to alleviate the manic symptoms of bipolar disorder but also drink alcohol concurrently.
People being treated with lithium who continue consuming alcohol may be prescribed another mood stabilizer that does not interact as adversely with alcohol. They should also be referred to alcohol treatment, starting with medically assisted detox followed by an inpatient treatment program, depending on the severity of their problems.
How Long Does Lithium Withdrawal Last?
Most individuals have no lithium withdrawal timeline – it’s just a matter of reducing the lithium intake to zero. Any prolonged symptoms that someone may be experiencing could result from the body attempting to recover while taking lithium. These lithium withdrawal symptoms could also be related to other medications or circumstances the individual is dealing with.
It is essential to remember that you know your mind and body better than anyone else – so you should be able to feel any possible lithium withdrawal symptoms. Some individuals have said that they experience a lithium withdrawal. Still, it is unknown to what degree these symptoms are from coming off of the lithium or be attributed to something else.
Lithium Withdrawal Timeline Chart
Below is a simplified and general timeline for lithium withdrawal, although withdrawal experiences can vary significantly from person to person:
|Lithium Weaning Off Withdrawal Duration
|Lithium Carbonate Withdrawal Symptoms
|Initial Days (0-7 days)
|You may start to notice early withdrawal symptoms, both physical and emotional, shortly after discontinuing lithium. These could include nausea, vomiting, tremors, irritability, and mood swings.
|First Two Weeks (7-14 days)
|Withdrawal symptoms can intensify during this period, making it challenging. It’s essential to have support from a healthcare provider during this phase to monitor your condition and manage symptoms.
|Many acute withdrawal symptoms may begin to subside, but some emotional and psychological symptoms, such as mood swings, anxiety, and irritability, may persist.
|Emotional and psychological symptoms can continue but typically become less severe and more manageable as your body adjusts to being off lithium.
|Long-Term (After 3 Months)
|Most withdrawal symptoms should have been resolved by now. Still, it’s crucial to continue monitoring your mental health and working closely with your healthcare provider to manage any ongoing mood-related issues.
How Long Does Lithium Stay in Your System?
Lithium has a half-life of approximately 24 hours, which means it takes about five half-lives (around five days) for the medication to be mostly cleared from your system. However, traces of lithium can still be detectable in your blood and urine for a more extended period, depending on factors like dosage and individual metabolism. Here’s a summary list:
- Half-Life: Around 24 hours.
- Time to Clear: Approximately five days a week for most medication to be eliminated.
- Detectability: Lithium may be detectable in blood and urine for a more extended period, potentially up to a few weeks, depending on the sensitivity of the drug test.
- Variability: Clearance time can vary based on factors like metabolism and dosage.
- Maintenance: Individuals on long-term lithium therapy will maintain steady blood levels with regular dosing.
How to Cope with the Withdrawal Symptoms of Lithium?
Coping with the withdrawal symptoms of lithium can be challenging, but there are several strategies to help manage the process:
- Consult Your Healthcare Provider: Always work closely with your healthcare provider when discontinuing lithium. They can provide guidance, monitor your progress, and make necessary adjustments to your treatment plan.
- Taper Off Slowly: Instead of stopping lithium abruptly, your doctor may recommend a gradual tapering schedule to minimize withdrawal symptoms. This can make the transition more manageable.
- Seek Emotional Support: Share your experiences and feelings with trusted friends or family members. Consider joining a support group or engaging in therapy to help cope with emotional and psychological challenges during withdrawal.
- Practice Self-Care: Prioritize self-care activities such as regular exercise, a balanced diet, adequate sleep, and stress management techniques like mindfulness or meditation. These practices can help you better manage mood swings and emotional fluctuations during withdrawal.
Remember, everyone’s withdrawal experience is unique, so it’s essential to have a personalized plan developed with your healthcare provider to ensure your safety and well-being during this transition.
How to Wean Off Lithium Safely?
Weaning off lithium safely minimizes withdrawal symptoms and avoids potential complications. Here’s a general guideline:
- Consult Your Healthcare Provider: Discuss your desire to discontinue lithium with your doctor. They will assess your condition, overall health, and the reasons for discontinuation to develop a safe and personalized tapering plan.
- Gradual Reduction: Typically, your doctor will recommend a gradual reduction in your lithium dose over several weeks or months, depending on your individual needs. This slow taper allows your body to adjust to lower levels of the medication, reducing the risk of withdrawal symptoms and mood instability.
- Regular Monitoring: Your healthcare provider will closely monitor your physical and emotional well-being throughout tapering. Be sure to attend all scheduled appointments to address any concerns or symptoms that may arise.
- Alternative Treatment: Sometimes, your doctor may recommend an alternative medication or therapy to help manage your condition after discontinuing lithium. It’s essential to follow their recommendations for ongoing care and support.
The key to a safe and successful transition is open communication with your healthcare provider and a well-managed tapering plan tailored to your needs and circumstances. Never attempt to discontinue lithium on your own without medical guidance.
What’s the Use of Lithium for Withdrawal of Alcohol?
Many ask if drinking on lithium is safe, and others if they can take lithium to alleviate the symptoms of alcohol withdrawal. Lithium is not a standard or first-line medication for the withdrawal of alcohol. The primary treatment for alcohol withdrawal syndrome typically involves drugs such as benzodiazepines (e.g., diazepam, lorazepam) or anticonvulsants (e.g., gabapentin) to manage the physical and psychological symptoms of alcohol withdrawal, including anxiety, seizures, and tremors.
Lithium is primarily used to treat mood disorders, such as bipolar disorder, and is not considered a standard treatment for alcohol withdrawal. It is essential for individuals attempting to use lithium alcohol withdrawal medication to seek medical care and follow a treatment plan prescribed by healthcare professionals to ensure their safety during this challenging period. The use of lithium for alcohol withdrawal and the choice of other medications is typically based on the specific symptoms and needs of the individual.
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Is Lithium Addictive?
Despite lithium’s potency as a mood stabilizer and the hesitation to prescribe it in the United States, lithium is not addictive except because anything can become psychologically addictive.
One of the fundamental signs of addiction is that when a person stops taking the drug, they start to withdraw, experiencing sweats, pain, anxiety, and an urge or craving to retake the drug. Everyone wants to get more of the drug in advanced dependence or addiction.
Lithium causes no such craving, and any symptoms felt after the drug is stopped are symptoms of the underlying cause, the depression or mania that initiated the use of the drug in the first place. On the other hand, one reason that doctors may have been reluctant to prescribe lithium in the past is that lithium can be or can become toxic.
Lithium toxicity happens when someone takes too much of this drug, either too much on one occasion or too much over a long period. This isn’t necessarily on purpose because other factors can affect how lithium affects them. Other contributing factors to the lithium lethal dose include the body’s water, sodium levels, and other medications people use.
According to some researchers, lithium has a narrow range of safety, making a lithium overdose or toxicity all too easy. However, others claim that lowering the dose can quickly fix any such toxicity. According to most, side effects from average amounts of lithium are rare, especially severe ones.
There is no specific antidote for lithium overdose or toxicity. The management of lithium toxicity typically involves supportive care and various interventions to reduce lithium levels in the body. These interventions may include:
- Gastric Lavage: In some cases, a healthcare provider may perform gastric lavage (stomach pumping) to remove unabsorbed lithium from the stomach.
- Activated Charcoal: Activated charcoal may be administered to help absorb and reduce further absorption of lithium in the gastrointestinal tract.
- Intravenous (IV) Fluids: Hydration with IV fluids can help promote the excretion of lithium through the kidneys.
- Hemodialysis: In severe cases of lithium overdose or when levels are incredibly high, hemodialysis may be necessary to remove lithium from the bloodstream. Hemodialysis is the most effective method for rapidly lowering lithium levels.
Treatment for lithium overdose should be administered in a hospital setting, and it’s crucial to seek immediate medical attention if you suspect lithium toxicity. The specific treatment approach will depend on the severity of the overdose and the individual’s condition, so it’s essential to follow healthcare professionals’ guidance closely.
Tapering Off Lithium Fact Sheet
How to Taper Off Lithium?
To safely taper off lithium, consult your healthcare provider for a personalized plan. Your doctor will assess your condition, determine the appropriate pace for tapering, and monitor your progress. Tapering typically involves gradually reducing your lithium dosage over several weeks or months. During this process, you’ll have regular check-ups to assess withdrawal symptoms or mood changes. Following your doctor’s guidance closely ensures a smooth transition while managing potential side effects or relapse risks.
Effects of Weaning Off Lithium
Effects of weaning off lithium can include:
- Risk of relapse in mood disorders.
- Emotional and psychological symptoms (mood swings, anxiety, irritability).
- Potential withdrawal symptoms (nausea, tremors, flu-like symptoms).
Adjustment to new treatment strategies or medications may be required.
Pros and Cons of Lithium for Bipolar
The decision to use lithium for bipolar disorder should be made in consultation with a healthcare provider, considering the individual’s unique medical history and preferences.
Pros of lithium for bipolar disorder:
- Effective Mood Stabilization: Lithium is one of the most effective mood stabilizers for bipolar disorder, particularly in managing manic episodes.
- Reduces Suicidal Risk: Lithium has been shown to reduce the risk of suicide in individuals with bipolar disorder, making it a valuable option for long-term treatment.
- Long-Term Efficacy: It has a well-established track record of long-term effectiveness in preventing relapses and maintaining stability.
- Low Risk of Weight Gain: Compared to some other medications used for bipolar disorder, lithium is less likely to cause significant weight gain.
Cons of lithium for bipolar disorder:
- Side Effects: Common side effects include hand tremors, increased thirst, weight gain, and frequent urination. These side effects can be bothersome for some individuals.
- Narrow Therapeutic Range: Lithium requires careful monitoring of blood levels because it has a limited therapeutic range. Too little lithium may be ineffective, while too much can be toxic.
- Kidney and Thyroid Issues: Long-term use of lithium can lead to kidney problems and thyroid dysfunction, requiring regular monitoring.
- Drug Interactions: It may interact with other medications, and its use should be carefully managed in individuals taking multiple drugs.
Lithium Coming Off General Guideline
Always seek professional guidance for a safe and successful transition.
- Consult Your Doctor: Discuss your decision to discontinue lithium with your healthcare provider.
- Gradual Reduction: Follow a personalized tapering plan developed by your doctor.
- Regular Monitoring: Attend check-ups to monitor withdrawal symptoms and mood changes.
- Alternative Treatment: Consider alternative treatments or therapies to manage your condition after discontinuation.
Coming Off Lithium General Timeline
The duration of a lithium taper can vary widely depending on individual circumstances and the specific treatment plan outlined by your healthcare provider.
Tapering typically occurs over several weeks to months to minimize withdrawal symptoms and reduce the risk of mood destabilization.
For some individuals, a slower taper over several months may be necessary, especially if they have been on lithium for an extended period or at higher doses. The pace of the taper is determined by factors such as your medical history, current dosage, and your doctor’s assessment of your condition.
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Lithium Addiction Statistics
Lithium is extensively documented as a highly effective maintenance treatment for bipolar disorder. However, its utilization exhibits significant variations both among and within countries. Whether these regional variances in lithium prescription rates correspond to distinct regional outcomes in managing the condition remains uncertain.
Bipolar disorder affects roughly 2.8% of adults in the United States in their lifetime. It can occur at any age, although it often first appears in late adolescence or early adulthood.
Bipolar I & II
Lithium is a medication used to treat both bipolar I disorder and bipolar II disorder. The timing of when to take lithium can vary depending on individual factors, including the specific treatment plan developed by a healthcare provider.
Recent studies in the US find that lithium overdose is not usually deadly, with a mortality rate of 0.8%. However, in rare cases, lithium overdose can lead to long-lasting issues like coordination problems, speech difficulties, memory and thinking problems, and kidney issues such as nephrogenic diabetes insipidus or tubulointerstitial nephropathy.
Lethal Dose Lithium Symptoms
The lethal dose of lithium can vary significantly from person to person, so it’s essential never to attempt to test the limits of lithium ingestion. Lithium overdose can be life-threatening, and symptoms can vary depending on the level of toxicity. Some common symptoms associated with a potentially lethal dose of lithium can include:
- Severe vomiting and diarrhea.
- Confusion and disorientation.
- Tremors or shaking.
- Muscle weakness.
- Irregular heart rate or rhythm.
If you suspect that someone has overdosed on lithium or if you are witnessing symptoms of lithium toxicity, it is crucial to take immediate action. Here are the steps to follow:
- Call Emergency Services: Dial 911 (or the appropriate emergency number in your area) to request immediate medical assistance. Lithium overdose is a medical emergency, and professional help is necessary.
- Do Not Delay: Time is critical in cases of overdose. Don’t wait to see if symptoms worsen; seek medical help immediately.
- Provide Information: When calling emergency services, provide as much information as possible, including the person’s age, weight, the amount of lithium ingested (if known), and any symptoms they are experiencing.
- Do Not Induce Vomiting: While inducing vomiting may be recommended for some poisonings, it is unsafe to induce vomiting in cases of lithium overdose. Leave this decision to medical professionals.
- Do Not Give Anything by Mouth: Avoid giving the person anything to eat or drink until they receive medical attention.
- Stay Calm and Reassure: Keep the person calm while waiting for medical help. Monitor their vital signs if you can do so safely.
Seek immediate medical attention. Lithium toxicity is a medical emergency and requires prompt treatment to prevent severe complications or death.
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Abusing Lithium and other Mood Stabilizers
While mood stabilizers, such as lithium, are not considered addictive drugs, longtime users can become psychologically or physically dependent on the effects of the medication. Quitting these drugs too abruptly or without clinical supervision may cause a sudden return of the symptoms they used to treat.
Mood-stabilizing medications do not trigger the compulsive use or addictive behaviors that stimulants and narcotic pain medications do. Furthermore, mood stabilizers do not create a high like euphoria or high energy. Mood stabilizers are usually misused by individuals looking to experiment with prescription drugs, hoping to control their moods or attempting self-harm.
One can easily overdose on lithium, as the therapeutic and lethal doses are not far off. This is why people with mood stabilizer prescriptions must participate in regular blood work to monitor the levels of the drug.
People who are emotionally unstable or have bipolar may be prompted to overdose on mood-stabilizing drugs when depressed or experiencing suicidal thoughts. Taking large doses of lithium or any anticonvulsant medication can cause severe side effects or death.
We Level Up NJ Treatment for Lithium Abuse and Discontinuation Side Effects
Individuals who are taking lithium are the same individuals who are suffering from bipolar disorder. Both lithium and other substance abuse, such as alcoholism, have a complex impact on the brain. In the case of alcohol and lithium withdrawal and abuse with a co-occurring mental condition, such as bipolar disorder, it is best to treat them all together. Ignoring one or the other can mean missing a crucial part of why the person turned to addiction.
If you or someone you love is experiencing polysubstance abuse and co-occurring mental disorders, get them the safest help they need and deserve. We Level Up NJ offers a safe and medically-assisted addiction detox program as part of our dual diagnosis approach to the bipolar and substance abuse treatment program. Contact our team at We Level Up NJ today!
Overcoming Withdrawal Symptoms Lithium Can Cause. Find the Care You Need.
The effects of sudden lithium withdrawal are often challenging to go through alone. Many people experience relapses during withdrawal in an attempt to alleviate symptoms and satisfy cravings. However, you can manage the effects that weaning off of lithium can cause and successfully recover with detox and rehab therapy and a robust support system at the We Level Up NJ treatment center. If you require assistance with your rehab journey, contact a We Level Up treatment professional now. Your call is free and confidential.
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Top 5 Lithium Stopping Side Effects FAQs
What happens when you stop taking lithium?
Suddenly stopping lithium can lead to a relapse of the condition it was prescribed for, such as bipolar disorder, increasing the risk of manic or depressive episodes. It’s crucial to consult with a healthcare professional before getting off lithium or changing your medication regimen to ensure a safe and managed transition.
What happens if you stop taking lithium cold turkey?
Stopping lithium abruptly, also known as going “cold turkey,” can be dangerous and may lead to a sudden recurrence of symptoms in individuals with bipolar disorder. This can result in severe mood swings, including manic and depressive episodes, and can be life-threatening. Working closely with a healthcare provider to develop a safe and gradual lithium tapering off plan to minimize potential risks when considering discontinuing lithium is crucial.
Is low lithium levels dangerous?
Low lithium levels can be dangerous as they may render lithium therapy ineffective for managing mood disorders like bipolar disorder. Moreover, deficient lithium levels may lead to mood instability, increased risk of relapse, and potential lithium withdrawal side effects, emphasizing the importance of regular monitoring and maintaining therapeutic levels when prescribed lithium.
Can you drink on lithium?
Drinking alcohol while taking lithium can be risky as it can interact with the medication, potentially increasing the side effects and impairing judgment. It’s essential to consult with your healthcare provider regarding alcohol consumption while on lithium, as they can provide guidance tailored to your specific medical history and condition.
Is lithium a narcotic?
No, lithium is not a narcotic. It is a medication used primarily to treat mood disorders, such as bipolar disorder, and it works by stabilizing mood rather than causing narcotic effects. Lithium is a prescription medication that should only be taken under the guidance of a healthcare professional.
Safely detoxing from lithium, a medication commonly used to treat bipolar disorder, requires careful medical supervision. It’s essential to consult with a healthcare professional, typically a psychiatrist, who can assess your circumstances and develop a plan for discontinuation. Abruptly stopping lithium can be risky and may lead to withdrawal symptoms or the re-emergence of bipolar symptoms.
Detox often involves gradually tapering the medication to minimize potential side effects and withdrawal symptoms. Throughout this process, close monitoring of your mental and physical health is crucial to ensure a safe transition. Always follow your healthcare provider’s guidance and do not attempt to detox from lithium without their supervision.
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Search We Level Up NJ Lithium WIthdrawal Detox, Mental Health Topics & Resources
 Balon R, Yeragani VK, Pohl RB, Gershon S. Lithium discontinuation: withdrawal or relapse? Compr Psychiatry. 1988 May-Jun;29(3):330-4. Doi 10.1016/0010-440x(88)90056-9. PMID: 2897893. Lithium Withdrawal related topic.
 Gutwinski S, Fierley L, Schreiter S, Bermpohl F, Heinz A, Henssler J. Entzugssyndrom nach dem Absetzen von Lithium – Eine systematische Literaturübersicht [Lithium Withdrawal Symptoms – A Systematic Review]. Lithium Withdrawal related topic.
 Chokhawala K, Lee S, Saadabadi A. Lithium. [Updated 2023 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519062/
 Hedya SA, Avula A, Swoboda HD. Lithium Toxicity. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499992/
 LITHIUM CARBONATE Tablets USP, LITHIUM CARBONATE Capsules USP, LITHIUM Oral Solution USP – Food and Drug Administration (.gov)
 Lithium or Valproate Associated with Better Outcomes Compared to Second-Generation Antipsychotics for Bipolar Disorder – Veterans Affairs (.gov)
 Provisional Peer Reviewed Toxicity Values for Lithium – United States Environmental Protection Agency (.gov) Lithium Withdrawal related topic.
 Gitlin M. Lithium side effects and toxicity: prevalence and management strategies. Int J Bipolar Disorder. 2016 Dec;4(1):27. Doi 10.1186/s40345-016-0068-y. Epub 2016 Dec 17. PMID: 27900734; PMCID: PMC5164879.