Medication Review: Lithium

[Paula]

Wow! Lithium, where do I start? I left this to last cos there's so much to tell. Unlike others, Lithium is not an Ad. It's a mood stabiliser and is, I understand, the drug of choice for those with Bipolar. It does exactly what it says on the tin - it stabilises your mood. In Bipolar, it stops the highs and lows of that condition. But with depression, it is sometimes used to boost the effects of the anti-depressants where ADs alone aren't working. 1psychiatrist once told me they're not entirely sure why it works, just that it does.

The thing with Lithium is that the range of lithium needed in your blood to work, and the range between where it becomes toxic is very small. On lithium, I need to have a blood test every three months to ensure I'm at the right level. Lithium toxicity is a scary thought - and requires instant hospitalisation. The first thing you and your family are told when you go on lithium is how to recognise the symptoms. Lithium can easily damage your liver and kidneys (regular blood tests are given to check) your heart (I have an ECG once a year), your thyroid (mine had to be killed off with radioactivity because of an over active thyroid caused by the lithium).

Aside from that, there are a huge range of medications which are contraindicated with lithium. These include NSAIDs, aspirin, tramadol, citalopram, antacids, and hundreds more.

It can be very easy to become lithium toxic - upset stomach, dehydration, heat, too much salt in the diet, dieting - the list goes on.

Having said all that, I have been on lithium for approx 10 years now. I have thyroid disease as a direct result but, by knowing all the potential risks and being careful, I have never suffered any other detrimental effect as a result of the lithium. I have to wear a medical alert, but that's not a problem. And nothing else was working at the time so I was in far more danger by not taking lithium than I was by starting on it.