Lithium Medication: What You Need to Know

If you or a loved one has been told to take lithium, you probably have a lot of questions. Lithium is one of the oldest mood‑stabilizing drugs and is still a first‑line treatment for bipolar disorder. It works by calming the brain’s chemistry, which can reduce the extreme highs (mania) and lows (depression) that come with the condition.

Before you start, it helps to understand why doctors choose lithium over newer meds. Many patients respond better to lithium, especially when they have a family history of the drug working well. It also has evidence showing it can lower the risk of suicide, something many other mood stabilizers don’t guarantee.

When Is Lithium Prescribed?

Doctors typically write a lithium prescription for three main reasons:

• Bipolar I or II disorder: Lithium helps keep mood swings in check.
• Manic episodes: It can stop a manic run before it becomes severe.
• Maintenance therapy: After an acute episode, lithium can keep you stable long‑term.

Sometimes, lithium is added to other meds if a single drug isn’t enough. If you’re pregnant or nursing, discuss risks with your doctor because lithium can affect the baby. Your healthcare provider will weigh benefits against possible side effects before starting you on it.

Dosing, Monitoring, and Safety

Getting the dose right is crucial. Most adults start with a low dose, like 300 mg once or twice a day, and the doctor will adjust based on blood tests. Lithium has a narrow therapeutic range, meaning the level that helps can be close to the level that causes problems. That’s why regular blood draws are a must, especially in the first few weeks.

Typical target blood levels are:

• Acute mania: 0.8‑1.2 mmol/L
• Maintenance: 0.6‑0.8 mmol/L

Blood draws are usually done 12 hours after the last dose. If the number is too high, the doctor may lower the dose or pause treatment for a day.

Common side effects you might notice include:

• Tremor (shaky hands)
• Increased thirst and frequent urination
• Mild nausea or stomach upset
• Weight gain

Most of these settle down after a few weeks. If you feel extreme dizziness, vomiting, severe diarrhea, or notice a rapid heart beat, call your doctor right away—those can be signs of lithium toxicity.

Kidney and thyroid function can also be affected over the long term. Your doctor will check kidney labs and thyroid hormone levels at least twice a year. Staying hydrated, limiting salty foods, and taking the medication exactly as prescribed can help protect your kidneys.

Here are a few practical tips to keep things smooth:

• Take lithium at the same time each day, preferably with food.
• Don’t switch brands or formulations without checking with your doctor.
• Avoid NSAIDs (like ibuprofen) unless advised, as they can raise lithium levels.
• Keep a list of all other meds and supplements—you’ll need to share it with any new prescriber.

Remember, lithium isn’t a quick fix. It may take several weeks to see the full mood‑stabilizing effect. Patience and regular check‑ins with your healthcare team are key.

If you’re starting lithium, ask your doctor to explain the monitoring schedule, what symptoms should prompt a call, and how to handle missed doses. Knowing the basics up front can make the treatment smoother and help you stay on track with your mental health goals.