Lithium is used to treat a mood disturbance called bipolar disorder (mood changes between feeling very high [mania] and very low [depression]).
This medicine is also used in the management of repeated episodes of depression and to control aggressive and self-harming behaviour.
Lithium may be used to treat other conditions as decided by your doctor.
Take Lithium exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with food to reduce any stomach discomfort that it may cause. Try to take it at the same time each day.
Lithium is available as a conventional tablet or capsule, extended-release or slow-release tablet or as an oral solution.
If you are taking the conventional tablet or capsule, swallow it with a glass of water.
If you are taking the extended-release type of tablet (usually marked as “ER” or "PR") or the slow-release tablet (usually marked as "SR"), swallow it whole. Do not chew or crush the tablet. Ask your doctor or pharmacist whether you can divide the tablet to provide the needed dose. Different brands of this medicine may be taken differently.
If you are taking the oral solution, use the dropper or measuring spoon provided to measure your dose.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Lithium must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as it may worsen your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- severe heart disease
- heart disease associated with rhythm disorder
- conditions with low body sodium levels e.g. dehydrated, on low sodium diet, or Addison’s disease (a rare disorder where the adrenal glands produce insufficient hormones)
- debilitation (physical or mental weakness usually due to illness or old age)
- existing, suspected or family history of Brugada syndrome (heart rhythm disorder)
- untreated hypothyroidism (thyroid deficiency due to underactive thyroid gland)
- severe kidney disease
as Lithium may not be suitable for you.
Do not take Lithium with “water pills”.
Inform your doctor if you have the following conditions:
- with risk factors for QT interval (heart rhythm) prolongation e.g. heart disease, thyroid disease, low potassium, magnesium or calcium levels
- myasthenia gravis (muscle weakness disorder)
- having thoughts of self-harm
- seizure
- family history of cardiac arrest or sudden death
- mild to moderate kidney disease
Let your doctor know if you are pregnant or breastfeeding.
It is important that you do not get pregnant while being treated with Lithium. You may wish to discuss birth control methods with your doctor or pharmacist.
Be sure to check with your doctor or pharmacist before giving this medicine to the children or elderly. Children/elderly people may be more sensitive to the side effects.
Do not switch brands unless instructed by your doctor. Different brands of Lithium may have slightly different ways of working in your body.
If you are going to have an operation or electroconvulsive therapy (a procedure wherein brief seizures are intentionally induced to manage mental disorders), inform your doctor that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Before and during your treatment, your doctor will conduct certain tests to ensure that your kidneys, heart, and thyroid gland are working well.
- Routine tests (e.g. lithium level, electrolyte level, complete blood count, ECG) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of weight and signs of depression or unusual changes in behaviour may also be needed.
Lithium may cause drowsiness or dizziness. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: abdominal discomfort, diarrhoea, dry mouth, shaky or trembling hands, tiredness, poor memory, blurred vision, thirst, weight gain, rash, hair loss, acne, loss of sexual desire, unpleasant taste, muscle rigidity, muscle weakness, trouble controlling body movements, change in balance, trouble swallowing or speaking, and frequent urination.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- fast or irregular heartbeat
- persistent muscle or joint pain, muscle cramps, weakness or numbness
- excessive passing of urine
- persistent headache and sudden blurring or loss of vision
- agitation, confusion, seeing or hearing things that are not existent, sweating, flushing, fever, tremors, stiff muscles, muscle twitching, seizures, nausea or vomiting, as this could be signs of a potentially serious reaction
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Lithium with “water pills” e.g. hydrochlorothiazide.
Inform your doctor and pharmacist if you are taking any of these medicines:
- NSAIDs (medicine for pain and inflammation) e.g. diclofenac, naproxen, celecoxib
- medicines for high blood pressure e.g. methyldopa
- medicines for heart disease e.g. amiodarone, sotalol, ranolazine
- medicines for epilepsy (fits or seizure) e.g. carbamazepine, phenytoin, clonazepam
- other medicines for mood disorder e.g. thioridazine, haloperidol, chlorpromazine
- medicines to treat depression e.g. fluoxetine, flupentixol, selegiline
- certain antibiotics e.g. metronidazole, tetracycline, co-trimoxazole, trimethoprim, spectinomycin
- theophylline (medicine for asthma)
- sodium bicarbonate (medicine for neutralising stomach acid)
- medicines for mood disorders e.g. olanzapine, clozapine, haloperidol, thioridazine
- steroids (anti-inflammatory medicine)
- sumatriptan (medicine for migraine)
- strong painkillers e.g. fentanyl, tramadol
- medicines for cold or allergy e.g. astemizole, terfenadine
- medicines for prevention of malaria e.g. mefloquine, halofantrine
- cisapride (medicine for stomach problems)
- potassium iodide (medicine for underactive thyroid gland)
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Lithium.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Avoid caffeine-containing beverages such as coffee, tea, and certain soft drinks.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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