Lithium is used as a mood stabilizer, maintaining a balance between the highs and lows of bipolar disorder, but substitutes for calcium and modulates sodium flux in nerve endings. It is better at decreasing the mania than increasing mood in depression. It was the first mood-stabilizing drug approved by the Food and Drug Administration (FDA) in the early 1970s, back when Bruce Springsteen and the Jackson 5 rocked their way to the top of the charts.
Lithium affects the flow of sodium through nerve and muscle cells. Sodium flow determines how excited or manic you feel, so by taking lithium you are less likely to be hyperactive, have rushed speech, and be as aggressive and angry as a lioness separated from her cub.
But if you take lithium, you have to be closely monitored and you will need frequent blood tests. Lithium can cause kidney and thyroid problems and other side effects like weight gain, tremors, and problems with digestion.
Lithium in the treatment of bipolar disorder
Lithium was the first drug discovered to treat bipolar disorder. Among “mood stabilizers” it is one of the few that does the following: treats acute manic episodes, treats bipolar depression (if lithium blood levels are at least 0.8) and works to prevent recurrence of both mania and depression. The most serious concern with bipolar disorder is possible suicide. Up to 19% of people who suffer from bipolar disorder take their own lives (this is most often due to repeated failures on medication treatment; often due to significant side effects of the drugs and patients discontinuing medication).
Lithium has been shown to dramatically decrease suicides in people with bipolar disorder. It does this much more effectively than any other bipolar medication. It is important to note that lithium taken in an accidental or intentional overdose is very toxic. For this reason, if a person is experiencing a severe episode of bipolar depression or mixed mania (a manic episode but with significant depression rather than euphoria) lithium can be risky at this point in treatment, since it is so toxic. When the person is in the throes of an episode, as noted above, over-dose suicide attempts with lithium can be fatal. Where lithium has such promise in treating bipolar and preventing suicide generally is when the medication is started at a time that the person is not feeling acutely suicidal. Then, once on lithium, it affords protection from suicide.
Lithium has a number of problematic side effects and about 30% of those tried on it cannot take it due to excessive side effects. Bipolar treatment experts are puzzled by the low rates of use of lithium used to treat bipolar in the USA. In Canada, England and Europe it is a common treatment used for bipolar disorder.
How does lithium work: there are a number of theories, but no definitely identified mechanism of action has been found. Lithium is non-habit forming and always a drug of choice if other bipolar medications have been ineffective and, as noted above, when significant suicidal behaviors have been experienced during bipolar episodes.
Lithium appears to be most effective for individuals with more "pure" or euphoric mania (where there is little depression mixed in with the elevated mood). It is also helpful for depression, especially when added to other medications. Lithium appears to be less effective in mixed manic episodes and in rapid-cycling bipolar disorder. Monitoring blood levels of lithium can reduce side effects and ensure that the patient is receiving an adequate dose to help produce the best response.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.