What are the side effects of lithium?

John Preston, PsyD
Here are side effects of lithium:

Common side effects: These include nausea or heartburn, muscle tremors or weakness, decreased sex drive, lethargy and drowsiness (which may impair the ability to safely drive an automobile), difficulty concentrating, weight gain, increased thirst and increased frequency of urination, and rash or acne.

Less common side effects: These include loss of balance, double vision, vomiting, diarrhea, slurred speech, and trembling. These side effects should be reported to your doctor.

Rare side effects: Rare, potentially dangerous side effects include soreness of the mouth, throat, or gums; severe rash or itchiness; swelling of the neck or face; severe nausea, vomiting, weakness, fever, or flu-like symptoms; and marked increase in thirst and very frequent urination. If any of these side effects occur, immediately contact your doctor.
Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner (The New Harbinger Loving Someone Series)

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Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner (The New Harbinger Loving Someone Series)

Maintaining a relationship is hard enough without the added challenges of your partner’s bipolar disorder symptoms. Loving Someone with Bipolar Disorder offers information and step-by-step advice...
The more common problems with lithium are the immediate and annoying side effects which many patients complain of. In those who are prone to acne, it can significantly worsen the acne. While all of us have a tremor of the hands to some degree, lithium can increase this tremor (usually to a mild degree, but sometimes quite severely). This tremor side effect can be treated with a drug called Propanolol, which blocks the adrenaline receptors responsible for the tremor. People on lithium can become quite thirsty, and need to be well hydrated. This can require frequent trips to the bathroom. Rarely, this can lead to problems with the electrolytes (salt balance) in the blood, and the doctor will need to check the electrolytes with the other kidney functions on a quarterly basis. Children placed on lithium may return to wetting the bed at night. In the elderly, or in those with compromised kidney function, the dose may have to be adjusted downward.

In addition to being eliminated through the kidneys, lithium is also excreted in sweat. This can become an issue in endurance athletes, like marathon runners, who sweat a great deal in their training. One can have a perfectly normal lithium level, then upon commencing endurance training, the level can drop due to sweat excretion. Conversely, one might adjust the lithium dosage in a person who is an endurance athlete, then if that person stops training the level may climb as they are no longer excreting very much of it in sweat.

Lithium generally does not cause weight gain, unless one quenches their thirst with excessive calorie containing beverages. Water should be the beverage of choice, and caloric liquid intake should not be increased in response to the increased thirst. Lithium can also interact with drugs used to control hypertension, called thiazides, hydrochlorothiazide or Diazide. If an internist changes the dosage of thiazide, one's lithium level can change, causing sickness.

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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.