Lithium

What is Lithium for?

Lithium is used as a mood stabilizer to help reduce mood swings in bipolar disorder.

Lithium may also be used for other conditions. Check with your healthcare professional if you are unsure why you are given this medication.

How should I take or use Lithium?

• Take your medication according to the instructions stated on the medication label.
• Lithium should be taken with or after food to reduce stomach discomfort.
• The controlled-release (CR) tablet must be swallowed whole or halved; do not crush or chew it. Do not change the brand of this medication you are taking without informing your doctor.
• Lithium needs to be taken regularly for a few weeks before you can feel its full benefits. You should not stop taking this medication even if you do not feel better at the beginning. Continue to take this medication even after you feel better to prevent your symptoms from returning.
• Do check with your doctor on how long you will have to be on this medication.
• Do not stop taking or adjust the dose of this medication without checking with your doctor.

What should I do if I forget to take or use Lithium?

• If you forget to take a dose, take it as soon as you remember. However, if more than half of the time to the next dose has passed, skip the missed dose and take the next dose at your usual timing.
• For example, for a medication to be taken two times daily at 8am and 8pm, and you missed your first dose at 8am, skip the first dose if it is after 2pm, and take your second dose at the usual timing at 8pm. Do not take two doses to make up for the missed dose.

What precautions should I take when taking or using Lithium?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication.
• You are pregnant, planning to become pregnant, or breastfeeding. If you are pregnant and/or breastfeeding, your doctor would have discussed the potential benefits and side-effects with you and should you have further questions or concerns, do consult your doctor.
• You are taking any other medications (including those that can be bought without a prescription), supplements such as St John’s Wort, traditional Chinese medicine and herbal products. Some of them may affect how this medication works or cause serious drug interactions.
• You intend to start on a low salt diet as it may affect the way this medication works.
• You have or have ever had:
  • Other drug allergies
  • Medical conditions such as:
    • Leukaemia, Psoriasis, Myasthenia Gravis (an autoimmune condition that affects the nerves and muscles)
    • Heart disease (including Brugada syndrome)
    • High or low blood pressure
    • Low sodium levels (symptoms may include confusion, headache, nausea, vomiting, tiredness and cramps)
    • Kidney disease
    • Thyroid disease

It is important to remain well hydrated while you are taking this medication. Drinking too much or too little water can affect the amount of Lithium in your body and may result in unpleasant effects.

• Drink more water when you exercise, especially in hot weather.
• If you have an infection or illness that causes heavy sweating, vomiting or diarrhoea, consult a doctor and try to drink more water.
• Keep all appointments with your doctor. Your doctor may order blood tests to make sure the amount of Lithium in your body is just right.

What food or medication should I avoid when I take or use Lithium?

Avoid drinking alcohol while taking Lithium as it can cause excessive sleepiness.

What are some common side effects of Lithium?

The mentioned side effects generally affect up to 10% of patients.

• Drowsiness or feeling tired
  • Avoid driving or taking part in activities that require concentration
  • Discuss with your doctor if you can take your medication at a different time of the day
• Nausea, vomiting
  • Take the medication with or after food
  • Take small but more frequent meals, and avoid fatty or spicy food
• Thirst, dry mouth
  • Chew sugar-free gum, suck on sugar-free hard candies or ice chips, sip water regularly
• Passing out more urine than usual
  • Drink more water to replace the loss of fluids
  • Speak to your doctor if you are concerned
• Diarrhoea
  • Drink more water to replace the loss of fluids
• Weight gain
  • Exercise regularly and eat a healthy and balanced diet
• Headache
• Fine hand movements that are difficult to control; joint or muscle pain
• Loss of appetite, changes in taste, bloating or stomach pain

Most of the side effects listed here will improve with time. Speak with your doctor if any of them continues, worsens or affects your daily life.

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

If the amount of Lithium in your body is too high, you may experience:

• Blurred vision
• Feeling sick, severe diarrhoea or vomiting
• Muscle weakness
• Confusion, clumsiness, dizziness, extreme tiredness, feeling shaky
• Ringing in the ears

Consult your healthcare professional immediately for advice if you experience any of these symptoms.

Rarely this medication may cause:

• Seizures (fits)
• Unable to pass urine, or passing urine less often than usual, or swelling in the ankles or feet (signs of a kidney problem)
• Irregular heart beat
• Unexplained fever, confusion, fast heartbeat, severe weakness, uncontrolled movements or twitching of the muscles (signs and symptoms of serotonin syndrome)
• Change in weight, feeling nervous, excitable, restless or weak, hair thinning, low mood, eye or neck swelling, not able to focus, trouble with heat or cold, menstrual changes, shakiness, or sweating (signs and symptoms of thyroid problems)

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store Lithium?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How do I throw away Lithium safely?

Pack this medication into a trash bag and seal it tightly before throwing into the rubbish chute or bin.