If you have bipolar disorder, your medical professional may prescribe a drug called lithium.

Lithium is used for the following purposes in adults and some children:

  • acute (short-term) treatment of manic and mixed episodes related to bipolar I disorder
  • maintenance (long-term) treatment of bipolar I disorder

We explain more about bipolar disorder and how lithium helps treat it in the “How is lithium used for bipolar I disorder?” section below.

Lithium details

Lithium’s classification (the group of drugs it belongs to) is a mood stabilizer. It’s a generic medication.

Comparing lithium’s forms

Lithium comes in several forms, all of which you take by mouth:

  • extended-release (ER) tablets, which are long-acting
  • immediate-release (IR) tablets, which are short-acting
  • capsules
  • liquid solution

We cover only the capsule, liquid solution, and IR tablet forms of lithium in this article. These forms of lithium aren’t available as brand-name drugs.

If you’d like to learn about lithium ER tablets, your medical professional or pharmacist can tell you more.

Most medications, including lithium, may cause side effects that can be serious or mild. To give you an idea of what might occur with lithium, we’ve listed some of the medication’s more common side effects below. It’s important to note that we haven’t included all the potential side effects.

For more complete information about possible side effects of lithium, you can talk with your medical professional or pharmacist. They may also be able to recommend tips on how to help prevent and ease side effects.

Note: Certain factors may affect a medication’s side effects. These factors can include other health conditions you may have, other drugs you may be taking, and your age.

Mild side effects

Some of the mild side effects that lithium may cause are listed below. For information about other mild side effects of the drug, we suggest that you talk with your medical professional or pharmacist. It may also be helpful to refer to the medication guide for lithium.

Mild side effects of lithium that have been reported in studies include:

Mild side effects of many drugs tend to lessen in a couple of days or a few weeks. But if you find that the side effects bother you, we encourage you to talk with your medical professional or pharmacist.

* For details about this side effect, you can see “Side effects: A closer look” below.

Serious side effects

Lithium may cause serious side effects, but this isn’t common. If you do develop serious side effects while taking lithium, be sure to call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Serious side effects of lithium that have been reported in studies include the following:

* For details about this side effect, you can see “Side effects: A closer look” below.
† See the “What is lithium toxicity?” section below for more information.

Long-term side effects

It’s possible that lithium may cause long-term side effects. But the length of time lithium’s side effects last tends to vary from person to person.

For example, some side effects like hypothyroidism (low thyroid hormone levels) and kidney problems may cause effects that last for months or years. Lithium toxicity (high levels of lithium in your blood) may also cause certain long-term problems.

To help monitor for these side effects, your medical professional may give you thyroid or kidney function tests periodically during treatment. They’ll also check your lithium levels frequently with a blood test.

For more details about what to expect with lithium treatment, you can talk with your medical professional.

Side effects: A closer look

This section provides a close-up look at key side effects of lithium.

Weight gain or weight loss

Weight gain or weight loss may occur with lithium. But weight changes were a rare side effect in studies of the drug.

Changes in weight are a common symptom of depressive episodes related to bipolar disorder. And lithium is used to treat bipolar I disorder. So you may gain or lose weight while you’re taking lithium because your symptoms are improving. Weight changes may not be a side effect of the drug itself.

Tips for managing

If you’re concerned about weight changes while taking lithium, we encourage you to talk with your medical professional. They can suggest ways to help you maintain a weight that’s healthy for you.

Tremors

Tremors (shaking you can’t control) may occur with lithium. This was a common side effect in studies of the drug.

You may have different types of tremors with lithium. Some may be mild, such as shaky hands. But others can be a symptom of more serious conditions.

For example, tremors that affect your arms, legs, or whole body may be more severe. This type of tremor can be a symptom of serious conditions such as:

* Lithium has a boxed warning from the Food and Drug Administration (FDA) about lithium toxicity. For details, you can see the “What is lithium toxicity?” section above.

Tips for managing

If you have tremors while taking lithium, it’s recommended that you tell your medical professional right away. They can help figure out if the side effect is a symptom of a more serious condition.

Rash

A rash may occur with lithium. This side effect was more common in children than in adults during studies of the drug.

You may have other symptoms along with rash. These include:

  • itchy skin
  • dry skin
  • skin redness or darkened skin color
  • swelling

Tips for managing

If you have a rash while taking lithium, we suggest you tell your medical professional right away. A rash can be a sign of a serious allergic reaction. Your doctor can recommend ways to treat this side effect.

Allergic reaction

Many drugs, including lithium, can cause an allergic reaction. Even though allergic reaction wasn’t reported in studies of lithium, it can still happen.

Symptoms that can occur with a mild allergic reaction may include:

  • itchiness
  • skin rash
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction may also occur, but this is rare. Symptoms of a severe allergic reaction may include swelling of your mouth, tongue, or throat, which may cause trouble breathing. You may also experience swelling under your skin, often in your lips, eyelids, hands, or feet.

Tips for managing

If you have symptoms of an allergic reaction to lithium, be sure to call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Lithium has a boxed warning about lithium toxicity. A boxed warning is a serious warning from the Food and Drug Administration (FDA). This warning appears on the drug’s label and alerts you to possible serious risks.

Lithium toxicity refers to a high level of lithium in your blood, which may cause serious side effects.

Your risk for lithium toxicity may be higher if you:

To lessen your risk for lithium toxicity, your medical professional will check your lithium levels frequently with a blood test.

Symptoms of lithium toxicity

Lithium toxicity can cause the following mild or moderate symptoms:

More serious symptoms of lithium toxicity include coma, seizures, and death. You may also have heart problems (such as an abnormal heart rhythm) or kidney problems (such as kidney failure).

If you have any symptoms of lithium toxicity, it’s important to tell your medical professional right away. They’ll likely lower your lithium dosage. Or they may switch you to a different treatment for your condition.

If you have bipolar I disorder, your medical professional may prescribe lithium for you.

Bipolar disorder causes extreme mood shifts that may last for several days. Generally, these moods alternate between manic episodes and depressive episodes. Manic episodes are periods of very high energy and excitement. Depressive episodes are periods in which you have depression symptoms.

You may also have mixed episodes with bipolar disorder. Mixed episodes (also called mixed features) may describe either:

  • periods of mania that occur with symptoms of depression, or
  • periods of depression that occur with symptoms of mania

Lithium is specifically used for acute (short-term) treatment of manic and mixed episodes related to bipolar I disorder. Lithium can also be used as a maintenance (long-term) treatment for bipolar I disorder. Lithium is used for these purposes in adults and children ages 7 years and older.

How lithium makes you feel

Lithium is a mood stabilizer. This means it can help stabilize the mood changes that bipolar disorder causes. The effects of lithium can vary from person to person. The way the drug works in your body isn’t exactly known.

If you have questions about how lithium might make you feel, you can talk with your medical professional or pharmacist.

Below we share answers to some commonly asked questions about lithium.

Is lithium approved to treat depression?

Lithium isn’t approved to treat depression. But it may be prescribed off-label to treat certain types of depression. Off-label means using a drug for a condition it hasn’t been approved to treat.

Lithium is approved to treat manic and mixed episodes related to bipolar I disorder. It’s also sometimes used off-label to treat depressive episodes caused by bipolar I disorder.

If you’d like to learn more about using lithium for depression and what this dosage would be, you can talk with your medical professional or pharmacist.

How does lithium work? And what is its half-life?

Lithium is a mood stabilizer. This means it can help stabilize the mood changes that bipolar disorder causes. But the way lithium works* to treat this condition isn’t known for sure.

The half-life of lithium is 18 to 36 hours. (A drug’s half-life is the amount of time it takes for half of a dose to leave your system.) So it takes about 18 to 36 hours for your body to get rid of half of a dose of lithium.

* The way a drug works in your body is called its “mechanism of action.”

Can lithium be used for schizophrenia or anxiety?

Although lithium isn’t approved to treat schizophrenia or anxiety, it may be prescribed off-label to treat these conditions. Off-label means using a drug for a condition it hasn’t been approved to treat.

When used for these purposes, lithium is usually taken along with other drugs that treat schizophrenia or anxiety. If you’d like to learn more about lithium treatment for these conditions, you can talk with your medical professional.

Is Lamictal an alternative to lithium?

Yes, lamotrigine (Lamictal) is a possible alternative to lithium. Both lithium and Lamictal are mood stabilizers. Both drugs can be used as maintenance (long-term) treatments for bipolar disorder.

However, Lamictal may cause serious skin reactions such as Stevens-Johnson syndrome. For this reason, your medical professional may recommend that you try lithium before Lamictal.

To learn more about how lithium and Lamictal are alike and different, we suggest talking with your medical professional or pharmacist.

Is lithium a controlled substance?

No, lithium isn’t a controlled substance.

Controlled substances are medications that have a high potential for addiction or misuse. (Addiction refers to the continued use of a drug even if it’s causing you harm. Misuse refers to taking a drug differently than the way it was prescribed.) But lithium isn’t known to be addictive or to have a high potential for being misused.

Your medical professional can provide more information if you have more questions about lithium and controlled substances.

Before taking lithium, we encourage you to talk with your medical professional. You can tell them about any medical conditions you have. You can also tell them about your overall health and other medications you’re taking.

We provide more details about these considerations below.

Interactions

Taking certain drugs, foods, vaccines, and other substances with a medication may affect how that medication works. These effects are known as interactions.

Before you take lithium, it’s important to tell your medical professional about any other drugs you take. This includes prescription and over-the-counter medication. It’s also important to mention any herbs, supplements, and vitamins you take. They or your pharmacist can tell you about possible interactions these substances may have with lithium.

Interactions with drugs or supplements

Lithium can interact with several types of drugs. These drugs include:

It’s important to note that we haven’t listed all types of drugs that may interact with lithium. Your medical professional or pharmacist can provide more details as well as information about other possible interactions.

FDA boxed warning

Lithium has a boxed warning from the Food and Drug Administration (FDA) about lithium toxicity. This is a high level of lithium in your blood. The boxed warning appears on the drug’s label and alerts you to possible serious risks.

For details, you can see the “What is lithium toxicity?” section above.

Other warnings

If you have certain medical conditions or other factors that affect your health, lithium may not be the right choice for you. Before you take lithium, it’s important to discuss your health history with your medical professional. The list below includes some factors to consider.

  • Heart problems. If you have heart problems, be sure to tell your medical professional before starting lithium. Lithium may reveal a condition called Brugada syndrome (a type of abnormal heart rhythm) in people who have heart problems. Your medical professional may check for symptoms of this condition during treatment.
  • Kidney problems. It’s very important to tell your medical professional if you have any kidney problems before starting lithium. Kidney problems increase your risk for lithium toxicity. If you have kidney problems, your medical professional may lower your lithium dosage or prescribe a different drug for you.
  • Thyroid problems. Lithium may cause thyroid problems. These can include hypothyroidism (low thyroid hormone levels) and hyperthyroidism (high thyroid hormone levels). Your risk for this side effect may be higher if you have thyroid problems before starting lithium. We suggest you tell your medical professional if you have a thyroid problem before you start lithium. They’ll likely watch your thyroid function closely while you take the drug.
  • Allergic reaction. If you’ve had an allergic reaction to lithium or any of its ingredients, you should not take lithium. Your medical professional can recommend other treatments that might be better choices for you.
  • Use of antipsychotic drugs. It’s important to tell your medical professional if you’re taking any antipsychotic drugs before starting lithium. These drugs can increase your risk for nerve problems while taking lithium, such as neuroleptic malignant syndrome. If you take these drugs, your medical professional can advise whether lithium is right for treating your condition.

Lithium and alcohol

It’s recommended that you avoid drinking alcohol while taking lithium.

Drinking alcohol with lithium can raise your risk for lithium toxicity, which can cause serious side effects. If you drink alcohol, it’s important to talk with your medical professional about whether it’s safe to drink while you’re taking lithium.

Lithium treatment while pregnant or breastfeeding

It may not be safe to take lithium while pregnant or breastfeeding. Your medical professional can advise you about taking lithium during these times.

Your medical professional can advise you on how much lithium to take and how often. It’s important to follow the instructions they provide. Commonly used dosages are mentioned below, but always take the dosage your medical professional recommends.

Forms and strengths

Lithium comes in several forms that you take by mouth:

  • extended-release (ER) tablets, which are long-acting
  • immediate-release (IR) tablets, which are short-acting
  • IR capsules
  • IR liquid solution

We cover only the IR tablet, capsule, and liquid solution forms of lithium in this article. The table below shows the available strengths of each of these forms of lithium.

FormStrength
IR tablet300 milligrams (mg)
capsule150 mg, 300 mg, and 600 mg
liquid solution8 milliequivalents (mEq) of lithium per 5 milliliters (mL) of solution

If you’d like to learn about lithium ER tablets, your medical professional or pharmacist can tell you more.

Dosage for bipolar I disorder

Typically, your medical professional will start by prescribing a low dosage of lithium. Then they’ll slowly increase your dosage over time until the symptoms of your condition have been reduced.

Lithium can be used in adults and children ages 7 years and older. Below are the recommended starting dosages of lithium for bipolar I disorder.

Tablet or capsule starting dosageLiquid solution starting dosage
Adults and children who weigh 31 kilograms (kg)* (66 pounds [lbs.]) or more)300 mg 3 times per day8 mEq (5 mL) 3 times per day
Children who weigh 20 kg to 30 kg (44 lbs. to 65 lbs.)300 mg 2 times per day8 mEq (5 mL) 2 times per day

If your child weighs less than 20 kg, their medical professional will recommend whether lithium is right for them, and what their dosage would be.

Your medical professional may adjust your lithium dosage depending on factors such as:

  • your age
  • your weight
  • other medications you take
  • other health conditions you have
  • the level of lithium in your blood

If you have questions about the dosage that’s right for you, we recommend that you talk with your medical professional.

* One kg equals about 2.2 lb.

Normal range of lithium

To lessen your risk for side effects from lithium, your medical professional may regularly check your lithium levels with blood tests.

Your doctor will start by prescribing a low dose of lithium. Then they’ll check your lithium blood levels 3 days later. Your medical professional may increase your dosage every few days until your lithium blood level is 0.8 mEq/mL to 1.2 mEq/mL. This is considered a normal range for lithium levels.

Your medical professional may continue to check your lithium blood levels frequently until your condition is stable.

Lithium is a generic prescription drug. The costs of prescription medications may depend on several factors, such as your insurance coverage and the pharmacy you use. To find current prices for lithium tablets, capsules, or liquid solution near you, you can visit GoodRx.com.

If you’re wondering how to pay for lithium, we suggest that you talk with your medical professional or pharmacist. You may also want to visit Medicine Assistance Tool or NeedyMeds to see if support options are available.

It’s possible. Withdrawal symptoms weren’t reported in studies of lithium. However, some people have reported withdrawal symptoms after suddenly stopping lithium.

Withdrawal symptoms

Possible withdrawal symptoms with lithium can include:

  • anxiety
  • irritability
  • trouble sleeping

It’s also possible that after stopping lithium, your bipolar disorder symptoms may start to come back.

It’s important that you do not stop taking lithium unless your medical professional says it’s safe to do so. They may lower your dosage slowly over time when it’s safe for you to stop lithium treatment. This can lessen your risk of side effects after stopping the drug.

It’s important that you don’t take more lithium than your medical professional recommends. Taking more than the recommended dosage can lead to severe side effects, including lithium toxicity. This is a high level of lithium in the blood, which can cause serious side effects.

In fact, lithium has a boxed warning from the Food and Drug Administration (FDA) about lithium toxicity. The boxed warning appears on the drug’s label and alerts you to possible serious risks. For details about lithium toxicity, including its symptoms, you can see the “What is lithium toxicity?” section above.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you take too much lithium

If you believe you’ve taken too much lithium, call your medical professional right away. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if your symptoms are severe, immediately call 911 (or your local emergency number) or go to the closest emergency room.

Your medical professional can give you instructions on how to take lithium. They can also explain how much to take and how often. It’s important to follow the instructions they provide.

Lithium comes in several forms that you take by mouth:

  • extended-release (ER) tablets, which are long-acting
  • immediate-release (IR) tablets, which are short-acting
  • capsules
  • liquid solution

We cover only the IR tablet, capsule, and liquid solution forms of lithium in this article. If you’d like to learn about lithium ER tablets, your medical professional or pharmacist can tell you more.

Tips for taking lithium

You’ll likely take lithium two to three times a day.

It’s important to avoid becoming dehydrated or overheated while taking lithium. You can stay hydrated and keep your body temperature low by drinking plenty of liquids. This is especially important while in hot weather or while exercising.

It’s also important to eat a consistent amount of salt while taking lithium. Changing your salt intake could affect your lithium blood levels. Lower lithium blood levels could make the drug less effective. But higher lithium blood levels could raise your risk for lithium toxicity.*

Your medical professional can help determine the right amount of liquid and salt for you while taking lithium.

* Lithium has a boxed warning from the Food and Drug Administration (FDA) about lithium toxicity. For details, you can see the “What is lithium toxicity?” section above.

When to take

It’s recommended that you take lithium doses around the same times each day. This helps keep a steady level of lithium in your system, which may help prevent withdrawal symptoms. (To learn more about withdrawal, you can see the “Can lithium cause withdrawal if you stop taking it?” section above.)

Taking lithium with food may help reduce some side effects of the drug.

Taking lithium with other drugs

Your medical professional may prescribe lithium by itself to treat your condition. But depending on the severity of your symptoms, they may prescribe lithium along with other drugs.

For example, your medical professional may prescribe lithium along with certain antipsychotics. Examples include:

Before starting lithium, it’s important to tell your medical professional about any other drugs you take. This is because certain drugs, including antipsychotics in some cases, may increase your risk for side effects from lithium. Or they may affect how lithium works.

For more information about possible interactions with lithium, you can see the “What should you know before taking lithium?” section above.

Frequently asked questions about taking lithium

Below we share answers to some questions you may have about lithium treatment.

  • How long does lithium take to work? You may not notice lithium starting to reduce your symptoms until you’ve taken the drug for about a week. It typically takes several weeks for your symptoms to be reduced completely. We recommend talking with your medical professional about when you can expect to notice lithium working.
  • What should I do if I miss a dose of lithium? It’s recommended that you take a missed dose of lithium as soon as you remember. But if it’s almost time for your next dose, you can skip your missed dose and take your next dose at its regular time. It’s important that you do not take two doses of lithium to make up for a missed dose. An extra dose can raise your risk for side effects from the drug. If you aren’t sure whether to take a missed dose or skip it, we suggest you talk with your medical professional or pharmacist.
  • Is lithium meant for long-term use? Your medical professional may prescribe lithium for short-term or long-term use. If the drug is working for you and isn’t causing bothersome effects, you may take lithium long term.
  • Can you chew, split, or crush lithium? The manufacturer of lithium hasn’t stated if the drug can be chewed, split, or crushed. You should not chew split or crush lithium tablets or capsules without first talking with your medical professional or pharmacist. They can help you if you’re not able to swallow the tablets or capsules whole.
  • Should you take lithium with food? You can take lithium with food or without it. But taking lithium with food can help reduce certain side effects of the drug, such as nausea.
What should you ask your medical professional?

It’s common to have questions about your treatment plan for lithium. Your medical professional is there to work with you and help address any concerns you have.

To help guide your discussion, here are some suggestions:

  • You can write down questions you have before your visit. For example, “How will taking lithium affect my mood, body, and lifestyle?”
  • You can think about asking a loved one or friend to come with you to your appointment. Having in-person support may help you feel more at ease.
  • You can ask your medical professional to explain something that you find unclear.

Working with your healthcare team may help you stay on track with your treatment. If you find that you’re not getting answers to your questions or receiving the care you deserve, consider seeking a second opinion.

If you still have questions about lithium after reading this article, talking with your medical professional may be helpful. Together you can decide if lithium might be a good choice for you.

You can also discuss other treatments, forms of support, and resources that may benefit you. We’ve listed some suggestions below.

Additional treatment options

While you take lithium, additional treatments or remedies may help you better manage your condition. These can include:

Finding support

Whether you’re looking for a therapist, support group, or information about how to afford therapy, these resources may help:

Other resources

To receive weekly information about mental health, you may want to sign up for the Psych Central newsletter. You’ll find stories directly from other people about their mental health journey as well as the latest information about treatments.

Disclaimer: Psych Central has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.