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Mar 1, 2024

Mental Health

Bipolar Disorder

Lithium for Bipoloar Disorder

What is Lithium?

Lithium is a mood-stabilizing medication that helps to reduce the severity and frequency of mania. It is prescribed for treating acute manic episodes and managing bipolar disorder. It’s an effective treatment option for bipolar disorder. However, due to its narrow range of safety, side effects, and newer medications it isn’t as widely used as it once was.

Read our blog: The Highs and Lows of Bipolar Disorder

How is Lithium Dosed?

Lithium is a medication that has a very narrow range for effectiveness. This means that small differences in the blood can have a big impact. Too little drug, and the medication will not work. Too much drug and lithium toxicity may develop.

Dosing is adjusted until the lithium concentration level in your blood reaches a therapeutic range. The actual amount of medication needed will vary from person to person. Your doctor may periodically order bloodwork to monitor the lithium level. The dose may be altered during an acute episode of mania.

Because of its narrow therapeutic range lithium can become dangerous when taken in excess. Lithium poisoning/toxicity symptoms are similar to its side effects but more severe. The toxicity symptoms vary depending on the concentration in the body:

  • Slightly high
    May display with diarrhea, vomiting, drowsiness, poor concentration.
  • Moderately high
    May display with a lack of coordination, blurred vision, increased amount of dilute urine.
  • Severely high
    May display with seizures, low blood pressure, coma.

It is important to notify your doctor if you experience any signs of lithium toxicity, as they can investigate the cause and prevent the concentration from increasing further.

What Are The Typical Side Effects of Lithium?

Even within normal concentration range in the blood, lithium may have some adverse effects. Side effects are quite common when taking lithium and are often the reason why people stop taking the medication. It can be difficult to discern between mild side effects and lithium toxicity symptoms. The most common general side effects are:

  • Hand tremor
  • Tiredness
  • Increased thirst
  • Increased urine output

Who Should Not Take Lithium?

There is a long list of individuals who should not take lithium. This is most often because lithium can more easily reach toxic levels in people with certain conditions. These conditions include:

  • Kidney impairment
    Long-term use of lithium may cause damage to the kidneys and decrease some of its ability to concentrate the urine. This may result in increased, dilute, urine output. It is therefore recommended that kidney function be monitored during lithium therapy and that lithium should be avoided in those with current kidney impairment.
  • Cardiovascular disease
    Lithium can lead to heartrate and blood pressure changes and therefore should be avoided in those with pre-existing cardiovascular disease.
  • People who are dehydrated or have low sodium
    It is extremely important to maintain hydration and consistent sodium intake while taking lithium. This is because lithium can lead to fluid and electrolyte loss and thus maintaining your fluids and sodium in order to avoid the concentration of lithium in the body to toxic levels.
  • Brugada syndrome
    Lithium has been thought to unmask or worsen hidden brugada syndrome. This is a condition in which there is an increased risk of irregular heartbeat as well as sudden death. It is therefore important to inform your HCP immediately if you experience irregular heartbeats of dizziness/light-headedness while taking lithium
  • Pregnancy
    It’s possible that taking lithium while pregnant may pose a risk to the normal development of the fetus. Because of this, it is generally recommended to avoid lithium use when pregnant or planning to become pregnant, unless specifically told otherwise by your HCP.
  • Breastfeeding
    Lithium is excreted into breastmilk from the nursing mother, and therefore the medication should be avoided by individuals who are nursing, or nursing should be avoided for individuals taking lithium.

Can I Take Lithium If I Am Taking Other Medication?

Certain medications should be avoided while taking lithium. Any medication that can alter the level of lithium in your blood can lead to dangerous lithium toxicity and must be avoided.

  • Haloperidol
    Combination of lithium and haloperidol has been associated with serious symptoms such as weakness, fever, confusion, tremors, and abnormal blood values, followed by irreversible brain damage. The connection between the two medications is not clear, but in order to prevent this possible risk it is ideal to avoid the combination if possible.
  • Diuretics
    Diuretics may cause a rise of lithium levels and therefore potentially lead to toxicity.
  • People who are dehydrated or have low sodium
    It is extremely important to maintain hydration and consistent sodium intake while taking lithium. This is because lithium can lead to fluid and electrolyte loss and thus maintaining your fluids and sodium in order to avoid the concentration of lithium in the body to toxic levels.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
    Lithium levels must be closely monitored when you take NSAIDs, as they have been shown to increase lithium to possibly toxic levels in the blood.

This is not a full list of all medications that interact with lithium. It is important to be transparent with your HCP about all medications, prescription and non-prescriptions and substances you consume in order to prevent any safety concerns while taking lithium.

How Much Does Lithium Cost?

Lithium is one of the medications on the Marley Drug wholesale price list. That means that you can get a 6-month supply of your prescription for $37 or even a full 12-month supply for only $70! This long supply of medication can also be shipped directly to your home, so you don’t have to take time-consuming trips to the pharmacy or pay multiple pharmacy dispensing fees throughout the year. In addition, since bipolar disorder is typically treated life-long with medication, it is helpful to get longer supplies of medications used as treatment for the condition.

To learn more about how you can get your lithium prescription from Marley Drug, call us at 800-810-7790.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of September 9, 2022.


  1. Lithium – Access data FDA-Approved Drugs [Internet]. [Amended 09/2011; accessed 09/2022].
  2. Lithium – GoodRx ( Accessed 2022-09-08.
  3. Hedya SA, Avula A, Swoboda HD. Lithium Toxicity. [Updated 2022 Jun 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:

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