Understanding the Long Term Side Effects of Lithium
Lithium is often an effective medication for stabilizing mood swings in people with bipolar disorder. But like all medications, it does come with potential side effects that are important to understand before starting treatment.
How Lithium Works
Doctors aren't entirely sure how lithium works to control bipolar disorder. It is thought to adjust levels of neurotransmitters in the brain that are unbalanced in mood disorders. It takes several weeks to begin working.
Effectiveness of Lithium
Multiple research studies have found that lithium is useful for stabilizing manic and depressive episodes in bipolar disorder. It may also help prevent recurrence of symptoms. Many patients use it long term.
Common Long Term Side Effects
Lithium requires regular blood testing to monitor levels and potential side effects. With appropriate monitoring, many patients can use it safely long term, but potential long term side effects can include:
1. Weight Gain
Gaining weight is a problem for some long term lithium users. The average is about 10-20 pounds gained over time. Staying active and mindful of diet can help manage weight on lithium.
2. Hypothyroidism
Lithium use can sometimes lead to hypothyroidism, or an underactive thyroid gland producing fewer hormones. This can result in tiredness, weight gain and feeling cold. Thyroid levels should be monitored.
3. Memory Loss and Confusion
Some lithium users report experiencing problems with memory and concentration that can occur after using it for years. Lowering lithium levels often helps with this side effect if it occurs.
4. Kidney Damage
There is a small risk of decreased kidney functioning over many years of lithium use. Blood tests help assess kidney function. Staying well hydrated also helps the kidneys clear lithium from the body.
Less Common Long Term Effects
Skin Changes
Skin problems like acne and psoriasis can sometimes occur with long term lithium treatment. Lowering lithium levels often resolves these skin reactions if they are bothersome.
Hair Loss
Temporary thinning of hair or alopecia may happen in some people using lithium long term. This hair loss is nearly always reversible once lithium doses are adjusted or the medication is stopped.
Tremors
Tremors or shakiness, particularly in the hands, can arise as a later side effect of lithium treatment. These tremors are treatable by lowering lithium blood concentrations.
Swollen Glands
A small number of people using lithium long term may develop swollen lymph nodes or glands. This side effect often resolves by slightly reducing the lithium dosage.
Rare Long Term Side Effects
Cardiac Effects
In rare cases, long term lithium use can negatively impact heart functioning if blood levels become extremely high. This underscores the need for repeated lithium blood tests.
Lung Inflammation
A few cases of lung inflammation or fibrosis have been reported following years of lithium therapy. Patients with existing lung conditions may be more susceptible.
Who Should Not Take Lithium Long Term?
Impaired Kidney Function
Severely impaired kidney function is a contraindication for long term lithium therapy given the risks of reduced kidney functioning over time and its clearance by the kidneys.
Certain Heart Conditions
Patients with advanced cardiac disease or conditions causing electrolyte imbalance should generally avoid sustained lithium treatment given potential heart risks in rare cases.
Pregnancy/Nursing
There are risks of birth defects with lithium exposure during pregnancy. Patients who may become pregnant should discuss options with their doctor. Lithium also passes into breastmilk so careful evaluation is needed.
Tips for Managing Long Term Lithium Treatment
Stay Hydrated
Drinking plenty of fluids supports kidney functioning and clearance of lithium from the body. Carry a water bottle and aim for at least six to eight glasses daily.
Monitor Diet and Exercise
Engaging in regular physical activity and limiting sodium can help manage lithium-related weight gain. Follow a balanced low sodium diet focused on whole foods.
Supplement Judiciously
Some supplements like fish oil may help with lithium side effects. But many supplements can negatively interact with lithium, so check with your doctor before starting anything new.
Don't Stop Suddenly
Suddenly stopping lithium after long term use can trigger withdrawal effects. Do not quit lithium without guidance from your healthcare provider on safely tapering off.
The Takeaway
Used properly under medical supervision, lithium can be safe and effective long term treatment for many with bipolar disorder. But side effects are possible in some users, underscoring the importance of diligent monitoring and blood testing.
Learning about the potential long term side effects of lithium beforehand allows patients to make educated, shared decisions with their doctor about this potent mood stabilizing medication.
FAQs
What are the most common long term side effects of lithium?
The most common long term side effects of lithium include potential weight gain, hypothyroidism where the thyroid is underactive, mild memory and concentration problems, and decreased kidney functioning in some cases.
How can I reduce lithium side effects?
Staying well hydrated, maintaining a low sodium diet, exercising regularly, avoiding interacting supplements, and sticking closely to prescribed lithium doses and medical monitoring can help reduce side effects.
When do side effects usually start?
Most short term side effects begin within the first few weeks of lithium treatment. Long term side effects tend to start presenting after someone has been using lithium continuously for years.
Can the side effects be reversed?
Yes, many side effects like memory problems, tremors, swollen glands and skin changes often resolve by lowering the lithium dosage. Kidney damage may not always be reversible depending on severity.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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