Lithium for Depression (A Complete Guide)
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In this guide, we will discuss Lithium for depression, how it works, side effects and recommendations.
Lithium for depression treatment
Lithium is the generic name for the chemical composition and some of the brand names can be Eskalith or Lithobid.
This is one of the most used and prescribed medicines for treating bipolar disorder.
Lithium acts by reducing the severity and frequency of manic episodes and also helps to relieve or prevent bipolar depression.
According to WebMD, studies have found that lithium can significantly reduce suicide risk, helping prevent manic and depressive episodes.
As a result, it may be prescribed long-term as maintenance therapy.
Depression is considered one of the most diagnosed mental health illnesses in the world, followed by anxiety, schizophrenia, and bipolar disorder (Mental Health Foundation UK).
They have estimated that in 2014, 19.7% of people in the UK aged 16 and over showed symptoms of anxiety or depression – a 1.5% increase from 2013.
This percentage was higher among females (22.5%) than males (16.8%).
In the US alone, there is an estimated amount of over 16 million Americans per year according to the Centers for Disease Control Prevention (CDC) and it keeps increasing.
What is Lithium?
Lithium is a mineral that occurs naturally in the environment and it is commonly prescribed as a mood stabilizer.
It is mainly used to treat bipolar disorder, which manifests in episodes of mania, depression, and hypomania.
Additionally, lithium is used as an adjunctive medication for patients who haven’t responded to antidepressants for the treatment of unipolar depression (Michael Gitlin, MD).
According to Mind.org.uk, when you are prescribed lithium for the first time, your doctor should give you a purple lithium treatment pack.
This pack should include:
- An information booklet (there’s an example on the NHS website here).
- A lithium alert card (there’s an example on the NHS website here). You should always carry this card with you, and show it to any health professional before they treat you for any condition (including your dentist).
- A record book for blood test results.
How does Lithium work?
Lithium acts on your central nervous system, meaning your brain and spinal cord, stabilizing your mood and it is also believed to strengthen your nerve cell connections and regions in the brain involved in mood regulation, thinking, and behavior.
When will I start seeing results?
It usually takes several weeks for Lithium to begin working.
It is possible that your doctor can order some blood tests during your treatment since Lithium can affect your kidney and liver functioning.
It is important for the levels of Lithium to be maintained not to low or too high.
Additionally, your doctor may suggest drinking 8 to 12 glasses of water or fluid a day and will recommend using a moderate amount of salt in your body since both salt and fluids can affect your levels of lithium in your blood.
How much do I have to take?
It varies from one individual to the other and as the phases of the illness change.
Also, bipolar disorder is often to get prescribed more than one drug at a time but some people can control their condition with Lithium alone (WebMD).
Additionally, your dose for Lithium will depend on your age, weight and medical history.
You should be careful when taking this medication and always follow your doctor’s instructions.
The standard prescribed amount for oral lithium for an adult is said to be between 600-900 mg, two or three times per day.
Forms: Oral Lithium comes in capsules but there is also a liquid solution and extended-release tablets.
Can anyone use Lithium?
Lithium is not considered safe for children under the age of 7, pregnant or breastfeeding women.
Also, it is not considered safe if you have a condition called Brugada Syndrome.
Side effects
It is believed that about 75% of people will manifest side effects but they tend to be mild and they can become less troublesome after a few weeks while your body adjusts to the dose.
However, try to avoid changing your dose schedule on your own and do not change your Lithium brand without consulting with your doctor or pharmacist first.
Common side effects of lithium can include:
- Hand tremor (If tremors are particularly bothersome, dosages can sometimes be reduced, or an additional medication can help.)
- Increased thirst
- Increased urination
- Diarrhea
- Vomiting
- Weight gain
- Impaired memory
- Poor concentration
- Drowsiness
- Muscle weakness
- Hair loss
- Acne
- Decreased thyroid function (which can be treated with thyroid hormone)
It is important to stay alert to any changes in your symptomatology that may indicate it is getting worse or if the symptoms persist.
If you develop persistent diarrhea, vomiting, fever, unsteady walking, fainting, confusion, slurred speech or faster heart rate you should notify your doctor.
Less common side effects include:
Blurred vision, chills, dizziness/vertigo and loss of appetite.
Is Lithium for depression effective?
According to Zara Risoldi Cochrane from Healthline “Lithium does have a strong clinical track record as an effective treatment for bipolar depression.
Specifically, over 300 studies in a clinical review showed that lithium use notably suppressed suicide attempts and suicides in study participants”.
Are there other drugs like Lithium?
According to Mind.org.uk, the 5 individual drugs that can be used as mood stabilizers are:
- lithium (Camcolit, Liskonum, Priadel, Lithonate, Litarex, Li-liquid)
- carbamazepine (Tegretol)
- lamotrigine (Lamictal)
- valproate (Depakote, Epilim)
- asenapine (Sycrest)
Does lithium interact with other medications?
Lithium on its own shouldn’t cause any major complications, however, other medications can interact with how your kidneys get rid of the Lithium in your body so it may lead to an increased amount of Lithium.
It is believed that most of the blood pressure medications and nearly all non-steroidal anti-inflammatories such as ibuprofen and naproxen have a higher interaction with Lithium levels.
Lithium toxicity
Lithium overdose occurs when you ingest too much Lithium.
The right dose varies from one person to the other with any other drug but it is usually prescribed between 900 mg to 1200 mg per day in divided doses.
Some people can take higher amounts and show no symptoms or complications and others can take minimum dosages and be highly sensitive.
According to Dena Westphalen, PharmD of Healthline “a safe blood level of lithium is 0.6 and 1.2 milliequivalents per liter (mEq/L). Lithium toxicity can happen when this level reaches 1.5 mEq/L or higher. Severe lithium toxicity happens at a level of 2.0 mEq/L and above, which can be life-threatening in rare cases. Levels of 3.0 mEq/L and higher are considered a medical emergency”.
Mild to moderate toxicity symptoms
Symptoms of mild to moderate lithium toxicity include:
- diarrhea
- vomiting
- stomach pains
- fatigue
- tremors
- uncontrollable movements
- muscle weakness
- drowsiness
- weakness
Severe toxicity symptoms
Lithium levels above 2.0 mEq/L can cause severe toxicity and additional symptoms, including:
- heightened reflexes
- seizures
- agitation
- slurred speech
- kidney failure
- rapid heartbeat
- hyperthermia
- uncontrollable eye movements
- low blood pressure
- confusion
- coma
- delirium
- death
Is Lithium addictive?
There is no known risk for addiction when taking Lithium.
However, for some individuals, it can become addictive in the sense where after suddenly stopping Lithium intake, symptoms can return very fast.
It is recommended to gradually decrease the amount of Lithium to give your body some time to adjust to this change.
Why is this blog about Lithium for depression important?
When starting a new treatment we may have a lot of unanswered questions and for some, it can be a bit scary.
However, it is important to stay informed about the treatment we are about to start, knowing how it is going to help, the risks and recommendations can make the treatment easier.
We have discussed how Lithium has substantial scientific evidence to support the benefits when treating bipolar disorder and also for the treatment of depression symptoms.
Even though Lithium is a mineral doesn’t mean it is free of risks and side effects.
Maintaining the balance of the Lithium levels in your blood is key for the efficacy of the treatment and also the prevention of developing other medical conditions.
Please let us know if you have any comments on the content of Lithium for depression in the comments section down below.
Frequently Asked Questions (FAQs) about Lithium for depression
Can lithium be used as an antidepressant?
The chemical compounds found in lithium are more commonly used in psychiatric treatments as prescription medication and is mostly used to treat severe depressive disorders when prescribed antidepressants are not improving the condition and additionally has been proven to reduce the risk of suicide, a risk that is common when using antidepressants.
How long does Lithium take to work for depression?
Lithium treatment benefits can be seen after several weeks, so it is important not to be discouraged if you don’t see results after the first week.
It is necessary to keep your Lithium levels balanced to avoid having kidney or thyroid complications.
This is why your doctor will ask to monitor your levels of lithium through blood tests.
Can too much lithium cause depression?
Lithium works by increasing your levels of serotonin in your brain, this is a neurotransmitter that has been associated to be responsible for regulating your mood and energy levels.
Usually, Lithium is combined with other medications for the treatment of depression but it can be responsible of side effects as heart problems, shivering and anxiety if there is an increased amount of serotonin.
What are the side effects of lithium?
Some of the known side effects include but are not limited to blurred vision, nausea, loss of appetite, severe thirst, vomiting, shivering and trouble walking normally.
This is why is imperative to contact your doctor if the symptoms get worse or if you have severe complications while using Lithium.
Why does lithium cause weight gain?
Weight gain is considered a side effect, but this is because it triggers increased thirstiness, which makes you retain fluids and gain weight.
This can make your search for full-calorie sodas of fruit juice which contributes to gain some weight.
Additionally, Lithium might also cause sodium and water retention if you have a high-salt diet, leading to gaining weight.
Recommended Books:
- Lithium: A Doctor, a Drug, and a Breakthrough
- Integrative Medicine for Alzheimer’s: The Breakthrough Natural Treatment Plan That Prevents Alzheimer’s Using Nutritional Lithium (Psychiatry Redefined)
- Life After Lithium: A Story of Survival and Triumph Over Bipolar
- Lithium and Lithium Carbonate: A medicinal product for Depression, Alzheimer and Dementia, for improving well-being and managing stress
- Lithium and Manic Depression: A Guide
References:
Michael Gitlin, MD. Unipolar depression in adults: Treatment with lithium
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