Evidence Based

Common & Rare Lithium Carbonate Side Effects

Written by Mathew Eng, PharmD | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:
Jonathan Ritter
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology) | Written by Mathew Eng, PharmD | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:

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Lithium carbonate

If you’ve been recently prescribed lithium, chances are you are worried about the side effects. Read on to learn what to expect from lithium carbonate and some ways you and your doctor can reduce side effects.

What is Lithium Carbonate?

Lithium is a chemical element that is naturally found in rocks and minerals throughout the earth. It’s also the very first psychiatric drug, which started being used back in the 1940s [1].

The lithium inside drugs and supplements is normally combined into salts, which improve stability and absorption in the body [2].

A prime example of a lithium salt is lithium carbonate (Lithobid).

Lithium carbonate is the most common form of lithium in medications. It’s used to treat psychiatric conditions like bipolar disorder and depression [1].

Other forms of lithium include lithium citrate, which is used in liquid formulations, and lithium orotate, a popular supplement.

Lithium carbonate has a narrow therapeutic window, meaning that blood concentrations need to be in a tight range for it to safely work [3].

If your lithium levels rise too much, side effects and toxicity may occur. If your levels are too low, the drug becomes ineffective [4].

We already spoke about lithium levels and testing in this article. Here we’ll focus on the side effects, which refer to high-dose prescription lithium only. If you’re taking low-dose lithium orotate, that’s an entirely different story.

Side Effects of Lithium Carbonate

Common Side Effects

Mild side effects are fairly common with lithium medications. According to some estimates, about 67-90% of lithium-treated patients experience at least one side effect at some point [4].

Common side effects include [4, 5]:

  1. Increased thirst
  2. Increased urination
  3. Dry mouth
  4. Nausea
  5. Diarrhea
  6. Tremors (usually in the hands)
  7. Weight gain
  8. Stomach discomfort
  9. Drowsiness
  10. Constipation
  11. Acne

Many of these side effects will typically appear when you first start taking the medication and may diminish over time [4].

If any of these side effects persist or become worse, you should let your doctor know. Some of these side effects, such as tremors and nausea, can also be a sign of serious lithium toxicity [6].

Serious (Rare) Side Effects

While much less common, lithium medications can cause a number of serious side effects, including [7, 5]:

  1. Impaired coordination
  2. Impaired cognition
  3. Slurred speech
  4. Blurred vision
  5. Ringing in the ears
  6. Confusion
  7. Seizures
  8. Hallucinations
  9. A large increase in urination

If any of these side effects occur, get medical attention right away.

These side effects are usually caused by spikes in lithium levels. This means there is significant overlap between these side effects and symptoms of toxicity or overdose. But other factors also affect lithium toxicity, and the signs of an overdose are not identical [4].

How to Manage & Reduce them

There are several strategies that your doctor may try out to help reduce side effects. These include [4]:

  • Lowering the dose
  • Taking lithium at a different time of day
  • Changing the lithium formulation (capsules to sustained release)
  • Adding medications to treat side effects

You can actually build a tolerance to certain side effects of lithium, including nausea and diarrhea. Sometimes, your doctor may simply wait and see if your side effects subside on their own [4].

On the other hand, some serious side effects may prompt your doctor to discontinue lithium altogether [6].

In any case, you should not try to do any of these methods on your own – consult with your doctor first before changing how you take your medications.

However, there are steps that you personally can take to minimize side effects, such as [8]:

  • Drinking 8 to 10 glasses of water every day
  • Keeping your salt and caffeine intake consistent each day
  • Avoiding alcoholic beverages
  • Taking lithium with food or milk

Maintaining a consistent intake of water, salt, and caffeine (while avoiding alcohol) each day can help keep lithium levels stable [8].

Taking lithium with food or milk may improve stomach-related side effects, like diarrhea, nausea, and abdominal pain [8].

You can also try out some natural remedies to manage mild but common side effects (assuming your doctor is ok with this), such as for:

Risk Factors for Side Effects

1) Lithium Level

Side effects and lithium levels in the blood are inherently linked. Generally speaking, higher lithium levels (> 1.2 mmol/L) can increase the number and severity of side effects [6, 9].

However, side effects can occur even at lithium levels considered normal or therapeutic [6, 9].

2) Age

Side effects can become more prevalent with age. Older individuals are often more susceptible to side effects, even at lower lithium levels [4].

For this reason, doctors will typically target a lower range of lithium levels when treating the elderly [3].

3) Other Medications

A number of medications can increase the concentration of lithium in the blood, potentially leading to more side effects. These include [10]:

  • Thiazide diuretics (hydrochlorothiazide)
  • Loop diuretics (furosemide)
  • ACE inhibitors (lisinopril, benazepril)
  • ARBs (losartan, valsartan)
  • NSAIDs (aspirin, ibuprofen)

There are also various case reports of other drug interactions, including tetracycline, methyldopa, phenytoin, haloperidol and lactulose [11, 12, 13, 9, 14].

It’s always important to let your doctor know about all the medications and supplements you are taking, in case of possible interactions.

Want Better Ways to Improve Your Mood?

If you’re interested in natural and more targeted ways of improving your mood, we at SelfHacked recommend checking out this mood DNA wellness report. It gives genetic-based diet, lifestyle and supplement tips that can help improve your mood. The recommendations are personalized based on your genes.

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Mild side effects are common with lithium carbonate, especially when you first start taking the medication.

Luckily, some of these side effects can diminish over time as your body builds tolerance.

Let your doctor know if any symptoms persist or become worse – it could be a sign of lithium toxicity.

A good way to prevent side effects is to ensure that your lithium levels in the blood remain stable. This includes drinking plenty of water each day as well as keeping your daily intake of caffeine and salt consistent.

About the Author

Mathew Eng

Mathew Eng

Mathew received his PharmD from the University of Hawaii and an undergraduate degree in Biology from the University of Washington.
Mathew is a licensed pharmacist with clinical experience in oncology, infectious disease, and diabetes management. He has a passion for personalized patient care and believes that education is essential to living a healthy life. His goal is to motivate individuals to find ways to manage their chronic conditions.

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