lithium

If your blood lithium levels are too high, you can experience lithium toxicity, which can cause serious side effects. Your risk is higher if you're taking medications that can raise the levels of lithium in your body. To prevent lithium toxicity, your provider will measure lithium levels regularly to see if you're within a safe range, and adjust the dose of your medication as needed. Get medical help right away if you're experiencing symptoms of having too much lithium in your body, such as diarrhea, vomiting, abnormal eye movements, shaking, muscle weakness, impaired speech, loss of balance or coordination, confusion, and trouble breathing.

Lithium can directly damage your kidneys, which could potentially be reversed if you stop taking lithium. Lithium can also affect your kidneys' ability to balance salt and water in your body. When first starting treatment or after long-term use, you might experience more frequent urination and more thirst. It is important that you keep your fluid and salt intake relatively the same each day. You should also avoid dehydration and becoming overheated in hot weather and exercise. Your provider will monitor your kidney health before and during treatment and will adjust or stop your dose of lithium if there's evidence the medication is damaging your kidneys. Contact your provider if you notice bloody or foamy urine, lower back pain, or fatigue, because these could be signs of damaged kidneys.

Some people taking lithium have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens where there's too much serotonin in the brain. Your risk for serotonin syndrome is higher if you use lithium with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, pain medications, and migraine medications. Let your provider know about all the medications you take before starting lithium. Also, don't start any new medications without talking to your provider first. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.

Lithium can build up in the thyroid and lead to thyroid problems such as hypothyroidism (low thyroid hormone) or hyperthyroidism (overactive thyroid). Your provider will monitor your thyroid health before and during treatment to make sure your thyroid gland is working properly and your thyroid hormone levels are normal. If you get symptoms of hypothyroidism (e.g., tiredness, weight gain, and feeling cold, contact your provider right away) or hyperthyroidism (e.g., weight loss, feeling hot, irritable, sweating), contact your provider.

Lithium can worsen the symptoms of a rare but life-threatening heart rhythm condition called Brugada syndrome. Lithium should be avoided in patients with Brugada syndrome or those suspected of having Brugada syndrome. People with a family history of Brugada syndrome or sudden death before the age of 45 years should consult with a heart specialist (cardiologist) to discuss the benefits and risks of starting lithium treatment.

Lithium can cause low sodium levels in your blood. Your provider might closely monitor your blood sodium levels before and during treatment with lithium. Get medical help right away if you experience weakness, confusion, difficulty concentrating, headache, or memory problems because these could be signs of low blood sodium levels, which is a medical emergency.

Taking lithium for a long time can raise the calcium levels in your blood due to too much parathyroid hormone. Sometimes, these changes in your parathyroid glands won't go away and the only way to fix it is through surgery. Your provider will monitor your blood calcium levels and parathyroid hormone levels during treatment to make sure your parathyroid gland is working properly and that your calcium levels are normal. Let your provider know if you have symptoms of high calcium levels, such as tiredness, muscle weakness, loss of appetite, nausea, vomiting, constipation, and confusion.

Taking lithium with antipsychotics such as quetiapine (Seroquel), aripiprazole (Abilify), and olanzapine (Zyprexa) can raise your risk for certain brain side effects, such as weakness, fever, tremors, confusion, and muscle stiffness. If you notice any of these symptoms, get medical help right away.