LITHIUM (‘Camcolit’, ‘Priadel’ etc)
Lith - ee - um
Why have I been prescribed lithium?
Lithium is used to help treat mood swings, as happens in bipolar affective disorder or manic depression. People with
bipolar affective disorder have mood swings that are much more severe than the small changes in mood that everybody
experiences. With bipolar affective disorder, mood may be elevated or depressed (up or down).
When the mood is extremely elevated this is called hypomania or mania. People with hypomania feel very energetic and
elated but can be irritable and frustrated. They may talk very quickly, sleep very little and be full of ideas and plans. They
can be described as being “high”. Treatment is usually needed because when people are “high” they may make poor
judgements and can quickly become exhausted. Periods of depression will also occur in bipolar disorder. Symptoms
include feelings of sadness, tiredness and poor sleep. Antidepressants may be required to help lessen these obviously
unpleasant symptoms. Lithium helps stabilise the mood. It reduces the highs and the lows. Lithium is also prescribed
together with certain antidepressants to increase their effect when someone is suffering from severe depression.
What exactly is lithium?
Lithium is a type of salt, which can be found naturally. It has been used for over 50 years as a mood stabiliser. The trade or
brand name of your lithium might be ‘Priadel’, ‘Camcolit’, ‘Liskonum’ or ‘Li-Liquid’. Sometimes your doctor may not write the
trade name of your lithium on your prescription. Always make sure you tell your pharmacist the trade name of your lithium.
It's worth remembering it.
Why do I need to have some blood tests?
The first blood test is to check that it's safe for you to take lithium. Your kidneys need to be in good shape and your thyroid
gland must be working properly. After about a week, you will need another blood test. This will tell the doctor if you are
taking the right dose of lithium. If they are satisfied, you will only need a blood test every three to six months.
Is lithium safe to take?
It is usually safe to have lithium regularly as prescribed by your doctor, but it doesn’t suit everyone. Let your doctor know if
any of the following apply to you, as extra care may be needed:
a) if you have any other medical condition, such as myasthenia gravis or thyroid disorder, or suffer from heart or kidney
trouble, or are about to undergo surgery;
b) if you are taking any other medication, especially for arthritis or heart or blood pressure problems. This includes
medicine from your pharmacist, such as ibuprofen (e.g. ‘Nurofen’ and others), antacids containing sodium, or
theophylline;
c) if you are pregnant, breast feeding, or wish to become pregnant.
What is the usual dose of lithium?
The starting dose of lithium is usually between 200mg and 400mg a day. This is usually increased to anything between
400mg and 1200mg a day.
How should I take lithium?
Look at the label on your medicine; it should have all the necessary instructions on it. Follow this advice carefully. If you
have any questions, speak to your doctor or pharmacist. Most medicines are now dispensed with an information leaflet for
you to read.
What should I do if I miss a dose?
Never change your dose without checking with your doctor. If you forget a dose, take it as soon as you remember, as long
as it is within a few hours of the usual time.
What will happen to me when I start taking lithium?
For most people with bipolar affective disorder highs and lows occur quite rarely. Lithium should make these highs and
lows less extreme or less frequent. So, it may take months or years to appreciate the beneficial effects of lithium. The best
way to know whether lithium is working for you is to compare your highs and lows before and whilst taking it.
Unfortunately, you might get some side effects before your mood gets any better. Most of these should go away after a few
weeks. Sometimes, the amount of lithium in your body gets too high which can be dangerous. You need to be able to spot
the side effects that can mean a high level of lithium. Look at the table overleaf. It tells you what to do if you get any side
effects. Not everyone will get the side effects shown. There are many other possible side effects. Ask your pharmacist,
doctor or nurse if you are worried about anything else that you think might be a side effect.
Side effect What is it? What should I do if it happens to me?
COMMON
TREMOR Fine shaking of the hands If it annoys you, your doctor can give you something for it. If it
gets worse and spreads to the legs or jaw, stop taking your
lithium and see your doctor.
STOMACH UPSET This includes feeling and being sick and getting
diarrhoea.
If it's mild, see your pharmacist. If it lasts for more than a day,
stop taking your lithium and see your doctor
POLYURIA Passing a lot of urine. Don't drink too much alcohol. Tell your doctor about it.
POLYDIPSIA Feeling very thirsty. Your mouth is dry and
there may be a metallic taste.
Drink water or low calorie drinks in moderation. Suck boiled
sweets.
LESS COMMON
WEIGHT GAIN Drinking more and eating more sweet things or
carbohydrates.
Avoid fatty foods like chocolate, crisps and fizzy drinks. A diet
full of vegetables and fibre will usually help, as will physical
activities such as walking. If it becomes a problem or you are
worried, ask to see a dietician.
OEDEMA When your ankles or feet swell up. Discuss this with your doctor when you see them next.
HYPOTHYROIDISM Low thyroid activity - this makes you feel tired. It's not serious. Tell your doctor the next time you see them.
RARE
SKIN RASHES Blotches seen anywhere. Stop taking your lithium and see your doctor.
Signs of toxicity:
your lithium level may be too high if you suffer any of the following:
!
Blurred vision (things look fuzzy or you can't focus properly)
!
Drowsiness or feeling sleepy or sluggish
!
Confusion or slurred speech
!
Increased thirst or passing more urine or water
!
Dizziness and vomiting
!
Unsteadiness on your feet
!
Severe tremor or twitching
!
Clumsiness
If these happen, stop taking it and contact your doctor now. But remember, just stopping lithium can be dangerous.
What about alcohol?
It is officially recommended that people taking lithium should not drink alcohol. This is because if both lithium and alcohol are taken at
the same time, drowsiness can occur. This can lead to falls or accidents. As well as this, drinking alcohol can often make your mood
unstable. Excessive drinking is especially likely to do this. Once people are used to taking medication, they can sometimes drink
alcohol in small amounts without any harm. Avoid alcohol altogether for the first one or two months. After this, if you want a drink, try a
glass of your normal drink and see how you feel. If this doesn’t make you feel drowsy, then it is probably OK to drink small amounts. It
pays to be very cautious because alcohol affects people in different ways, especially when they are taking medication.
Don’t stop taking your medication because you fancy a drink at the weekend. If you do drink alcohol, drink only small amounts. Never
drink any alcohol and drive while on lithium. Discuss any concerns you may have with your pharmacist, doctor or nurse.
When I feel better, can I stop taking it?
You should never stop taking lithium suddenly. People that do suddenly stop taking lithium become ill much more quickly than those
who come off it slowly. Lithium is usually a long-term treatment. It is not addictive. You and your doctor should decide together when it
is time for you to come off it. This should be gradually over at least 4 weeks, if not longer.
Do I need to know anything else?
Yes. The amount of salt in your diet can change the level of lithium in your body. Eat a balanced diet and don't change the amount of
salt you usually have in your food. Some illnesses can change the amount of salt in our bodies. We lose salt in our sweat, and when
we have a fever or ‘flu. We also lose salt if we are sick or have diarrhoea. All these conditions can change the level of lithium in our
bodies. Do not ignore feelings of thirst – keep up your fluid intake.
Remember, leaflets like this can only describe some of the effects of medication. You may find other
books or leaflets also useful. If you have access to the internet you may find a lot of information
there as well, but be careful, as internet based information is not always accurate.
2001 United Kingdom Psychiatric Pharmacy Group www.ukppg.org.uk
This leaflet is to help you understand about your medicine. It is not an official manufacturer's Patient Information Leaflet.
For more information call the UKPPG National Telephone Helpline, 11am to 5pm, Monday to Friday on 020 7919 2999 or
visit www.nmhct.nhs.uk/pharmacy
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