Medical Health Encyclopedia

Very high blood levels of lithium can be fatal.

If toxicity occurs, drugs should be stopped immediately and one or more of the following steps taken, depending on severity:

• Patients are given fluids and drugs to increase excretion of lithium salts.
• Gastric lavage, a procedure that rinses the stomach may be used to treat very recent overdoses.
• Hemodialysis, a procedure that filters lithium out of the blood, may also be performed in severe cases.

Long-Term Side Effects. Even for patients who do not experience a toxic response, long-term use of lithium is not without problems. Some patients may experience the following:

• An unpleasant taste in the mouth.
• Hair loss.
• Weight gain. In one study 16% of patients gained weight. It is a frequent reason for noncompliance and for relapse.
• Skin eruptions that can resemble acne. (It can worsen psoriasis in patients who also have this condition.)
• Thyroid problems. Up to 20% of patients who take lithium develop symptomatic hypothyroidism, and another 20% to 30% develop hypothyroidism without symptoms.
• An increased risk for diabetes.
• A blunted sexual drive.
• Dulled emotions and mental acuity.
• Memory loss.
• Lack of motor coordination.
• An increased risk for diabetes associated with kidney impairment.
• Reduced sensitivity to light. In some cases, this may slightly affect color recognition. More seriously it can cause problems with night driving. This effect occurs regardless of how long a person has been on the drug. Experts recommend that patients wear sunglasses outside and avoid extensive exposure to bright light.

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Drug Interactions. Because lithium is eliminated from the body by the kidneys, any drugs or dietary factors that slow the kidneys' actions may increase lithium blood levels and should be used with great caution. Such drugs include the following:

• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Thiazide diuretics.
• ACE inhibitors.