Lithium

What is Lithium?

Lithium is a prescription mood stabilizer used to treat bipolar disorder and other mood conditions. It helps reduce the intensity and frequency of mood swings, particularly manic episodes, and can also help with depression, aggression, and suicidal thoughts when other medications have not worked. Though highly effective, it requires regular monitoring to stay within a safe blood level.

What Is Lithium Used For?

• Bipolar disorder (both mania and long-term maintenance)
• Acute manic episodes marked by impulsivity, agitation, or grandiosity
• Hypomania, a less severe form of mania
• Recurrent major depression, especially when resistant to antidepressants
• Aggression or self-harm, particularly in certain neurological or psychiatric conditions (off-label use)
• Schizoaffective disorder, in combination with other medications

How Does Lithium Work?

Lithium is classified as a mood stabilizer, but its exact mechanism is not fully understood. It’s believed to regulate activity in the brain by affecting neurotransmitters like serotonin, dopamine, and norepinephrine. It may also promote neuroprotection and reduce overactivity in brain circuits linked to emotional regulation. Over time, this leads to more stable moods and fewer extreme highs and lows.

How Long Does Lithium Take to Work?

Lithium can help with a variety of mental health conditions, but how quickly it works depends on what it’s being used for:

Bipolar Disorder (Mania):
When used to treat manic episodes—such as impulsivity, agitation, or inflated mood—lithium can start to reduce symptoms in about 5 to 7 days, but it often takes 1 to 3 weeks to see the full effect. It’s important to stay on the medication even if you don’t feel better right away.

Long-Term Stabilization (Maintenance in Bipolar Disorder):
To help prevent mood swings from returning, lithium needs to be taken consistently every day. It may take several weeks to months to see how well it works in keeping your mood stable over time.

Hypomania:
For this milder form of mania, lithium may begin to help within several days, but like full mania, full improvement can take up to a few weeks.

Recurrent Major Depression (especially treatment-resistant cases):
When used alongside antidepressants, lithium’s mood-stabilizing effects may take 2 to 6 weeks to show results. It’s often used when other medications haven’t been effective on their own.

Aggression or Self-Harm (Off-Label Use):
In certain psychiatric or neurological conditions, lithium may be prescribed to reduce impulsive or harmful behaviors. Effects can vary, but some patients notice improvement in a few weeks, while others may take longer.

Schizoaffective Disorder (used with other medications):
Lithium is sometimes added to help with mood symptoms in this condition. The response time depends on the individual and other medications involved, but a few weeks is typical for improvement.

Consistency Is Key:
For all conditions, lithium must be taken every day at the same time to keep the right amount in your body.

How Should I Take Lithium?

Lithium is typically taken 2 to 3 times per day, or once daily if using the extended-release version. It should be taken with food to reduce stomach upset and with plenty of water to avoid dehydration.
You’ll need to avoid a low-sodium diet since too little salt can increase lithium levels and risk of toxicity. Regular blood tests are essential to monitor lithium levels, kidney function, and thyroid activity. Always follow your provider’s instructions closely.

What Are Common Side Effects of Lithium?

Along with its helpful effects, lithium can sometimes cause side effects—although not everyone will experience them. The table below lists some of the more common early or mild side effects associated with lithium. You can find a full list in the information leaflet that comes with your medication.
Many of these effects improve as your body gets used to lithium or after adjusting the dose. However, speak with your doctor or pharmacist if any of the following continue or become bothersome.

Do I Need to Know About Lithium Toxicity When Starting Treatment?

Yes—but don’t panic. Lithium is very effective when taken correctly, but taking too much or getting dehydrated can cause lithium levels to become too high, which can be dangerous. This is called lithium toxicity, and it’s important to recognize the signs early.

What Are the Signs of Lithium Toxicity?

Call your doctor or go to the ER right away if you experience:

• Severe hand tremors that don’t go away
• Feeling confused or acting strangely
• Slurred speech
• Ongoing vomiting or diarrhea
• Muscle twitching or jerky movements
• Trouble walking or feeling unsteady
• Fainting or seizures

What Causes Lithium Toxicity?

• Dehydration (for example, from sweating a lot, vomiting, or not drinking enough water)
• Other medications that affect lithium levels (like NSAIDs or certain blood pressure meds)
• Changes in kidney function
• Accidentally taking too much lithium

How Can I Prevent It?

• Take your lithium exactly as prescribed
• Stay well-hydrated, especially during hot weather or illness
• Tell your doctor about any new medications

Knowing the warning signs and keeping your care team informed can help you safely get the benefits of lithium without complications.

What Should I Avoid While Taking Lithium?

Alcohol – increases risk of sedation and dehydration
NSAIDs (like ibuprofen) – can raise lithium levels
Dehydration – from illness, exercise, or hot weather
Low-salt diets – can lead to dangerously high lithium level

Can You Take Lithium During Pregnancy or While Breastfeeding?

Lithium is an effective mood stabilizer, but its use during pregnancy—especially in the first trimester—has been associated with certain risks, including potential effects on fetal heart development. That said, abruptly stopping lithium can significantly increase the risk of relapse, which may also pose serious health risks to both mother and baby.

If you are pregnant, planning to conceive, or breastfeeding, it’s essential to work closely with your psychiatrist and OB-GYN to weigh the risks and benefits. In many cases, lithium can be continued with adjusted dosing, more frequent lab monitoring, and individualized planning.

For a deeper look at how psychiatric medications are managed during pregnancy, read our related blog:

Managing Mental Illness during Pregnancy

Frequently Asked Questions

Does lithium cause weight gain?

Yes, lithium can cause weight gain in some individuals. This may be due to changes in metabolism, increased thirst leading to higher fluid intake, or effects on appetite. Weight gain is more likely with long-term use and may be managed with diet, regular exercise, and monitoring by your healthcare provider.

How does lithium make you feel?

Lithium helps stabilize mood, so many people feel more emotionally balanced and less affected by extreme highs (mania) or lows (depression). Some people experience mild side effects like tiredness, brain fog, or hand tremors, especially when starting treatment. It may take several weeks to feel the full benefits, and your doctor will monitor your response over time.

What does lithium do to the brain?

Lithium alters the activity of neurotransmitters such as serotonin, dopamine, and norepinephrine. It also helps protect brain cells and regulate signal transmission in the central nervous system. This helps reduce the frequency and intensity of mood episodes and supports overall emotional regulation in people with mood disorders.

Is lithium a mood stabilizer?

Yes, lithium is a classic mood stabilizer. It is commonly used to treat bipolar disorder by helping to prevent both manic and depressive episodes. Unlike antidepressants or antipsychotics, lithium targets the underlying mood instability, making it one of the most effective long-term treatments for mood disorders.

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