Maintenance Treatment for Bipolar Disorder
Lithium for Bipolar Disorder
Lithium (brand names include Eskalith or Lithobid) is the most widely used and studied medication for treating bipolar disorder. It has been used for more than 50 years and helps reduce the severity and frequency of manic states. It may also help relieve bipolar depression.
People with bipolar disorder may take lifelong lithium as maintenance therapy to prevent relapses. When lithium treatment stops, relapses can occur within six months in 90% of patients. Moreover, subsequent lithium treatment may sometimes be less effective, particularly if lithium is stopped abruptly rather than gradually (meaning, over a period of 2 weeks or longer).
Studies show that lithium can significantly reduce the risk of suicide among people with bipolar disorder. It also helps prevent future manic episodes.
Lithium is a simple salt that acts on a person's central nervous system. Doctors don’t know exactly how lithium works to stabilize mood. However, it helps people with bipolar disorder have more control over their emotions and cope better with the problems of daily life.
When lithium is used as part of maintenance therapy for bipolar disorder, your doctor will want to take regular blood tests during your treatment because it can affect kidney and thyroid function. Blood tests will also help your doctor monitor the level of lithium in your blood. Your doctor also will probably suggest you drink two or three quarts of water or fluid a day during treatment and use a normal amount of salt in your food. Both salt and fluid can affect the levels of lithium in your blood, so its important to consume a steady amount every day.
Lithium Side Effects
About 75% of people who take lithium for bipolar disorder have some side effects, although they may be minor. Sometimes side effects can be relieved by changing the dose of lithium. Never change your dose or drug schedule on your own. If you are having any problems, talk to your doctor about your options.
Common side effects of lithium include:
- Weight gain
- Impaired memory
- Poor concentration
- Mental slowness
- Hand tremor
- Sedation or lethargy
- Impaired coordination
- Nausea, vomiting, or diarrhea
- Hair loss
- Excessive thirst and dry mouth
- Excessive urination
- Decreased thyroid function (which can be treated with thyroid hormone)
Particularly bothersome tremors can be treated with additional medication.
There are a few serious risks to consider. Lithium may weaken bones in children. The drug has also been linked to a specific birth defect in heart valve formation occurring in 1 in 1000 to 1 in 2000 patients and should be administered with caution to pregnant women. Also, in a very few people, long-term lithium treatment can interfere with kidney function.