Medication is the primary treatment for bipolar disorder, although 20% of people will still have persistent symptoms even with treatment. Finding the right treatment is difficult and can take years. Treatment has to be personalized to the individual’s specific experience with bipolar disorder, whether they suffer from severe depression, irritable mania or any combination of symptoms. The current internationally recommended maintenance treatment for bipolar disorder is lithium.

     LaRae LaBouff   LaRae LaBouff lives in Maine with her husband and her dog. She’s an amateur photographer and enjoys traveling, reading, writing and roller derby. Due to personal experience with Bipolar Disorder, she delved into the literature and research of the human mind. She currently writes of her own life experiences both with Psych Central and on her personal site.

Editor:  Saad Shaheed

The first modern use of lithium to treat mental illness began in the mid-nineteenth century. At the time it was used to treat what was called “brain gout.” The disease was debunked within a few decades and lithium fell out of use until the 1940’s and 50’s after trials showed it was effective in treating mania in bipolar disorder patients. It became a staple for treatment starting in the 1970’s.

Currently, lithium is one of the least prescribed medications for bipolar disorder, despite being the highest recommended as far as how effective it is as a maintenance therapy drug. About 34% of people with bipolar disorder are prescribed lithium as either singular treatment or in combination with other drugs.

Brand names

  • Camcolit
  • Eskalith
  • Eskalith-CR
  • Lithane
  • Lithium Carbonate ER
  • Lithobid

How it Works
Lithium is a salt compound that inhibits transmission of what are called “excitatory” neurotransmitters like dopamine and glutamate. Meanwhile, it increases transmission of GABA, which helps calm the nervous system and regulate anxiety. It also reduces oxidative stress in the brain that can cause neurodegenerative diseases.

Effectiveness of Lithium

  • It reduces the risk of manic relapse by about 40%.
  • It can reduce both the number of episodes (manic and depressive) and the total time spent ill by about half.
  • It is more effective at preventing mania than depression.
  • It is not recommended for treating acute mania or depression.
  • It has neuroprotective properties that can preserve cognitive function.

Lithium can negatively affect both thyroid and kidney function at toxic levels. Blood tests must be done regularly to make sure medication is at an optimum level without causing physical illness. Blood levels can also be affected by seasons of the year, hormone levels and other medications. Signs of toxicity include:

  • Blurred vision
  • Tinnitus
  • Dizziness
  • Nausea/vomiting
  • Diarrhea
  • Poor motor coordination
  • Muscle aches
  • Tremors/Seizure
  • Coma

Common Side Effects of Lithium

  • Confusion
  • Feeling faint
  • Irregular heartbeat
  • Difficulty breathing
  • Muscle stiffness
  • Tiredness or weakness
  • Weight gain
  • Frequent urination
  • Increased thirst

Withdrawal Effects from Lithium

  • Nausea
  • Headaches
  • Chest pain
  • Anxiety
  • Relapse into mania or depression
  • Suicidal ideation

Always consult a physician before adding, discontinuing or changing any medication regimen. If you experience any side effects or signs of toxicity or withdrawal, contact your doctor immediately.

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