Lithium has adverse effects on the kidneys, thyroid gland and parathyroid glands, necessitating monitoring of these organ functions through periodic blood tests. In most cases, lithium-associated renal effects are relatively mild.
Taking lithium for long periods can affect your kidneys and your thyroid. Lithium can also cause drowsiness. Your doctor will carry out blood tests regularly to monitor how much lithium is in your blood. They will also monitor your kidney function, your thyroid gland and your parathyroid gland.
Liver test abnormalities have been reported to occur in a small proportion of patients on long term therapy with lithium. These abnormalities are usually asymptomatic and transient, reversing even with continuation of medication.
The most common renal side effect of lithium is of concentrating urine despite normal or elevated concentrations of the antidiuretic hormone vasopressin (Table 1). The concentrating defect leads to decreased urine osmolality and increased urine volume (polyuria).
Lithium may cause problems with kidney health. Kidney damage due to lithium may include acute (sudden) or chronic (long-term) kidney disease and kidney cysts. The amount of kidney damage depends on how long you have been taking lithium.
Dental Side Effects of Lithium
People are more susceptible to particular dental issues when they lack saliva from lithium, such as tooth decay, gingivitis, and gum disease. The gums and other oral tissue can become red, inflamed, and ulcerated, making it painful to eat and follow a proper oral hygiene regimen.
Lithium May Extend Longevity
In addition to the well-known positive effects on mood,18 lithium has also been linked with longer overall longevity. Two studies have found that individuals living in areas with even modest, low levels of lithium in the drinking water tend to live longer.
Lithium is generally safe to take for a long time. Most people take it for years with no problems. If you've been taking lithium for some time, it can cause weight gain. It can also cause problems with your kidneys or thyroid gland.
Lithium also exerts antisuicidal, immunomodulatory, and neuroprotective effects. The main problems associated with long-term lithium treatment include kidney, thyroid, and probably cognitive issues.
► Exposure to Lithium can cause loss of appetite, nausea, vomiting, diarrhea and abdominal pain. ► Lithium can cause headache, muscle weakness, twitching, blurred vision, loss of coordination, tremors, confusion, seizures and coma.
Lithium overdose can be associated with cardiac toxicity, especially in those with underlying heart disease. Toxic levels of serum lithium are associated with cardiotoxic effects ranging from simple ECG disorders to dysrhythmias, cardiomyopathy and even acute myocardial infarction (AMI).
With respect to other cancers, lithium has been found to be lethal to neuroblastoma cells but not to normal nerve cells (11). A similar effect was found in ovarian cancer cells (12), although a subsequent similar study on ovarian cancer cells suggests only a more modest benefit (13).
Prolonged lithium intoxication >2 mM can cause permanent brain damage. Lithium has low mutagenic and carcinogenic risk.
Although several reports suggest little effect of lithium on renal function, other studies estimate prevalence of chronic kidney disease (CKD) amongst lithium users between 10 and 35% (Presne et al.
Furthermore, as lithium treatment is associated with adverse effects and the long-term effects on the body are insufficiently understood, many patients stop their lithium medication due to unwanted effects. The most common reasons are diarrhoea, tremor, diabetes insipidus, creatinine increase, and weight gain (124).
Long-term lithium treatment is more effective than second-generation antipsychotics. For the majority of patients, the side effect profile of lithium carries less risk than the use of second generation antipsychotic medications.
Common drug–drug interactions with lithium
The most commonly prescribed drugs that have the potential to interact with lithium are ACE inhibitors, angiotensin II receptor antagonists (sartans), diuretics, and non-steroidal anti-inflammatory drugs (NSAIDs).
A cardiology consult is necessary if a patient experiences unexplained palpitations and syncope. It is also not advisable to consider lithium for treatment in children under 12 years of age. Lithium is not considered for treatment during pregnancy due to a 2 to 3 fold increase of significant congenital disabilities.
It will probably take several weeks to see big enough changes in your symptoms to decide if lithium is the right medication for you. Mood stabilizer treatment is generally needed lifelong for persons with bipolar disorder.
In research settings, lithium appears to have virtually no effect on concentration or on short- or long-term memory, but it does have modest effects on psychomotor speed, verbal memory, and verbal fluency.
mood swings, anxiety and irritability, which may feel very similar to the symptoms of bipolar disorder. headaches. dizziness. stomach and gut problems.
Conclusion: Chronic maintenance treatment with lithium affects the peripheral nerves, even if the impairment rarely is such as to warrant discontinuation of treatment. Monitoring of ENG results could be useful for the early detection of neurotoxicity of lithium.
Muscular weakness develops early in lithium toxicity, and may occur at lithium levels below 2 mEq/L. Muscle hyperirritability includes fasciculations, twitching, clonic movements of whole limbs. The development of swollen/painful joints and polyarthralgia were unrelated to dosage.
The mean (+/-SD) bone density in lithium treated patients was 4.5% higher at the spine (P<0.05), 5.3% higher at the femoral neck (P<0.05) and 7.5% higher at the trochanter (P<0.05).