Lithium Side Effects and Managing Mood Disorders

Bipolar disorder / Medication side effects

Hello, doctor.
I have been taking lithium for about a week, but during this time, I have reduced the dosage on my own due to side effects.
1.
I would like to ask if this behavior is appropriate.
When I visited the hospital, the doctor asked if I was willing to take lithium to stabilize my mood.
I asked, "What side effects might there be?" The doctor replied that there wouldn't be any as long as I didn't take more than four pills in a day.
However, after returning home, I took one pill and felt dizzy, which made me reluctant to take a second pill.
It wasn't until the fourth night that I took the second pill, and that night I experienced intermittent pressure pain in my left calf.
I usually don't wake up at night, but the discomfort in my calf caused me to wake up repeatedly, and I also felt a warmth in my neck.
Later, I found out that it seemed like muscle spasms.
During the time I was taking lithium, I felt that my thinking was slower and my memory was somewhat impaired.
For various reasons, I am now very resistant to taking medication, as I do not want lithium to diminish my cognitive abilities.
2.
I would like to ask the doctor if lithium can indeed cause cognitive slowing and impaired thinking as I described.
3.
If so, would this be temporary or permanent? 4.
If I stop taking lithium after a long period of use, will there be withdrawal symptoms? Specifically, what might those symptoms be? Thank you, doctor.
🙏

Kagami, 10~19 year old female. Ask Date: 2023/06/14

Dr. Qiu Junda reply Psychiatry

Hello.
1.
Lithium salts are a type of mood stabilizer.
The situation you described is relatively uncommon.
I'm not sure if you are using any other medications concurrently.
I recommend that you follow up with your physician for a discussion.
If it is indeed related to lithium, you might consider switching medications.
2.
Lithium salts are used to treat your mood symptoms and will not cause cognitive slowing.
3.
They are not addictive, and discontinuation will not lead to withdrawal symptoms.
However, stopping the medication may increase the risk of symptom recurrence.
If you really need to discontinue, it is still important to discuss it with your physician.
Thank you.

Reply Date: 2023/06/14

More Info

Lithium is a well-established medication primarily used to treat mood disorders, particularly bipolar disorder. It is effective in stabilizing mood and reducing the frequency and severity of manic and depressive episodes. However, like any medication, lithium can have side effects, and it is crucial to manage these appropriately to ensure both safety and efficacy.

1. Self-Adjustment of Dosage: It is generally not advisable to adjust your medication dosage without consulting your healthcare provider. While it is understandable that you may want to reduce your dosage due to side effects, doing so can lead to inadequate treatment of your mood disorder. Lithium requires careful monitoring, and any changes in dosage should be made under the guidance of a physician. If you are experiencing side effects, it is essential to communicate these to your doctor, who can help you find a suitable solution, whether that involves adjusting the dose or considering alternative treatments.

2. Side Effects of Lithium: Common side effects of lithium include gastrointestinal disturbances, tremors, weight gain, increased thirst and urination, and cognitive effects such as slowed thinking or memory issues. The symptoms you described, such as dizziness and muscle cramps, can also be associated with lithium use. It is important to note that while some cognitive effects may occur, they are often transient and can improve with dose adjustments or over time. However, if you are experiencing significant cognitive impairment, it is crucial to discuss this with your doctor, as they may need to reevaluate your treatment plan.

3. Duration of Cognitive Effects: The cognitive side effects of lithium are typically not permanent. Many patients find that these effects diminish as their bodies adjust to the medication. However, if cognitive impairment persists, it may indicate that the dosage is too high or that lithium is not the right medication for you. Regular follow-ups with your healthcare provider can help monitor these effects and make necessary adjustments.

4. Withdrawal Symptoms: If you have been taking lithium for an extended period and decide to stop, it is possible to experience withdrawal symptoms. These can include a return of mood symptoms, increased anxiety, irritability, and in some cases, a rebound effect where mood swings may become more pronounced. It is crucial to taper off lithium gradually under medical supervision rather than stopping abruptly. Your doctor can provide a tapering schedule that minimizes withdrawal symptoms and helps maintain mood stability.

In summary, while lithium is an effective treatment for mood disorders, it is essential to manage its use carefully. If you are experiencing side effects or have concerns about cognitive function, it is vital to discuss these with your healthcare provider. They can help you weigh the benefits of continuing lithium against the side effects you are experiencing and make appropriate adjustments to your treatment plan. Remember, open communication with your healthcare team is key to successfully managing your mood disorder and ensuring your overall well-being.

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