Treating Bipolar Disorder with Medications: How Can Lithium Carbonate Help?

Many people still think that bipolar disorder simply drags those who lie with it into sudden bursts of energy one moment, and tearful epsiodes the next — but the condition is more complicated than this.

While it’s true that bipolar comes with mania (or "ups") and depression (or "downs"), they’re much more than your average mood changes. Many people with bipolar disorder go through long periods of feeling normal between manic and depressive episodes, especially those diagnosed with bipolar I disorder. But in untreated cases, the phases sometimes last for weeks or even months before they switch.

What is Lithium Carbonate?

Lithium carbonate was officially approved by the Food and Drug Administration (FDA) as a treatment for bipolar disorder, specifically mania, during the 1970s. It has remained the most popular psychiatric tool in the treatment of bipolar disorder, but also unipolar depression that can't be managed with antidepressants alone.

Commonly prescribed brand names include Camcolit, Eskalith, Li-liquid, Liskonum, Lithobid, Lithonate, Litrex, and Priadel, among others.

Treating bipolar disorder: How can mood stabilizers help?

Antidepressants can also cause rapid cycling — a form of bipolar disorder in which a person goes through four or more episodes of depression or mania within a single year. This is why it’s important to tackle both phases at the same time, which is best done with mood stabilizers.

Ever since its clinical effects were discovered, lithium carbonate has frequently been used as a mood stabilizer. It’s important to say that mood stabilizers don’t cure mental conditions such as bipolar disorder, major depressive disorder, or schizoaffective disorder, but they “stabilize” these conditions by reducing the intensity of the symptoms, making them easier to live with.

These medications help to normalize sleep patterns, reduce agitation, and keep more severe symptoms like hallucinations at bay, but it’s not rare that other drugs such as antipsychotics are also prescribed in combination with mood stabilizers.

What side effects can lithium cause?

People can successfully keep their bipolar disorder symptoms under control with lithium for years, but many have to switch to other medications because lithium can affecting thyroid or kidney function. According to a study published in the International Journal of Bipolar Disorders, up to 90 percent of bipolar patients who take lithium will go suffer at least one adverse effect.

How to prevent a lithium overdose

It is crucial to find the right amount of lithium that suits your body. Many people oversee or dismiss symptoms such as thirst, dry mouth, weight problems, or restlessness, but these are the common signs of lithium oversensitivity. They don’t necessarily mean that you’ve overdosed on lithium carbonate, but your dosage probably needs to be adjusted or your body still needs to adapt to the medication.

Mild overdose symptoms include lethargy, vomiting, and fatigue, but also shaky hands, spasms, diarrhea, speech impairments, and confusion in general.

How does lithium interact with other medications?

It’s been reported that the combination of lithium and certain selective serotonin reuptake inhibitors (SSRIs) can lead to a rare but serious disorder called serotonin syndrome. The symptoms are increased sweating, heart problems, high blood pressure, and even delirium. In fact, SSRIs should not be taken in combination with any other type of medications or herbal remedies.

Lithium carbonate shouldn’t be combined with ACE inhibitors, used to treat high blood pressure, either — because they can increase concentrations of lithium within the body, leading to toxicity.

Lithium can also interact badly with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen (common brands are Advil and Aleve).

Patients need sodium to effectively expel lithium from the body, so a low-salt won’t do you any good. Diuretic drugs tend to lower sodium levels in the body, so make sure any doctor who wants to prescribe you diuretics knows you are on lithium. 

Although antipsychotic medications and anticonvulsants are often co-administered with lithium, there’s a low risk of possible serious interactions, so scientists recommend approaching these combinations with care. Doctors should especially be cautious about prescribing lithium alongside the drugs haloperidol, flupenthixol, and fluphenazine.

The bottom line

If you follow all these precautions and your doctor frequently runs blood tests to keeo an eye on your lithium levels, lithium carbonate is usually safe for patients with bipolar disorder. Mood stabilizers don’t cause dependence, you are at risk of relapse if you quit using the medication suddenly.