What Are the Effects of Lithium Carbonate Withdrawal?

Lithium was the first effective treatment for bipolar disorder, a psychiatric condition that causes extreme mood swings from euphoric highs to crushing lows. Lithium is not strictly a drug, but a metallic element, with atomic number 3. Lithium carbonate is a powder formulation of lithium available in 150-mg, 300-mg and 600-mg capsules. If you are taking lithium carbonate for bipolar disorder, your doctor might recommend that you stay on it indefinitely. However, some circumstances can require withdrawal from lithium.

Reasons

• Side effects are one of the reasons people sometimes have to discontinue lithium. According to label information available on the U.S National Library of Medicine's DailyMed site, lithium can (rarely) cause severe tremor, uncontrollable muscle movements, incontinence, kidney problems, blackouts or seizures. Common side effects include weight gain, thirst and fine tremor.

Toxicity

• Signs of lithium toxicity, such as diarrhea, vomiting, mild ataxia (lack of coordination), drowsiness, or muscular weakness, require discontinuing the medication.

Symptoms

• Some researchers, including King and Hullin, have found evidence of a withdrawal syndrome, with heightened anxiety, irritability and mood swings. Other research, such as a paper by Verdoux and Bourgeois, suggests that such symptoms could be signs of depression or mania---still significant withdrawal risks.

Strategy

• If you decide to stop lithium, do so slowly and gradually to minimize the chance of withdrawal symptoms or a manic or depressive relapse. Talk to your psychiatrist about transitioning onto another mood stabilizer during this period, which can help prevent relapse.

Warning

• Since discontinuation of lithium can trigger a relapse, it is important to keep careful track of your moods. Let your doctor know if your sleeping patterns change, you start to feel unusually high or low, or if you have thoughts of suicide.