Why have I been prescribed Lithium?

Some people suffer from mood swings severe enough to interfere with their normal activities. Most people with this disorder will be helped by lithium. It may prevent further mood swings altogether of make them less severe and less frequent. It is a preventative medicine - not a cure - so it is only effective when taken regularly.

Lithium is a natural salt that is taken as capsules or tablets to keep moods balanced. It also helps stop attacks from returning. Lithium is also used for treating depression when it is taken with other antidepressants. Lithium treatment should be regularly supervised by a Psychiatrist or GP.

It is not known exactly how lithium works to prevent mood swings. It does replace some sodium in body and brain cells and does not cause interference to normally felt emotions or to other physical or mental illness.

The first blood test is to check that Lithium is safe for you. Your kidneys and thyroid gland need to be in good shape. When your doctor is satisfied that lithium is right for you, he/she will prescribe a dosage programme. Further blood tests will be necessary to ensure you are taking the correct dosage. The amount of Lithium in the blood is the most accurate measure for determining the correct dosage. When the dosage is right, blood tests are needed less often.

If the Lithium level in the blood is too high, it has a toxic effect. This can be serious if the Lithium dose is not quickly reduced. Early warnings of a toxic Lithium level include: shakiness of the hands, with nausea, vomiting or diarrhoea. Severe warning signs of toxic Lithium levels include: severe thirst, unsteadiness and dizziness, floppy and weak muscles, drowsiness and confusion. If these symptoms occur, stop taking Lithium and contact your doctor, psychiatrist or psychiatric nurse.

• If you have any other medical condition, such as myasthenia gravis or thyroid disorder, or suffer from heart or kidney trouble
• If you are taking other medication that may not be compatible with taking Lithium
• If you are pregnant, breast feeding, or wish to become pregnant

If any of the above conditions apply to you, please discuss them with your GP.

Follow your GPs instructions very carefully. Always take your dose with a full glass of water. Never be tempted to change your dosage yourself. If you forget to take a dose - take the next dose as soon as you remember, as long as it is only a few hours after the usual time - otherwise - take your next dose at the normal time.

• Drink plenty of water - 2 to 3 litres per day and decrease caffeine and sugary drinks
• Avoid drastic changes in diet, especially if they involve a reduction in normal salt intake. Always discuss any serious change in your diet/dieting with your GP
• Drink plenty of fluids during and after exercising.
• Avoid becoming dehydrated by drinking alcohol

Some commonly prescribed medicine can affect Lithium levels e.g. non-steroidals such as Brufen or Voltaren.