Lithium Basics: What It Is, How It Works, and When It’s Prescribed

If you’ve heard of lithium, you probably associate it with mood‑stabilizing medication for bipolar disorder. That’s the most common use, but lithium also treats certain types of depression and can help prevent recurring mood swings. It’s a simple metal salt that influences brain chemistry, especially the way nerve cells handle neurotransmitters like serotonin and norepinephrine.

Doctors don’t hand out lithium like a casual supplement. Because it sits right on the line between therapeutic and toxic, you’ll need a prescription, regular blood tests, and clear guidance on dosing. The goal is to keep your blood level in a narrow sweet spot – usually between 0.6 and 1.2 mEq/L for most patients.

Getting the Dose Right: Common Starting Points and Adjustments

Most adults start with a low dose, often 300 mg of lithium carbonate taken two to three times a day. Your doctor will check your blood level after about a week, then again after a few weeks, tweaking the dose until it lands in the target range. If you’re new to lithium, expect a slow titration – the aim is steadiness, not a rapid jump.

Weight, age, kidney function, and other meds all affect how much lithium you need. For kids or seniors, the starting dose is usually lower, and the monitoring schedule may be tighter. Always take lithium with plenty of water and at the same times each day to avoid spikes.

Side Effects You Should Watch For (And What to Do About Them)

Because lithium is a narrow‑window drug, side effects can pop up early or later in treatment. The most common ones include mild tremors, increased thirst, frequent urination, and a slight weight gain. These often settle down as your body adjusts.

More serious signs – like severe nausea, vomiting, diarrhea, confusion, or a rapid heartbeat – could signal lithium toxicity. If you notice any of these, call your doctor right away and get a blood test. Toxic levels usually appear above 1.5 mEq/L, and they require immediate medical attention.

Kidney and thyroid health are also on the radar. Long‑term lithium use can affect kidney function, so doctors check creatinine and eGFR every six months. Thyroid tests are done at least yearly because lithium can slow down thyroid activity, leading to hypothyroidism.

If side effects become a nuisance, talk to your doctor before stopping. Sometimes a simple dose reduction, switching to a slow‑release formulation, or adding a protective medication can make a big difference.

Remember, lithium isn’t a cure‑all; it’s a tool that works best when paired with therapy, lifestyle changes, and a solid support network. Keep track of your mood, sleep patterns, and any physical changes, and share them with your healthcare team.

In short, lithium can be a life‑changing medication when managed correctly. Stick to your monitoring schedule, stay hydrated, and don’t hesitate to ask questions. With the right approach, you’ll get the mood‑stabilizing benefits while keeping risks low.