Studies show that a gradual reduction of lithium carbonate produces less severe adverse reactions compared to sudden cessation.5,6,16,17
The subject of neurotoxicity after lithium carbonate has been widely studied, as in the article authored by Netto and Phutane, published in the Primary Care Companion for CNS Disorders of 2012.18
The authors observed that reversible neurotoxic effects of lithium carbonate may be undetectable until the drug is discontinued. The study focused on 6 cases, a small cohort, and does acknowledge that in other cases, the neurotoxic effects of lithium carbonate will be irreversible.
A more recent study 14 coins the term “SILENT” to describe the Syndrome of Irreversible Lithium Effectuated Neurotoxicity. These are lithium carbonate neurotoxic side effects that don’t go away even though the drug is discontinued. The most common symptom of SILENT is cerebellar dysfunction, a form of brain damage affecting the cerebellum. The cerebellum is the coordinator for balance, gait, and can affect speech and other motor movements, as seen in muscular dystrophy, Parkinsonism, dementia, and other conditions. The authors of this study aim to bring the phenomena related to SILENT into increased awareness of physicians and clinicians, so these damaging effects can be prevented, not simply discovered after lithium carbonate withdrawal.15
Similarly, other side effects that emerged during treatment with lithium carbonate such as renal impairment, may not go away even after stopping lithium orotate.2,11
Lithium discontinuation is generally desired for avoiding acute immediate lithium side effects, as a result of the emergence of chronic long-term Lithium side effects, the emergence of new health conditions (cardio, renal, etc.) or to avoid potential injuries or harms related to pregnancy or breastfeeding. While the decision to quit Lithium may be medically sound, proper Lithium protocols can reduce or eliminate Lithium withdrawal symptoms that may otherwise present.
Lithium withdrawal symptoms may include:
Heightened anxiety13
Sleep disturbances23
Return of mania, bipolar, or other original symptoms16
Increased suicidal risk, which is lessened with slow and gradual withdrawal17
It is uncommon, unfortunately, for a medical provider to have enough information regarding lithium withdrawal to be able to offer any non-toxic alternatives
Mood stabilizers like lithium carbonate are known to impair liver and kidney function which would make anyone consider … is there a better way?
Do Your Symptoms Require Lithium?
Alternative to Meds has been the leading authority on antipsychotic withdrawal and lithium alternatives for over 15 years. We have published evidence regarding our success. Usually, mood issues that are lessened by lithium carbonate can be addressed in less toxic ways. Often there are blood sugar instabilities, generalized mineral deficiencies, or even manageable genetic factors that contribute to situations that result in being medicated with Lithium
There is a big difference between someone who is symptomatic suddenly and other times seems normal, compared with one who is constantly symptomatic. Our belief is that neither of these is necessarily permanently broken — but more likely they have not received the treatments most pertinent to their needs. This video shows a young man who everyone had given up on except his mother… He was in and out of hospitals in a very dramatic way. He did the ATMC program, and now he is an international speaker and book author. He has been a testament to what is possible for 10 years.
15 Years Experience by Professionals Who Understand Your Journey.
Discontinuing/Quitting Lithium — How do You Wean Off Lithium?
Abrupt lithium withdrawal in contrast to gradual tapering can cause pronounced episodes of returning mania 5 as well as bipolar relapses. Gradual withdrawal observed in clinical studies demonstrated fewer instances of returning symptoms, 4x fewer suicides compared to continuing the medication, and where symptoms did return, patients had less severe versions of their returning symptoms overall.6,17,22
No published clinical studies were found relating to withdrawal from natural lithium or lithium orotate. At times, a prescribing physician may choose to slowly convert their patient from the prescription form of lithium (lithium carbonate) to lithium orotate as a way to bridge off the drug. This technique involves gradually taking away the medication version and slowly introducing lithium orotate. This is a pragmatic route for many, but it should be discussed with your integrative medical doctor before attempting.
There are reasonable theories regarding the role of trace minerals in respect to mental health. Deficiencies can play a prominent role in preparing for and executing Lithium withdrawal. At the Alternative to Meds Center, pre-taper lab testing is done to establish whether such deficiencies exist and then programs a person for corrective supplementation and diet to resolve these. In general, improving nutrition is beneficial for anyone recovering from medication discontinuation.
It may be possible that a trace mineral deficient person (which is common due to over-farming techniques in agriculture) may respond positively to lithium. An unsubstantiated hypothesis may be that lithium could play a certain role in these deficiencies and possibly covering the function of other similar minerals. It could be argued that trace mineral supplementation could offer support and that the use of trace mineral supplementation during withdrawal may be of benefit. As this is a bit of a tenuous assertion, please discuss this with an appropriate doctor who has both knowledge of medications as well as supplemental methods before considering this protocol.
A case study published in the 2019 Journal ofAdvanced Mind-Body Medicine concluded that lifestyle interventions, as well as nutritional interventions, were important components of recovery and remission of symptoms in a medication withdrawal clinically supervised setting.19
The protocols that are used in Lithium withdrawal at Alternative to Meds can be reviewed on our services overview page.
Lithium is an alkali metal, the lightest metal found in the earth.
Lab synthesized compounds are produced called lithium salts. Lithium salts such as Lithobid are prescribed for the treatment of mania, bipolar disorders, depression, and PTSD. Natural lithium supplements are available OTC. Prescribed as a mood stabilizer, Lithobid, Lithate, and other brand names, are synthesized forms of lithium that have been studied since FDA approval for their efficacy in treating certain disorders, as well as to explore the potential for unwanted side effects.1,2,13
Less information is available for clinical trials concerning the non-prescription form of lithium called lithium orotate. Lithium orotate is not available over-the-counter in all countries, due to concerns by regulators over hypothetical rather than observed toxicity dangers should the supplement be taken in extraordinarily large doses. One such occurrence was found in an article published in the Journal of Medical Toxicology, where a woman took 18 tablets (instead of one) of an over-the-counter lithium orotate supplement who became nauseous and experienced light hand tremors, both of which disappeared after 3 hours.20
Below is medical information concerning these and other topics related to lithium and may be helpful to those considering starting or stopping a prescription of this type of drug.
What Lithium Medication Is Used For
Lithium had been extensively used for the control of mania since the late 1870s but became an increasingly abandoned practice in psychiatry as new antipsychotic drugs were developed and approved by the FDA and around the world starting in the 1950s for the treatment of mania.3,4,21
Long-term studies on Lithium used in the treatment of mood disorders such as bipolar illness show a disappointing level of efficacy,23 so much so that some researchers consider the marketing of Lithium an overreach by pharmaceutical companies whose sole criteria is the profitability of such products.24
Lithium salts or compounds are used as psychiatric medication (mood stabilizers) and are prescribed for these conditions:
MDD or major depressive disorder
Bipolar disorder
Mania
MCI (minor cognitive impairment)
ADHD in children
PTSD
Schizophrenia3
Lithium Alternative Names and Slang
Lithium refers to the metal, or mineral, however, the word lithium has become synonymous (although not entirely accurate) with all the various compounds and salts that have been produced in pharmaceutical labs across the world. The natural form of the element is simply called lithium and is not patentable because it is a natural element found in mineral deposits in the earth. It is important to understand the nature and molecular structure of any drug or supplement that one takes.
Various forms of compounds and salts will contain lithium, synthesized using various types of binding agents, such as:
Lithium carbonate (lithium bound with carbon, currently prescribed as a mood stabilizer for mental disorders)
Lithium citrate (lithium bound with citric acid, used in original 7-UP soda pop, later banned for toxicity/deaths)
Lithium bromide (lithium bound with bromide in table salt, abandoned due to toxicity/deaths)
Lithium chloride (lithium bound with sodium chloride, used as a replacement table salt but later banned due to toxicity/deaths)
Lithium fluoride (lithium bound with fluoride, never used due to toxicity in trials)
Lithium iodide (lithium bound with iodine, never used due to toxicity in trials)
Lithium urate (lithium bound with urine extracts for dissolving uric acid crystals related to gout, but abandoned due to dose-related toxicity)
Lithium orotate (lithium bound with a natural chemical called orotic acid, found in breast milk7 and certain root vegetables, available as a supplement without a prescription)
There have been many other compounds/mixtures produced over the last century and a half. Some of these were found to be toxic, as in the table salt version, and unsuitable for use in food products, as in the 7-UP soda pop of the 1950s. Some have survived and exist in pharmaceutical products used today.
Brand names include numerous examples such as Theralite, Efalith, Lito, Prolix, and hundreds of additional trade names.
Lithium Side Effects
A study out of Norway published in the BMC Journal of Psychiatry showed that a majority of the participants discontinued the prescription drug lithium carbonate to avoid the side effects of the drug. Diarrhea, tremors, diabetes insipidus, and weight gain were the 5 most common reasons for discontinuation according to the authors of the study.9
According to the FDA label 2 for lithium carbonate, signs of lithium toxicity include a similar list, including diarrhea, vomiting, tremors, ataxia (clumsiness, loss of coordination), drowsiness, and muscular weakness. Other common reasons for discontinuing the medication due to side effects, according to a study published in the International Journal of Bipolar Disorders11 include weight gain, cognitive impairment, impaired kidney function, hyperthyroidism, and hypothyroidism. Because of the vast number of potential side effects, we have categorized a sampling of them for clarity. These side effects along with many others are listed on the FDA drug label.
Lithium carbonate side effects include:
Gastrointestinal & Renal:
Nausea, vomiting, diarrhea
Anorexia
Weight loss
Weight gain
Constipation
Increased urination
Increased thirst
Indigestion
Abdominal pain
Flatulence
Dry mouth/ excessive salivation
Kidney toxicity (may lead to kidney failure)
Incontinence of urine or feces
Musculoskeletal
Tremors, tics, twitches
Cogwheel rigidity
Seizures
Startled response
Uncontrolled tongue movements
Ataxia (clumsiness, loss of balance, difficulty walking)
Hyperreflexia (reflexes become over-responsive)
Restlessness
Muscle weakness
Fatigue
Swelling of ankles or wrists
Painful joints
Tightness in chest
Cognitive
Memory loss
Mental confusion
Poor concentration
Loss of alertness (warnings given for those operating heavy machinery or driving)
Giddiness
Slurred speech
Blackout spells
Coma
Stupor
Hallucinations
Dermatological
Lithium-associated acne, lesions
Alopecia
Drying and thinning of the hair
Anesthesia of the skin
Psoriasis, worsening psoriasis
Cutaneous ulcers
Swollen lips
Ocular/Aural
Blurred vision
Blindness
Tinnitus
Other Conditions & Disorders
Leukocytosis(elevation in white blood cell count)
Hypothyroidism (underactive thyroid)
Hyperthyroidism (overactive thyroid)
Gout (a painful form of arthritis linked to high uric acid levels in the foot)
Goiter (enlargement of the thyroid gland, inflammation/swelling of the neck)
Parkinsonism, dystonias, and other movement disorders
Headaches
Sodium depletion
Protracted sweating
Dental caries
Fever
Vertigo, dizziness
PREGNANCY SPECIAL NOTE: The use of lithium carbonate in pregnancy is potentially linked to birth defects, specifically in the malformations of the heart known as Ebstein’s anomaly.25
Lithium FAQs
It is important to distinguish lithium orotate (non-prescription form) from lithium carbonate and other lithium (prescription-only) compounds when comparing and assessing their characteristics of safety and efficacy.
Below are some of the most frequently asked questions about lithium carbonate, lithium orotate, other mood-stabilizing prescription drugs, Lithium Carbonate drug interactions, and other topics.
Is Lithium an Antipsychotic?
Lithium carbonate is classed as a mood stabilizer, although it is sometimes prescribed after antipsychotic medications have not worked in the treatment of mania, bipolar or other disorders.
Which Drugs Interact with Lithium?
Certain prescription drugs as well as over the counter preparations can interact with lithium carbonate or other forms of lithium and may cause adverse effects.2 Always speak with your doctor if you are already taking or plan to take the following types of medications:
NSAIDs such as Ibuprofen, Naproxen, Aleve, Advil, Motrin, Naprosyn, Celebrex, Voltaren, Lodine, Indocine, Orudis, Toradol, Mobic, Relafen, Daypro, etc.
These and other medications (whether prescribed or purchased over-the-counter) can increase lithium levels in the body, and cause negative interactions such as mental confusion, slurring of speech, nausea/vomiting, tremors, and other reactions.
Tylenol is considered a safe alternative.8
What is the Difference between Lithium vs Tegretol (Carbamazepine)?
Tegretol or carbamazepine is an anticonvulsive prescribed to treat seizures, and nerve pain. Tegretol does have potential life-threatening adverse effects such as severe skin reactions, suicidality, toxic allergic reactions, low sodium levels, and certain blood disorders.10
Lithium carbonate is a prescribed mood stabilizer for the treatment of mania or bipolar episodes and also carries certain risks that should be carefully monitored, including kidney failure and others that are listed in the side effects section of this article.
Both are prescription drugs and will interact with other medications or substances, but not necessarily the same ones or in the same way. Be sure to speak with your doctor if you have questions about combining certain drugs or other concerns about either of these medications.
Treatment for Lithium Abuse and Addiction?
Alternative to Meds Center is focused on reducing or eliminating the need for prescription drugs while helping clients attain sustainable natural mental health, without medication where possible.
Our goal is to help those who have been disappointed with the results of drug-based therapies by providing drug-free treatments. Many of these are listed on our services overview page. Prescription drugs may not have provided the relief that was hoped for, and may have introduced more problems than benefits. While drugs can be destructive, drugs can also have beneficial effects such as anesthesia or masking of emotional pain. But these temporary effects leave unresolved symptoms in place, with no curative result. These unresolved symptoms can be addressed using non-harmful methods and therapies for authentically restoring health and vibrancy. Nutrition, neurotoxin removal,counseling, lifestyle interventions, and other drug-free therapies may be of considerable benefit.
When needed, safe and gradual tapering is our specialty, and we have helped literally thousands of clients to achieve success in becoming drug-free, or as close to it as realistically possible. Please contact us for more information on how our programs may be beneficial to your specific health and wellness goals. Please ask us about insurance coverage when you call. You can find out more about safe Lithium withdrawal as well as methods to achieve sustainable mental health naturally today!.
12. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Lithium. [Updated 2019 Jun 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547877/ [cited 2021 July 26]
13. Balon R, Yeragani VK, Pohl RB, Gershon S. Lithium discontinuation: withdrawal or relapse? Compr Psychiatry. 1988 May-Jun;29(3):330-4. doi: 10.1016/0010-440x(88)90056-9. PMID: 2897893. [cited 2021 July 26]
14. Adityanjee, Munshi, Kaizad R MD, DPH, MPH; Thampy, Anita MBBS The Syndrome of Lithium-Effectuated Neurotoxicity” published Journal of Clinical Neuropharmacology Jan-Feb 2001 Issue 1 pg 38-49 doi: 10.1097/01.wnf.0000150871.52253.b7 [cited 2021 July 26]
15. Ataullah AHM, Naqvi IA. Cerebellar Dysfunction. [Updated 2020 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562317/ [cited 2021 July 26]
22. Verdoux H, Bourgeois M. Conséquences à court terme de l’interruption d’un traitement par sels de lithium [Short-term sequelae of lithium discontinuation]. Encephale. 1993 Nov-Dec;19(6):645-50. French. PMID: 12404784. [cited 2022 Feb 15]
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.
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Medication Withdrawal Success Stories
Can you imagine being free from medications, addictive drugs, and alcohol? This is our goal and we are proving it is possible every day!
Studies show that a gradual reduction of lithium carbonate produces less severe adverse reactions compared to sudden cessation.5,6,16,17
Nausea, vomiting, diarrhea
Alternative to Meds Center is focused on reducing or eliminating the need for prescription drugs while helping clients attain sustainable natural mental health, without medication where possible.
