Short-term
- Lithium may take longer to take effect (2-4 weeks) compared to other medications for BPII.
- Within the first 4 months of starting/increasing lithium, people commonly experience:
- Dry mouth
- 53 in 100 people (53%)
- Increased thirst
- 49 in 100 people (49%)
- Nausea/vomiting
- 47 in 100 people (47%)
- Upset stomach
- 43 in 100 people (43%)
- Increased need to urinate
- 33 in 100 people (33%)
- Cognitive ‘dulling’ (i.e., difficulties remembering, slowed down thinking)
- 20-25 in 100 people (20-25%)
In general, these side effects tend to pass.
Mid-term
- Within the first 18 months of taking lithium to prevent
relapse, people also may experience:
- Headache
- 19 in 100 people (19%)
- Tremor
- 17 in 100 people (17%)
- Sleepiness/drowsiness or fatigue
- 13 in 100 people (13%)
- Weight gain of = 7% of body weight *
- 10-12 in 100 people (12%)
*For a person weighing 70kg = ~ 5kg gain
For most people, these symptoms are mild to moderate in intensity and do not stop them taking lithium.
Long-term
- Regular, ongoing monitoring is needed for:
- blood serum levels, to ensure they remain in the therapeutic range and avoid lithium toxicity.
- kidney function,
- thyroid function and
- weight gain.
This usually involves urine and blood tests, and body weight measurement every 3-6 months.
- Over the long-term (5+ years on average) approximately 13-14 in 100 people taking lithium will experience clinical hypothyroidism. This means the thyroid gland is underactive. This condition can be treated with thyroid hormone replacement medication.
- Over the long-term (20+ years on average) about 1-2 in 100 people taking lithium will experience chronic kidney disease.
- About 5 in 1000 people taking lithium will experience complete kidney (renal) failure. This is uncommon.
With regular, ongoing monitoring you can greatly reduce the risk of possible long-term side effects.