Starting Lithium – Instructions for GPS Patients

Peter ForsterBipolar Treatment Leave a Comment

Take lithium near your bedtime and take it with a little food to reduce GI discomfort.

If you are particularly sensitive to medications you can start by taking either ½ of the 300 mg tablet or capsule or you can ask for your doctor to write for a couple of 150 mg tablets for the first day or two. If you are getting the controlled release form of lithium it is better to get a separate prescription for 150 mg tablets than to cut the 300 mg dose.

Your first set of labs should be done at least 5 days after you begin taking 600 mg at night. You must have taken 600 mg every night during those five days.

Day 1Either begin with ½ of the 300 mg tablet or take the full tablet.
Day 2Take 1 x 300 mg tablet at night
Day 3Take 2 x 300 mg tablet at night
Day 8 (or later)Get your lithium level drawn 12 hours after nighttime dose. Drink plenty of water in the morning before your labs are drawn.

Most people tolerate the first few doses of lithium well. If there are side effects, they usually go away after a few days.

Gastrointestinal side effects are the most frequent side effects associated with taking lithium, including dry mouth or a slightly metallic taste in the mouth, nausea, diarrhea, indigestion, bloated feeling, and excessive salivation. Stomach upset may be avoided by taking lithium immediately after meals or with food and the extended-release lithium may reduce some of these side effects as well. If this doesn’t work a different form of lithium can be used (lithium citrate).

Other side effects related to lithium therapy include slight drowsiness or feeling mentally slowed down, mild fine tremors of the fingers, hair changes (dry or thinner hair), worsening of acne and psoriasis, increased urination and thirst, and some weight gain (in those who are initially overweight).

For More Information

Lithium overview

Lithium mechanism of action

Predicting lithium response

Lithium hypothyroidism

Lithium weight gain