Lithium is the oldest and most well-known mood stabilizer. It is taken as a tablet, usually once nightly. It doesn’t work straight away – you must take it daily for one to two weeks before its mood stabilising effect takes hold. The effective dose for the person is determined by testing the blood lithium level a week after beginning lithium (or whenever dose changes are made) – this is done by a simple blood test performed in the morning, about 12 hours after the last lithium tablet has been taken.
As with all mood stabilisers, it is important to continue taking lithium even when the mood has stabilised – this is because it plays an important role in preventing further mood disturbances and also research has shown that if lithium is discontinued suddenly, it may trigger a ‘rebound’ episode of depression or mania. It is therefore very important to talk with your doctor before deciding to stop lithium.
The doctor will organise for routine blood tests and a heart tracing test (an ECG) before starting lithium to make sure that the person is fit to commence the medication, and it is also necessary to have regular blood tests once taking lithium (3-6 monthly).
Lithium may also be prescribed for those with unipolar depression to boost the effects of antidepressant medications, where these alone have not been effective in alleviating the symptoms of depression.
It is associated with an increased risk of certain foetal abnormalities if taken during pregnancy, so it is important if you are taking lithium and wish to become pregnant that you discuss your options with your doctor prior to trying to conceive. For some, it may be appropriate to continue lithium, but for others, a gradual phasing out of lithium and/or using an alternative medication may be indicated.
For more information on lithium see the below links: