Lithium Side Effects

I recently added Lithium Carbonate to my SSRI. I have Bipolar 2 with Major Depressive Disorder and a bunch of anxiety and CPTSD stuff.

So far, since starting Lithium a month ago, I really notice a positive improvement in my mood and also my stability. I'm only on a low dose of Lithium (300 mg. I started at 150 mg and I've been at 300 mg for about 2 weeks). I'm kind of blown away by the fact that this actually seems to be working for me so far. I was incredibly anxious about starting Lithium because it's notorious for causing side effects and actual kidney/thyroid damage if it's taken long term. Obviously I'm getting tested regularly.

Even at this low dose I'm having some unpleasant side effects, mostly to do with my digestive system, but also a really dry mouth, dry eyes and a scratchy throat. I take the Lithium with food and the nausea has got a bit better. But I still get bad indigestion (heartburn and reflux mainly). Does this get better? Did anyone else get the dry mouth/eyes/throat? Does that wear off?

I really want to stay on this medication, and ideally, I'd like to increase my dose a bit, but these side effects are bothersome and I don't want them to get worse.

Thank you!

It caused me thyroid damage pretty fast. I started on Lithium in 2009 and already in 2010 had to start taking Levoxyl. I have long stopped taking Lithium but I still need Levoxyl: the damage to thyroid is lifelong. So, be careful.

That is definitely scary. There are a lot of scary things about Lithium and I delayed taking it as long as possible. I did a lot of research and I found the alternatives to Lithium potentially very scary too. In the end I decided Lithium was the lesser evil.

I have to say Lithium is definitely helping my mood and stability, but I'm super concerned about irreversible damage.

Thanks for your feedback!

I just had a thyroidectomy, and it wasn't in direct cause of the Lithium, but I know it might have been a contributing factor. I get the dry mouth and the scratchy throat sometimes, but it is not as bad as it used to me. I started taking 300mg twice a day back in 2018 and it's been a miracle drug. As long as you get your levels tested regularly you should be fine.

Thank you!!! I'm so glad Lithium has helped you so much. But I'm sorry that it may have been a contributing factor to your thyroidectomy. I definitely worry a lot about long term damage to my kidneys and thyroid. I'm hoping I can stay on a low dose and that may lower the risk of future health problems. But obviously I need to make sure I'm taking enough for there to be a therapeutic benefit.

I started with 150 mg and I felt an improvement in my mood really quickly. Like after just a couple of days. I went up to 300 mg and I've been at that dose for about 2 weeks. I definitely feel less depressed and more stable. But I've had some bad days too over the past 2 weeks, so it's not like a total gamechanger for me. I probably need to increase my dose but I'm definitely struggling a bit with the side effects. At last check my blood level was only 0.2. But I guess it's not so much the level that matters, it's whether or not you feel better. And at 0.2 I do feel better, but would like to go up a bit higher if possible!

Thanks for sharing your experience!

No problem! I mean if you're feeling better that's a really good thing, right? I would ask questions to your primary care and pdoc to find out exactly what the harms and risks are of long-term Lithium use. Everyone is different of course, but my thyroidectomy came from a tumor on my neck I had for 20 years that was my thyroid but turned into something else. I am not sure if the Lithium contributed to its growth or not.

Like I said I am on 300mg twice a day and that's low compared to the average. I forgot my last Lithium level, but it wasn't high. To be honest all these meds that are supposed to help us impact our physical health in one-way or another so it's a matter of finding out what works or the lesser of two evils.

That is so true! I have always tried to take the lowest possible dose of any drug I'm prescribed (in the hope that will minimize any side effects and health risks). But that has definitely resulted in me being under-medicated for long periods of time. So while I do want to stay as low as possible on Lithium, I don't want to make the mistake of not taking enough out of fear, especially since it is helping me. There is risk, but also reward. I just hope the reward wins!

Anyhow, glad your surgery is behind you and you are recovering well!

I dunno why I'm still on this med. It was a last resort for depression. Doesn't do much..

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I'm sorry Lithium isn't helping you Do you get side effects from it?

I take Lithium mainly for treatment resistant depression, as an add on to my SSRI. I do also have Bipolar 2, but my Major Depressive Disorder predominates. At first I really thought Lithium was helping me. Now I'm not so sure and it's giving me a bunch of gastrointestinal issues so I don't know what to do next. I'm only on a low dose but don't want to increase with these side effects.

One thing to consider that there are 3 forms of lithium and sometimes you have to try them all to find the one your body tolerates well. For me it was Eskalith. There also are lithobid (which I think you said you are on it) and immediate release, which was also better than lithobid for me. On Eskalith I was on a very small dose and it did what it was supposed to do. It took a while to reach the point we tried it though.

Thank you. I'm really glad you found the version that works for you! I'm still in the experimentation phase I guess. I've been on Lithobid 300 mg extended release and I'm finding it hard to tolerate in terms of GI issues. So I switched to Eskalith 300 mg Immediate Release and that was too much at once. So now I'm back to Lithobid 150 mg Immediate Release twice a day. I think there is an Extended Release version of Eskalith so I might try that next if the twice daily lower dose Lithobid doesn't settle with me.

What dose do you take? And do you take anything else with it?

I'm not on it anymore. I had toxicities several times over a lot of years and it just wasn't worth it anymore. I've been on low dose ( 425 Eskalith) or high dose (1200? mg lithobid) but not anymore. It was good while it lasted which is why I put up with it despite the toxicities.

Thank you. Did you get the toxicities even at the low dose of Eskalith?

I think it makes me too drowsy and my depression is still not good. It feels useless at this point but my doctor doesn't want to lower it or discontinue it.
Don't know what to do.

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Yes. The first toxicity was on lithobid I think and I was on a lot, like 1200 mg. The 2nd I don't remember what I was taking. The 3rd and last I was on the low dose of eskalith.


My body just really didn't like lithium even though my brain did. I don't think 3 toxicities is normal; I just did it because few other meds were working for me and when I went off lithium after the first toxicity I started feeling awful. until I resumed it. But the 3rd one was the last straw.

What happened to me is rare and if you keep up with labs and tell your pdoc how you feel you are probably going to be just fine. I don't want to scare you.

It killed my thyroid so be sure to get frequent labs

I definitely worry about that. I'm hoping the fact that I'm on a low dose will help make sure that doesn't happen, but I know it's still a risk.


Aside from the thyroid problem (which is obviously a huge deal) did Lithium help you?