Consuming alcohol while on lithium is not considered safe. For individuals on lithium, alcohol use may decrease the potential benefits and the adverse effects of the medication. This is primarily due to the fact that alcohol interferes with a person’s ability to regulate mood and keep emotions stable.
What Is Lithium?
Lithium (lithium carbonate) is what is known as an antimanic agent, a mood stabilizer prescribed to treat mental health conditions, including bipolar disorder, depression, and schizophrenia. Lithium works to treat affective disorders by reducing abnormal activity in the brain. Lithium is available as a capsule, immediate-release and extended-release tablets, and liquid solution consumed orally by mouth. Brand names for lithium include Eskalith and Lithobid.
For the treatment of bipolar disorder, also formerly known as manic depression, lithium can be used independently or in combination with other medications such as the following:
- Ativan, Valium, or Xanax – Benzodiazepines prescribed for anxiety and panic attacks
- Seroquel, Haldol, or Risperdal – Antipsychotics prescribed for bipolar disorder and schizophrenia
- Paxil, Zoloft, or Celexa – SSRI antidepressants prescribed for depression and anxiety
Lithium is typically prescribed as maintenance therapy in between manic episodes in individuals with bipolar disorder.
Lithium Side Effects
Studies have shown that lithium can significantly reduce the risk of suicide in persons who experience mood disorders. Some individuals who use lithium for bipolar disorder experience side effects, which may subside or decrease in severity as the person’s body becomes accustomed to the drug. Common side effects include the following:
- Acne or rashes, itching
- Changes in tasting ability
- Changes in appetite
- Dry mouth
- Excessive salivation
- Gas and indigestion
- Joint or muscle pain
- Abdominal pain
- Swollen lips
- Thinning/brittle fingernails
- Thinning hair/hair loss
- Cold sensitivity
- Weight loss or gain
In rare instances, lithium may cause a reversible condition known as diabetes insipidus. If this occurs, affected individuals will notice a significant increase in thirst and urination frequency. Persons who experience these symptoms should consult their healthcare provider to prevent or identify the presence of this condition and proceed with treatment.
Symptoms of Lithium Overdose or Toxicity
Lithium toxicity is also called lithium overdose, and lithium poisoning is a potentially lethal condition that occurs when a person has dangerously high lithium levels in their blood. Specific drug interactions can also cause this condition.
Symptoms of lithium toxicity include the following:
- Crossed Eyes
- Muscle weakness
- Nausea and vomiting
- Cold fingers and toes
- Shortness of breath
- Swollen feet or lower legs
- Unusual tiredness/weakness
- Changes in vision
- Hand tremors
- Pounding headache
- Irregular heartbeat
- Impaired coordination
These symptoms likely indicate that lithium levels are perilously high. Individuals who experience these symptoms should discontinue lithium use and seek medical attention immediately. Lithium toxicity is a potentially life-threatening condition and should be addressed urgently by a healthcare professional. If untreated, lithium poisoning can lead to death.
Some medicines can increase the levels and effects of lithium and contribute to lithium toxicity, including the following:
- Angiotensin receptor blockers
- Angiotensin-converting enzyme (ACE) inhibitors
- Some blood pressure medications
- MAOIs or monoamine oxidase inhibitors, a class of antidepressants
- Non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen
Moreover, individuals using these medications should not take lithium in combination with them.
Lithium should usually not be taken by persons with significant heart or kidney disease, severe debilitation or dehydration, sodium depletion, and those using diuretics. The risk of lithium toxicity is significantly increased among these individuals.
Conversely, some medications and substances may reduce the levels and effectiveness of lithium. Also, persons should avoid consuming caffeine, salt (sodium chloride), and theophylline, a medication that treats lung conditions, such as COPD and asthma.
Patients are urged to disclose the use of any medications and substances they take to their health provider before taking lithium to prevent any adverse interactions.
Is Lithium Addictive?
Lithium is not thought to be physically addictive except in the sense that any mind-altering substance can be habit-forming, and an emotional dependence can develop. Although lithium is not a naturally addictive substance, it can still be misused or combined with addictive substances, which can produce dangerous interactions and, in some instances, death.
Is It Safe to Combine Lithium and Alcohol?
Because lithium is usually prescribed to individuals with bipolar disorder, it is not recommended to drink while on lithium as alcohol also induces mood-altering effects. Both of these substances impact the central nervous system (CNS). When alcohol and lithium interact, they can counterbalance each other. Someone who uses the two in conjunction may discover that their mental and emotional state worsens as a result.
There are other considerations with combining lithium and alcohol, including the fact that alcohol is very dehydrating. Because alcohol dehydrates the body, it can cause lithium levels to rise in the blood to rise and become toxic.
Persons taking lithium are advised to adopt and maintain a balanced diet, a habit that can be undermined by alcohol consumption. Due to how heavily lithium impacts sodium levels in the blood, it’s vital to be vigilant with salt/sodium consumption.
Other illicit drugs, including cocaine and marijuana, can cause severe interactions with lithium. Individuals with active substance use disorders should not be prescribed lithium. Lithium use has also been linked to an increased risk of hypothyroidism and consuming alcohol also adversely affects thyroid levels.
Lithium and Alcohol Side Effects & Risks
When alcohol and lithium are combined, their compounded effects may result in the following:
- Impaired motor function
- Impaired thinking/judgment
- Increased depression
- Liver damage
- Nausea and vomiting
- Joint and muscle pain
Alcohol abuse also complicates the management of bipolar disorder and other mood disorders commonly treated by lithium. Drinking impairs judgment and can make the person more impulsive and tending toward risky behavior resulting in injury.
Alcohol and lithium, when combined, also increase the risk of suicidal ideations and behaviors. The risk of suicide is nearly double in bipolar disorder-affected who abuse alcohol than people who don’t.
Concurrent Treatment for Lithium and Alcohol Abuse
Persons being treated with lithium who continue consuming alcohol may be prescribed another mood stabilizer that does not interact as adversely with alcohol. They should also be referred to alcohol treatment, either inpatient, intensive outpatient, or partial hospitalization, depending on the severity of their problems.
Just Believe Detox and Just Believe Recovery centers offer multifaceted, integrated programs that feature a wide variety of therapeutic interventions and activities, including the following:
- Behavioral therapy
- Peer group support
- Individual counseling
- Family counseling
- Relapse prevention
- Substance abuse education
- Health and wellness education
- Art and music therapy
- Aftercare planning
- Alumni events and activities