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Lithium Withdrawal (Carbonate, Lithobid, Lithate)

It is uncommon for a medical provider to have much information regarding Lithium withdrawal or be able to offer any non-toxic alternatives

Mood stabilzers like Lithium can obviously impair liver an kidney function which would make anyone consider … is there a better way?

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Alternative to Meds has been the leading authority on Lithium withdrawal for over 15 years. We have published evidence regarding our success. Usually, mood issues that are lessened by Lithium Carbonate can be addressed in ways that are less toxic. Often there are blood sugar instabilities, generalized mineral deficiencies, or even manageable genetic factors that contribute to situations that result in being medicated with Lithium
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Lithium is an alkali metal, the lightest metal found in the earth.
Lab synthesized compounds are produced called lithium salts. Lithium salts such as Lithobid are prescribed for the treatment of mania, bipolar disorders, depression, and PTSD. Natural lithium supplements are available OTC. Prescribed as a mood stabilizer, Lithobid, Lithate, and other brand names, are synthesized forms of lithium that have been studied since FDA approval for their efficacy in treating certain disorders, as well as to explore the potential for unwanted side effects.1,2

Less information is available concerning the non-prescription form of lithium called Lithium Orotate and will be covered in the topics below, although somewhat limited by available trials, testing, or other resources.

Below is medical information concerning these and other topics related to lithium and may be helpful to those considering starting or stopping a prescription of this type of drug.

What Lithium is Medication Used For

Lithium had been used for the control of mania since the late 1870s but became an abandoned practice in psychiatry until new compounds were developed and approved by the FDA in 1970 for the treatment of mania.3,4

Lithium salts or compounds are used as psychiatric medication (mood stabilizers) and are prescribed for these conditions:

  • MDD or major depressive disorder
  • Bipolar disorder
  • Mania
  • MCI, minor cognitive impairment
  • ADHD in children
  • PTSD
  • Schizophrenia after other antipsychotic medications have not worked3

Lithium Alternative Names and Slang

Lithium refers to the metal, or mineral, however, the word lithium has become synonymous (although not entirely accurately) with all the various compounds and salts that have been produced in pharmaceutical labs across the world. The natural form of the element is simply called lithium and is not patentable because it is a natural element found in mineral deposits in the earth.

Various forms of compounds and salts will contain lithium, synthesized using various types of binding agents, such as:

  • Lithium carbonate (lithium bound with carbon, currently prescribed as a mood stabilizer for mental disorders)
  • Lithium citrate (lithium bound with citric acid, used in original 7UP soda pop, later banned for toxicity/deaths)
  • Lithium bromide (lithium bound with bromide in table salt, abandoned due to toxicity/deaths)
  • Lithium chloride (lithium bound with sodium chloride, used as a replacement table salt but later banned due to toxicity/deaths)
  • Lithium fluoride (lithium bound with fluoride, never used due to toxicity in trials)
  • Lithium iodide (lithium bound with iodine, never used due to toxicity in trials)
  • Lithium urate (lithium bound with urine extracts for dissolving  uric acid crystals related to gout,  but abandoned due to dose-related toxicity)
  • Lithium orotate (lithium bound with a natural chemical called orotic acid, found in breast milk7 and certain root vegetables, available as a supplement without a prescription)

There have been many other compounds/mixtures produced over the last century and a half. Some of these were found to be toxic, as in the table salt version, and unsuitable for use in food products, as in the 7-up soda pop of the 1950s.  Some have survived and exist in pharmaceutical products used today.

Brand names include numerous examples such as Theralite, Efalith, Lito, Prolix, and hundreds of additional trade names.

Lithium Side Effects

Side effects that are very common happen in greater than 10% of the people taking prescription drugs containing lithium salts or compounds and these include:

  • Kidney toxicity may lead to kidney failure
  • Tremors
  • Memory loss
  • Gastrointestinal issues; diarrhea, constipation, nausea, vomiting
  • Increased urination
  • Thirst
  • Leukocytosis, elevation in white blood cell count
  • Hyperreflexia, reflexes become over-responsive
  • Mental confusion
  • Headaches
  • Weakness
  • Muscle twitches
  • Vertigo, dizziness
  • Weight gain
  • Lowered sodium levels

Common adverse effects were seen in patients at a rate of between 1% and 10%:

  • Hypothyroidism lowered thyroid hormone levels is 6 times more frequent compared to placebo in trials
  • Gout (a form of painful arthritis from deposits of uric acid in the feet)
  • Goiter (inflammation of the neck, enlargement of the thyroid gland)
  • Movement disorders, Parkinsonism, dystonia, etc.
  • Thinning or loss of hair
  • Use in pregnancy is potentially linked to birth defects, specifically in the malformations of the heart known as Ebstein’s anomaly.

Lithium Withdrawal Symptoms

Studies show that a gradual reduction of lithium medication produces less severe adverse reactions compared to sudden cessation.5,6

Withdrawal symptoms coming off lithium include:

  • Mood disorders
  • Return of mania
  • Return of bipolar symptoms
  • There are very few clinical studies remarking on any adverse effects other than the above.
  • There are anecdotal reports of nausea, sweating, fevers, tremors, dizziness, swelling, crying spells, chest pain and tightness across the chest, eye pain, insomnia, disturbed sleep, depression, suicidality, and many others. It is not clear whether these symptoms are related specifically to discontinuation of the medication, or return of original symptoms, or a combination of these factors. More investigative studies on this subject are needed.

Discontinuing/Quitting Lithium

Abrupt Lithium withdrawal can cause pronounced episodes of returning mania5 as well as Bipolar relapses. Compared to gradual withdrawal patients had less severe returning symptoms overall.6

No published studies were found relating to withdrawal from natural lithium or lithium orotate. At times, someone may choose to slowly convert from the prescription form of Lithium (Lithium Carbonate) to lithium orotate, as a way to bridge off of the drug. This technique involves gradually taking away the medication version and slowly introducing lithium orotate. This is a pragmatic route for many, but it should be discussed with an integrative medical doctor prior to attempting.

There are reasonable theories regarding the role of trace minerals in respect to mental health.  

It may be possible that a trace mineral deficient person (which is common due to over-farming techniques) may respond positively to lithium. An unsubstantiated hypothesis may be that lithium is providing a certain role for these deficiencies and possibly covering the function of other similar minerals. It could be argued that trace mineral supplementation could offer support and that the use of trace mineral supplementation during withdrawal may be of benefit. As this is a bit of a tenuous assertion, please discuss this with an appropriate doctor who has both knowledge of medications as well as supplemental methods before considering this protocol.

Lithium FAQs

It is important to distinguish lithium orotate (non-prescription form) from other lithium (prescription-only) compounds when comparing and assessing their characteristics of safety and efficacy.

Below are some of the most frequently asked questions about lithium mood-stabilizing prescription drugs, drug interactions, and other topics.

Is Lithium an Antipsychotic?

Lithium is classed as a mood stabilizer, although it is sometimes prescribed after antipsychotic medications have not worked in the treatment of mania, bipolar or other disorders.

Which Drugs Interact with Lithium?

Certain prescription drugs as well as over the counter preparations can interact with lithium and cause adverse effects. Always speak with your doctor if you are already taking or plan to take these medications:

  • NSAIDs such as Ibuprofen, Naproxen, Aleve, Advil, Motrin, Naprosyn, Celebrex, Voltaren, Lodine, Indocine, Orudis, Toradol, Mobic, Relafen, Daypro, etc.

These and other medications (whether prescribed or purchased over-the-counter) can increase lithium levels in the body, and cause negative interactions such as mental confusion, slurring of speech, nausea/vomiting, and tremors.

Tylenol is considered a safe alternative.8

What is the Difference between Lithium Vs. Tegretol (Carbamazepine)?

Tegretol or carbamazepine is an anticonvulsive prescribed to treat seizures, and nerve pain. The drug does have potential life-threatening adverse effects such as severe skin reactions, suicidality, toxic allergic reactions, low sodium levels, and certain blood disorders.9 

Lithium is a mood stabilizer for the treatment of mania or bipolar episodes, and also carries certain risks, including kidney failure and others as previously mentioned.

Both are prescription drugs and will interact with other medications or substances, but not necessarily the same ones or in the same way. Be sure to speak with your doctor if you have questions about combining certain drugs or other concerns about either of these medications.

Treatment for Lithium Abuse and Addiction?

Alternative to Meds Center is focused on reducing or eliminating the need for prescription drugs while helping clients attain sustainable natural mental health.

Our goal is to help those who have been disappointed with the results from prescription drugs or other drugs which may not have provided the relief that was hoped for. Drugs may leave certain unresolved symptoms as well, and these can be addressed using non-harmful methods and therapies for restoring health and vibrancy.

When needed, safe and gradual tapering is our specialty and we have helped literally thousands of clients to achieve success in becoming drug-free, or as close to it as realistically possible. Please contact us for more information on how our programs may be beneficial to your specific health and wellness goals. You can find out more about safe Lithium withdrawal as well as methods to achieve sustainable mental health naturally.

1. Greenblatt J MD, Grossman K RN “Lithium: The Untold Story of the Magic Mineral That Charges Cell Phones and Preserves Memory” Great Plains Laboratory Inc, 2017 Jan 23

2. Drug label from manufacturer, ANI Pharmaceuticals, Inc.

3. “Lithium (medication)” article, Wikipedia, edited 2020 May 13

4. Mitchell PB, Dusan Hadzi-Pavlovic D “Lithium treatment for bipolar disorder” Bulletin of the World Health Organization, 2000

5. Mander AJ, Loudon JB “Rapid Recurrence of Mania Following Abrupt Discontinuation of Lithium” PubMed 1988 Jul 2

6. Faedda GL, Tondo L, Baldessarini RJ, Suppes T, Tohen M “Outcome After Rapid vs Gradual Discontinuation of Lithium Treatment in Bipolar Disorders” PubMed 1993 Jun

7. Karatas F “An investigation of orotic acid levels in the breastmilkof smoking and non-smoking mothers” European Journal of Clinical Nutrition, 2002

8. “My doctor recently started me on lithium and told me there are lots of drug interactions with this m…” National Alliance on Mental Health website FAQs

9. “Compare Lithium vs. Tegretol” website

This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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