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Lithium Withdrawal Symptoms, Side Effects, Treatment Help

This entry was posted in Antipsychotic on by .
Medically Reviewed Fact Checked

Last Updated on July 26, 2021 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

Lithium Withdrawal Symptoms

lithium withdrawal symptomsStudies show that a gradual reduction of lithium carbonate produces less severe adverse reactions compared to sudden cessation.5,6,16,17

The subject of neurotoxicity after lithium carbonate has been widely studied, as in the article authored by Netto and Phutane, published in the Primary Care Companion for CNS Disorders of 2012.18

The authors observed that reversible neurotoxic effects of lithium carbonate may be undetectable until the drug is discontinued. The study focused on 6 cases, a small cohort, and does acknowledge that in other cases, the neurotoxic effects of lithium carbonate will be irreversible.

A more recent study 14 coins the term “SILENT” to describe the Syndrome of Irreversible Lithium Effectuated Neurotoxicity. These are lithium carbonate neurotoxic side effects that don’t go away even though the drug is discontinued. The most common symptom of SILENT is cerebellar dysfunction, a form of brain damage affecting the cerebellum. The cerebellum is the coordinator for balance, gait, and can affect speech and other motor movements, as seen in muscular dystrophy, Parkinsonism, dementia, and other conditions. The authors of this study aim to bring the phenomena related to SILENT into increased awareness of physicians and clinicians, so these damaging effects can be prevented, not simply discovered after lithium carbonate withdrawal.15

Similarly, other side effects that emerged during treatment with lithium carbonate such as renal impairment, may not go away even after stopping lithium orotate. 2,11

Lithium withdrawal symptoms include:

  • Heightened anxiety 13
  • Sleep disturbances
  • Return of mania, bipolar, or other original symptoms 16
  • Increased suicidal risk, which is lessened with slow and gradual withdrawal 17

It is uncommon, unfortunately, for a medical provider to have enough information regarding lithium withdrawal tor be able to offer any non-toxic alternatives

Mood stabilizers like lithium carbonate are known to impair liver and kidney function which would make anyone consider … is there a better way?

Do Your Symptoms Require Lithium?

successful lithium withdrawal
Alternative to Meds has been the leading authority on antipsychotic withdrawal and lithium alternatives for over 15 years. We have published evidence regarding our success. Usually, mood issues that are lessened by lithium carbonate can be addressed in less toxic ways. 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
There is a big difference between someone who is symptomatic suddenly and other times seems normal, compared with one who is constantly symptomatic. Our belief is that neither of these is necessarily permanently broken — but more likely they have not received the treatments most pertinent to their needs. This video shows a young man who everyone had given up on except his mother… He was in and out of hospitals in a very dramatic way. He did the ATMC program, and now he is an international speaker and book author. He has been a testament to what is possible for 10 years.
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Discontinuing/Quitting Lithium

Abrupt lithium withdrawal can cause pronounced episodes of returning mania 5 as well as Bipolar relapses. Gradual withdrawal observed in clinical studies demonstrated fewer instances of returning symptoms, and where symptoms did return, patients had less severe versions of their returning symptoms overall.6,17

No published clinical studies were found relating to withdrawal from natural lithium or lithium orotate. At times, a prescribing physician may choose to slowly convert their patient from the prescription form of lithium (lithium carbonate) to lithium orotate as a way to bridge off 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 your integrative medical doctor before attempting.

There are reasonable theories regarding the role of trace minerals in respect to mental health. Deficiencies can play a prominent role in preparing for and executing Lithium withdrawal. At the Alternative to Meds Center, pre-taper lab testing is done to establish whether such deficiencies exist and then programs a person for corrective supplementation and diet to resolve these. In general, improving nutrition is beneficial for anyone recovering from medication discontinuation.

It may be possible that a trace mineral deficient person (which is common due to over-farming techniques in agriculture) may respond positively to lithium. An unsubstantiated hypothesis may be that lithium could play a certain role in 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.

A case study published in the 2019 Journal of Advanced Mind-Body Medicine concluded that lifestyle interventions, as well as nutritional interventions, were important components of recovery and remission of symptoms in a medication withdrawal clinically supervised scenario.19

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.1,2,13

Less information is available for clinical trials concerning the non-prescription form of lithium called lithium orotate. Lithium orotate is not available over-the-counter in all countries, due to concerns by regulators over hypothetical rather than observed toxicity dangers should the supplement be taken in extraordinarily large doses. One such occurrence was found in an article published in the Journal of Medical Toxicology, where a woman took 18 tablets (instead of one) of an over-the-counter lithium orotate supplement who became nauseous and experienced light hand tremors, both of which disappeared after 3 hours.20

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 Medication Is Used For

Lithium had been extensively used for the control of mania since the late 1870s but became an increasingly abandoned practice in psychiatry as new antipsychotic drugs were developed and approved by the FDA and around the world starting in the 1950s for the treatment of mania.3,4,21

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
  • Schizophrenia3

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. It is important to understand the nature and molecular structure of any drug or supplement that one takes.

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 7-UP 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

A study out of Norway published in the BMC Journal of Psychiatry showed that a majority of the participants discontinued the prescription drug lithium carbonate to avoid the side effects of the drug. Diarrhea, tremors, diabetes insipidus, and weight gain were the 5 most common reasons for discontinuation according to the authors of the study.9

According to the FDA label 2 for lithium carbonate, signs of lithium toxicity include a similar list, including diarrhea, vomiting, tremors, ataxia (clumsiness, loss of coordination), drowsiness, and muscular weakness. Other common reasons for discontinuing the medication due to side effects, according to a study published in the International Journal of Bipolar Disorders11 include weight gain, cognitive impairment, impaired kidney function, hyperthyroidism, and hypothyroidism. Because of the vast number of potential side effects, we have categorized a sampling of them for clarity. These side effects along with many others are listed on the FDA drug label.

Lithium carbonate side effects include:

Gastrointestinal & Renal:

  • lithium side effectsNausea, vomiting, diarrhea
  • Anorexia
  • Weight loss
  • Weight gain
  • Constipation
  • Increased urination
  • Increased thirst
  • Indigestion
  • Abdominal pain
  • Flatulence
  • Dry mouth/ excessive salivation
  • Kidney toxicity (may lead to kidney failure)
  • Incontinence of urine or feces

Musculoskeletal

  • Tremors, tics, twitches
  • Cogwheel rigidity
  • Seizures
  • Startled response
  • Uncontrolled tongue movements
  • Ataxia (clumsiness, loss of balance, difficulty walking)
  • Hyperreflexia (reflexes become over-responsive)
  • Restlessness
  • Muscle weakness
  • Fatigue
  • Swelling of ankles or wrists
  • Painful joints
  • Tightness in chest

Cognitive

  • Memory loss
  • Mental confusion
  • Poor concentration
  • Loss of alertness (warnings given for those operating heavy machinery or driving)
  • Giddiness
  • Slurred speech
  • Blackout spells
  • Coma
  • Stupor
  • Hallucinations

Dermatological

  • Lithium-associated acne, lesions
  • Alopecia
  • Drying and thinning of the hair
  • Anesthesia of the skin
  • Psoriasis, worsening psoriasis
  • Cutaneous ulcers
  • Swollen lips

Ocular/Aural

  • Blurred vision
  • Blindness
  • Tinnitus

Other Conditions & Disorders

  • Leukocytosis (elevation in white blood cell count)
  • Hypothyroidism (underactive thyroid)
  • Hyperthyroidism (overactive thyroid)
  • Gout (a painful form of arthritis linked to high uric acid levels in the foot)
  • Goiter (enlargement of the thyroid gland, inflammation/swelling of the neck)
  • Parkinsonism, dystonias, and other movement disorders
  • Headaches
  • Sodium depletion
  • Protracted sweating
  • Dental caries
  • Fever
  • Vertigo, dizziness
  • PREGNANCY SPECIAL NOTE: Use of lithium carbonate in pregnancy is potentially linked to birth defects, specifically in the malformations of the heart known as Ebstein’s anomaly.

Lithium FAQs

It is important to distinguish lithium orotate (non-prescription form) from lithium carbonate and 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 carbonate, lithium orotate, other mood-stabilizing prescription drugs, Lithium Carbonate drug interactions, and other topics.

Is Lithium an Antipsychotic?

Lithium carbonate 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 carbonate or other forms of lithium and may cause adverse effects.2 Always speak with your doctor if you are already taking or plan to take the following types of 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, tremors, and other reactions.

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. Tegretol does have potential life-threatening adverse effects such as severe skin reactions, suicidality, toxic allergic reactions, low sodium levels, and certain blood disorders.10

Lithium carbonate is a prescribed mood stabilizer for the treatment of mania or bipolar episodes and also carries certain risks that should be carefully monitored, including kidney failure and others that are listed in the side effects section of this article.

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?

lithium drug rehab sedonaAlternative to Meds Center is focused on reducing or eliminating the need for prescription drugs while helping clients attain sustainable natural mental health, without medication where possible.

Our goal is to help those who have been disappointed with the results of drug-based therapies by providing drug-free treatments. Many of these are listed on our services overview page. Prescription drugs may not have provided the relief that was hoped for, and may have introduced more problems than benefits. While drugs can be destructive, drugs can also have beneficial effects such as anesthesia or masking of emotional pain. But these temporary effects leave unresolved symptoms in place, with no curative result. These unresolved symptoms can be addressed using non-harmful methods and therapies for authentically restoring health and vibrancy. Nutrition, neurotoxin removal, counseling, lifestyle interventions, and other drug-free therapies may be of considerable benefit.

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. Please ask us about insurance coverage when you call. You can find out more about safe Lithium withdrawal as well as methods to achieve sustainable mental health naturally today!.


1. Greenblatt J, Grossman K, “Lithium: The Untold Story of the Magic Mineral That Charges Cell Phones and Preserves Memory” Great Plains Laboratory Inc, 2017 Jan 23 [cited 2021 July 26]

2. FDA drug label Lithobid (lithium carbonate) [online 2009] [cited 2021 July 26]

3. Luo D et al., “Lithium for schizophrenia: supporting evidence from a 12-year nationwide health insurance database and from Akt1-deficient mouse and cellular models.” Nature Scientific Reports [online} Article No. 647 (2020) [cited 2021 July 26]

4. Mitchell PB, Dusan Hadzi-Pavlovic D “Lithium treatment for bipolar disorder” Bulletin of the World Health Organization, 2000 [cited 2021 July 26]

5. Mander AJ, Loudon JB “Rapid Recurrence of Mania Following Abrupt Discontinuation of Lithium” Lancet clinical trial report PMID 2898622 [1988 Jul 2] [cited 2021 July 26]

6. Faedda GL, Tondo L, Baldessarini RJ, Suppes T, Tohen M “Outcome After Rapid vs Gradual Discontinuation of Lithium Treatment in Bipolar Disorders” Arch Gen Psychiatry [1993 Jun] PMID8498879 [cited 2021 July 26]

7. Karatas F “An investigation of orotic acid levels in the breast milk of smoking and non-smoking mothers” European Journal of Clinical Nutrition, 2002 Nature Publishing Group [cited 2021 July 26]

8. “Medication Frequently Asked Questions.” National Alliance on Mental Health (N.D.) [cited 2021 July 26]

9. Ohland L, et al., “Reasons for lithium discontinuation in men and women with bipolar: a retrospective cohort study.” BMC Psychiatry {online} 2018 Feb 7 Article no. 37 (2018) [cited 2021 July 26]

10. FDA label Tegretol (carbamazepine) March 2018 [cited 2021 July 26]

11. Gitlin M. Lithium side effects and toxicity: prevalence and management strategiesInt J Bipolar Disord. 2016;4(1):27. doi:10.1186/s40345-016-0068-y [cited 2021 July 26]

12. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Lithium. [Updated 2019 Jun 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547877/ [cited 2021 July 26]

13. Balon R, Yeragani VK, Pohl RB, Gershon S. Lithium discontinuation: withdrawal or relapse? Compr Psychiatry. 1988 May-Jun;29(3):330-4. doi: 10.1016/0010-440x(88)90056-9. PMID: 2897893. [cited 2021 July 26]

14. Adityanjee, ; Munshi, Kaizad R MD, DPH, MPH; Thampy, Anita MBBS  “The Syndrome of Lithium-Effectuated Neurotoxicity”  published Journal of Clinical Neuropharmacology Jan-Feb 2001 Issue 1 pg 38-49 doi: 10.1097/01.wnf.0000150871.52253.b7 [cited 2021 July 26]

15. Ataullah AHM, Naqvi IA. Cerebellar Dysfunction. [Updated 2020 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562317/ [cited 2021 July 26]

16. Mander AJ, Loudon JB. Rapid recurrence of mania following abrupt discontinuation of lithium. Lancet. 1988 Jul 2;2(8601):15-7. doi: 10.1016/s0140-6736(88)92947-9. PMID: 2898622. [cited 2021 July 26]

17. Baldessarini RJ, Tondo L, Viguera AC. Discontinuing lithium maintenance treatment in bipolar disorders: risks and implications. Bipolar Disord. 1999 Sep;1(1):17-24. doi: 10.1034/j.1399-5618.1999.10106.x. PMID: 11256650. [cited 2021 July 26]

18. Netto I, Phutane VH. Reversible lithium neurotoxicity: review of the literatur. Prim Care Companion CNS Disord. 2012;14(1):PCC.11r01197. doi:10.4088/PCC.11r01197 [cited 2021 July 26]

19. Brogan K, Siefert A. Successful Discontinuation of Chronic Polypsychotropic Regimen and Resolution of Withdrawal Syndrome Through Nutrition and Lifestyle Interventions: A Case Report. Adv Mind Body Med. 2019 Summer;33(3):22-30. PMID: 31605602. [cited 2021 July 26]

20. Pauzé DK, Brooks DE. Lithium toxicity from an Internet dietary supplement. J Med Toxicol. 2007 Jun;3(2):61-2. doi: 10.1007/BF03160910. PMID: 18072162; PMCID: PMC3550087. [cited 2021 July 26]

21. Ramachandraiah CT, Subramaniam N, Tancer M. The story of antipsychotics: Past and present. Indian J Psychiatry. 2009;51(4):324-326. doi:10.4103/0019-5545.58304 [cited 2021 July 26]


Originally Published Sep 13, 2018 by Diane Ridaeus


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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Lithium Withdrawal Symptoms, Side Effects, Treatment Help
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Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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