Consuming alcohol with lithium, a medication used to treat bipolar disorder, can cause serious side effects. Typically, doctors advise people taking lithium to avoid consuming alcohol.
Lithium is a medication that treats bipolar disorder, a condition that involves episodes of depression, periods of mania, or both. While lithium is a common treatment for bipolar disorder, it has many side effects, including vision changes.
Additionally, the medication has a very narrow therapeutic index — this means a small dosage change can have significant effects. Consuming alcohol alongside lithium can worsen potential side effects. It can also adversely affect sleep and circadian rhythms.
Read on to learn more about lithium, its risks, side effects, and interactions.
Lithium (Priadel) is the
The primary target symptoms include unstable mood and episodes of mania, which can manifest in:
- feeling “high” or irritable
- feeling the need to talk continually
- feeling distracted
- feeling a lack of the need to sleep
- having racing thoughts
- engaging in potentially harmful activities
Lithium also has off-label uses. This refers to other uses that the Food and Drug Administration (FDA) has not approved. These
- Neutropenia: A condition involving a low number of neutrophils, which are white blood cells that fight infections.
- Depression: Lithium can be used as an add-on treatment for major depressive disorder (MDD).
- Vascular headaches: These are headaches that stem from changes in blood vessels in the head and neck.
While it is generally not advisable to consume alcohol while taking lithium, it is important to know and understand the risks. An older 2015 study notes that people with bipolar disorder have a high prevalence of alcohol use.
Alcohol and lithium have opposing effects on behavioral circadian rhythms. These are body processes, such as sleep, that follow a 24–hour cycle in response to light and dark.
Consequently, drinking alcohol and taking lithium may adversely affect sleep and circadian rhythms, which may worsen symptoms of bipolar disorder.
The National Alliance on Mental Illness (NAMI) also warns that consuming alcohol while taking lithium can reduce the benefits of bipolar disorder medication.
Alcohol may also increase the side effects. For example, both lithium and alcohol cause sedation, so taking them together can increase drowsiness, which can pose a danger when driving or operating machinery.
Before taking lithium, a person should tell their doctor if they consume alcohol. A healthcare professional can explain the risks and safest options for the individual. However, most advice is to avoid drinking alcohol while taking lithium.
Learn how alcohol can affect bipolar disorder here.
Common side effects of lithium include:
- nausea or vomiting
- dizziness or drowsiness
- hand tremors
- headache
- diarrhea
- change in appetite
- dry mouth
- thinning of hair or hair loss
- increased thirst and urination
- acne-like rash
Serious but rare side effects include:
- confusion
- severe nausea and vomiting
- unsteadiness when standing or walking
- severe hand tremors
- vision changes
- diabetes insipidus, a treatable condition causing significantly increased thirst and urination
Additionally, long-term use may result in kidney problems and hypothyroidism, which is low production of thyroid hormones.
Some medications can increase the levels and effects of lithium, while others can decrease them. For these reasons, most doctors advise not taking these medications together.
Medications that increase levels include:
- Diuretics: These drugs, such as furosemide (Lasix), increase urination.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These help with pain, inflammation, and fever. Examples include ibuprofen (Advil) and naproxen (Aleve).
- Angiotensin receptor blockers: These high blood pressure medications include valsartan (Diovan).
- Angiotensin converting enzyme (ACE) inhibitors: These drugs, such as enalapril (Vasotec), are another class of high blood pressure medications.
- Monoamine oxidase inhibitors (MAOIs): These are a class of antidepressants. One example is phenelzine (Nardil).
Medications that decrease levels include:
- sodium chloride, which is common table salt
- caffeine
- theophylline (Theo–Dur), a drug that treats breathing problems
When people have a cold or the flu, they can become dehydrated. This can affect lithium levels. For this reason, they should talk with a doctor if they:
- have an illness that involves a high fever, vomiting, severe diarrhea, or sweating
- are not eating or drinking much
- have a urinary tract infection (UTI)
As mentioned earlier, lithium has a
This is important regardless of how someone feels because high amounts of lithium can cause brain damage and death.
Signs of moderate lithium intoxication include:
- confusion
- fast heartbeat
- delirium
Signs of severe intoxication include:
- low blood pressure
- high body temperature
- seizures
- coma
Lithium toxicity is easily manageable if an individual gets medical attention. However, ignoring the signs can be fatal.
Learn more about lithium toxicity here.
Combining lithium and alcohol can worsen bipolar symptoms and increase the likelihood of side effects. For this reason, doctors advise people not to consume alcohol while taking the medication.
Although the main use of lithium is to treat bipolar disorder, the drug also has some off-label uses, such as treating major depressive disorder.
Lithium’s most common side effects include drowsiness, nausea, and hand tremors.