Drinking alcohol while taking lithium, a medication doctors prescribe for 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.

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Lithium (Priadel) is the first-line treatment for a manic episode in bipolar disorder. It also has use as a maintenance treatment for bipolar disorder in a person with a history of manic episodes.

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 include:

Learn more about lithium and its uses.

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:

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.

Learn more about the side effects of lithium here.

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:

Medications that decrease levels include:

  • sodium chloride, which is common table salt
  • caffeine
  • theophylline (Theo–Dur), a drug that treats breathing problems

Learn more about drug interactions here.

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 narrow therapeutic index. This means that a small difference in the dose can cause toxicity and lead to life threatening side effects. Because of this, if a person inadvertently takes a larger dose than their doctor prescribes, they should go to the emergency room.

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:

Signs of severe intoxication include:

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.