Harvard Women's Health Watch

By the way, doctor: What are the side effects of lithium?

Q. What can you tell me about the side effects of lithium? I've heard it causes thyroid and memory problems.

A. Lithium is a drug used to treat people with bipolar disorder (sometimes known as manic-depressive illness), a psychiatric disorder characterized by extreme shifts in mood, from excessively euphoric (mania) to desperately sad or hopeless (depression). In the manic phase, such individuals may be elated, require little sleep, or have inflated notions about themselves. In the depressive phase, they may have low energy, experience changes in eating or sleeping, or feel guilty, hopeless, or suicidal. Episodes of mania and depression may occur within days of each other, be separated by months or years, or occur in a "mixed" state (such as irritability or agitation and a sad or unpleasant mood). People with bipolar disorder can also experience delusions, paranoia, and other impaired perceptions of reality.

Lithium is a "mood stabilizer." It's very effective in preventing and treating mania and depression and has been shown to lower the rate of suicide in bipolar patients. However, it has a number of adverse effects, including nausea, diarrhea, increased urination and thirst, restlessness, hair thinning, and neurological symptoms, including tremor, confusion, and reduced alertness and mental acuity. Over the long term, lithium can cause the thyroid gland to grow (goiter) or, less often, to become underactive (hypothyroidism), which is more likely to occur in women over age 45. It can also adversely affect kidney and cardiovascular function.

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