People who experience any health issue that is treated with pharmaceuticals, or really any drugs, need to be aware of the benefits and the risks. They also need to be aware of any drug interactions that may alter the efficacy of the medication or cause adverse effects. Lithium and how it interacts with alcohol is no exception to this rule.
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What is Lithium?
Lithium – short for lithium carbonate – is a mood stabilizer that acts on the central nervous system to manage symptoms of mental health conditions such as schizophrenia, bipolar disorder, and depression. It is typically prescribed when antidepressants or other medications are not effective in treating the diagnosed condition.
Eskalith® is a brand-name lithium medication available in tablets, capsules, and liquid forms. Eskalith CR® and Lithobid® are the brand names of extended-release lithium tablets.
Common Lithium Side Effects
- Acne or rash
- Changes in the ability to taste
- Changes in appetite
- Constipation
- Depression
- Dry mouth
- Gas
- Headache
- Indigestion
- Itchy sensations
- Joint or muscle pain
- Noticeable weight changes
- Overactive salivary glands
- Pale skin
- Restlessness
- Sensitivity to cold temperatures
- Stomach Pain
- Swelling of the lips
- Thinning or brittle fingernails
- Thinning of hair or hair loss
Lithium Toxicity
Also known as an overdose, lithium toxicity is when the concentration of lithium in the bloodstream increases to the point of severe and possibly deadly consequences. Signs and symptoms of lithium toxicity include:
- Blackouts
- Confusion
- Crossed Eyes
- Diarrhea
- Dizziness or drowsiness
- Fainting
- Hallucinations
- Hand tremors
- Headache
- Irregular heartbeat
- Loss of coordination
- Muscle weakness
- Nausea or vomiting
- Painful, cold, or discolored fingers and toes
- Pounding noises inside the head
- Seizures
- Shortness of breath or chest tightness
- Swelling of the feet, ankles, or lower legs
- Unusual tiredness or weakness
- Vision changes
What Happens When You Mix Lithium & Alcohol
Although lithium toxicity is not common when taken as prescribed, mixing the medication with other substances can cause metabolic interactions that increase the risk of an overdose. Alcohol is one example of the substances that have negative interactions with lithium.
Lithium and alcohol are both substances that act on the central nervous system. When taken together, they not only increase the concentration of lithium in the blood and increase the risk of an overdose, but they also cancel out the mood-stabilizing effects of lithium. Other consequences of mixing alcohol and lithium include thyroid issues and a sodium imbalance. For these reasons, it is not safe to consume lithium and alcohol at the same time and patients who are prescribed this mood stabilizer are advised to avoid alcohol consumption.
Dual Diagnosis Treatment
About half of individuals who struggle with mental health issues also struggle with a co-occurring substance use disorder. These individuals are at an increased risk of overdose due to the potential effects of mixing their prescription medication with other substances, such as mixing lithium and alcohol. Additionally, dual diagnosis patients need assistance managing both of their conditions in a safe and effective manner. Someone who struggles with alcohol addiction and a mental health disorder may have a more difficult time overcoming substance abuse if they do not have their mental health in check. However, finding a medication regime to manage mental health without causing dangerous effects from alcohol consumption can be tricky.
Dual diagnosis treatment programs allow for clients with bipolar (or similar diagnosis) and an alcohol use disorder to receive treatment from a team of doctors that are experienced in creating safe and effective individualized treatment plans to meet each client’s unique needs.
FAQs About Mixing Lithium and Alcohol
Is it dangerous to drink while taking lithium?
Yes, it can be very risky. Lithium is a powerful medication used to balance moods, and it works best when the amount of water and salt in your body stays steady. Alcohol is a “diuretic,” which means it makes you lose water quickly through dehydration. When you get dehydrated, the level of lithium in your blood can rise to dangerous or even toxic levels.
How does alcohol change the way lithium feels?
Both lithium and alcohol can make you feel sleepy, dizzy, or a bit slow. When you mix them, these feelings become much stronger. You might find it very hard to concentrate, walk straight, or stay awake. This makes simple tasks like driving or even walking down stairs much more dangerous than usual.
Can drinking make my mood more unstable?
It often does. Most people take lithium to help keep their moods even. Alcohol is a depressant, which means it can trigger a “low” mood or make feelings of sadness much worse. It can also interfere with how well the medicine works to prevent “highs.” Mixing the two can lead to a “rollercoaster” of emotions that the lithium is trying to stop.
What are the signs of lithium toxicity?
If you have been drinking and notice that your hands are shaking more than usual, you feel very nauseous, or you are vomiting, these could be signs that there is too much lithium in your system. Other serious signs include blurred vision, slurred speech, or feeling very confused. If any of these happen, it is important to see a doctor right away.
Why does alcohol make me get “drunk” faster on lithium?
Lithium changes how your brain processes certain chemicals. Many people find that even a small amount of alcohol affects them much more than it used to. You might feel “intoxicated” after just half a drink. Because your judgment is impaired more quickly, it becomes harder to make safe choices about your health and your medicine.
Should I skip my lithium dose if I plan on drinking?
No, you should never skip your medicine without talking to your doctor. Stopping lithium suddenly can cause your mood symptoms to come back very quickly and very strongly. The safest choice is to talk honestly with your healthcare provider about your lifestyle so they can help you manage your treatment in a way that keeps your body and mind safe.
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