Lithium Withdrawal: What to Know

Prophylactic lithium was abruptly discontinued (under double-blind conditions and using placebo) in 18 manic-depressive patients for 15 days. Following lithium withdrawal tremor of hands, polyuria, general muscular weakness, polydipsia and dryness of mouth were significantly reduced. No withdrawal symptoms were noted. Three patients relapsed within 4 days of lithium discontinuation. The implications of these results are explored, and the likelihood that lithium could cause a rebound phenomenon is taken into account.

Lithium is a mood stabilizer often used to treat bipolar disorder. It works by helping to regulate the chemicals in the brain that are involved in mood swings. While lithium is generally safe and effective there are some potential side effects, including withdrawal symptoms when you stop taking it.

Can Lithium Cause Withdrawal Effects?

The short answer is that lithium does not typically cause withdrawal symptoms in the same way that some other medications, such as antidepressants, do. However, stopping lithium abruptly can lead to a recurrence of bipolar disorder symptoms, which can be just as disruptive and distressing.

What Happens When You Stop Taking Lithium Abruptly?

When you stop taking lithium suddenly, your brain chemistry can become unbalanced, which can lead to a return of bipolar disorder symptoms. These symptoms can include:

Mania: This is a state of abnormally elevated mood, energy, and activity. People experiencing mania may feel euphoric, talkative, and impulsive.
Hypomania: This is a milder form of mania that can still cause significant problems. People experiencing hypomania may feel irritable, restless, and have difficulty concentrating.
Depression: This is a state of low mood, loss of interest, and fatigue. People experiencing depression may also have changes in appetite, sleep, and concentration.

The risk of experiencing a recurrence of bipolar disorder symptoms is highest in the first few weeks after stopping lithium. The risk may be even higher than the risk of naturally occurring manic or depressive episodes.

How to Stop Taking Lithium Safely

If you are considering stopping lithium it is important to do so under the supervision of a doctor. A doctor can help you to taper off the medication slowly and safely, which can help to reduce the risk of withdrawal symptoms and a recurrence of bipolar disorder symptoms.

Here are some tips for stopping lithium safely:

Talk to your doctor. Before you stop taking lithium, it is important to talk to your doctor about the risks and benefits. Your doctor can help you to develop a plan for tapering off the medication safely.
Taper off the medication slowly. Do not stop taking lithium abruptly. Your doctor will likely recommend tapering off the medication gradually over a period of weeks or months.
Monitor your symptoms. Pay attention to your mood and energy levels. If you notice any changes, talk to your doctor.
Get support. If you are struggling to stop taking lithium, there are resources available to help you. You can talk to your doctor, a therapist, or a support group.

Next Steps

If you have been taking lithium for bipolar disorder and you want to stop, it is important to reach out to a doctor first With the right guidance, you can learn how to taper off your medication slowly and safely

And if you’re interested in exploring more resources that might make the transition smoother, here are a few to consider checking out:

The mental health charity Mind has a resource page for people who are considering tapering off medication.
The National Institute of Mental Health has a page full of digital resources for people living with bipolar disorder.
The Depression and Bipolar Support Alliance have a search tool that can help you find bipolar disorder support groups near you.

Remember, you are not alone. There are many people who have successfully stopped taking lithium and are living well with bipolar disorder. With the right support, you can do the same.

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FAQ

What happens if I stop taking lithium suddenly?

Relapses can occur even when lithium is stopped only for a few days. Abrupt discontinuation of lithium seems to be associated with an increased risk of recurrence. The pathophysiology of this rebound effect is still unknown. In clinical practice, lithium discontinuation has to be gradual when possible.

How long does it take lithium to completely leave your system?

Lithium can stay in your body for a long time. It typically takes about 18 to 36 hours for the body to clear half of the medication. However, lithium may take over a week to be fully cleared out of most people’s systems.

What happens if I miss a few days of lithium?

Missing doses of lithium may increase your risk for a relapse in your mood symptoms. Do not stop taking lithium or change your dose without talking to with your health care provider first. In order for lithium to work properly, it should be taken every day as ordered by your health care provider.

Will I lose weight if I stop taking lithium?

Does Lithium Weight Gain Go Away? Weight gain can result from taking Lithium, but it’s not necessarily permanent. In some cases, the weight gain from Lithium can be lost after stopping treatment. Studies show that Lithium weight gain seems to peak within the first 2 years of taking this psychiatric medication.