Drug Interactions

Lithium and Alcohol: Can You Drink Alcohol On Lithium?

Lithium has been used since 1949 to stabilise mood in bipolar disorder and manic disorders. Drinking alcohol has been found to alter the movement of lithium through the body and brain, which may increase the risks of taking lithium. Therefore, drinking alcohol while taking lithium should be consulted with a healthcare professional. In this blog, we will cover some of the indications and contraindications of taking lithium, as well as whether you can drink alcohol while taking lithium.
Klara Hatinova

Klara Hatinova

Klara is postgraduate researcher in experimental psychology at the
University of Oxford.

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Overview

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What is Lithium?

Lithium is an affordable mood stabiliser primarily used in the treatment of bipolar disorder, first described in 1949 [1]. Additionally, lithium is known to reduce suicidality and can be naturally found in some water supplies, where it reduces psychiatric illness and suicide rates [2]. More recently, lithium has been investigated as a potential treatment for Alzheimer's disease, where it could tackle tau and amyloid pathology [3].

Despite the wide-ranging benefits, lithium has a narrow therapeutic window, making it easy to overdose and experience toxic effects [4]. The side effects of therapeutic doses are also worth weighing against the mood-stabilising benefits, including weight gain, dry mouth or constipation [5].

The usual form of taking lithium is through tablets, which are taken several times a day [5].

People Also Ask

Lithium levels should be monitored regularly to ensure safety and effectiveness of treatment. Guidelines recommend monitoring lithium levels every 3 to 6 months [1]. However, studies have shown that adherence to these guidelines is often suboptimal, with monitoring occurring less frequently than recommended [2], [3]. Regular monitoring is important to prevent harm and optimize treatment outcomes for patients using lithium [2].

Yes, there are alternative forms of lithium administration. While the most common form is oral lithium carbonate or lithium citrate, there are other routes of administration available. One alternative is intravenous administration, which may be used in certain situations such as severe toxicity or when oral administration is not possible. Another alternative is rectal administration, where lithium can be administered as a suppository. However, it's important to note that these alternative forms of administration are typically used in specific circumstances and under medical supervision. [2], [1]

What are the side effects Lithium?

Taking lithium can have side effects ranging from mild to severe.

Mild side effects can include restlessness, small tremors, increased thirst, loss of appetite, stomach pain, gas, indigestion, weight gain or loss, dry mouth, excessive saliva in the mouth, change in the ability to taste food, swollen lips, acne, hair loss, unusual discomfort in cold temperatures, constipation, depression, joint or muscle pain, paleness, thin, brittle fingernails or hair, itching, and rash [5]. These side effects are highly individual and worth looking out for.

More severe side effects can include increased tiredness or weakness, dyskinesia or dystonia, blackouts, seizures, fainting, dizziness or lightheadedness, heartbeat abnormalities, shortness of breath, tightness in the chest, confusion, hallucinations, crossed eyes, problems with blood circulation in the fingers and toes, pounding noises inside the head, headaches and swelling of the feet, ankles, or lower legs [5].

To avoid these side effects, you must only take the prescribed dose.

Can I drink alcohol while taking lithium?

The interaction between alcohol and lithium is a complex issue. Because of this, it is advised not to drink alcohol while taking lithium, as alcohol may worsen the symptoms of your mental illness.

What will happen if I take alcohol while taking lithium?

First and foremost, alcohol can increase the levels of lithium in your blood, which is dangerous given the low therapeutic index of lithium [6]

You may experience disruption of your bedtime and natural wake-up time. This is because alcohol and lithium have opposing effects on circadian rhythms - lithium extends your natural circadian cycle, whereas alcohol reduces the length of your natural circadian cycle [7]. In animal studies, lithium increased the tendency to become addicted to alcohol and subsequently increased risks associated with alcohol withdrawal [8]. In another study, lithium ameliorated some of the cognitive effects of alcohol, which may encourage individuals to continue drinking [9, 10, 11]. The extent to which lithium counteracts alcohol intoxication was found to be dependent on individual factors [12], demonstrating the importance of seeking direct medical attention.

What should I do if I drank alcohol while taking lithium?

If you have consumed alcohol while on lithium, it's important not to panic. It is vital to be aware of the potential interactions and effects. This includes increased levels of lithium in the blood and body, which can lead to lithium toxicity [6]. If you have drunk alcohol while on lithium, you should monitor your symptoms and seek medical attention immediately if you experience any unusual symptoms. In the future, it's advisable to discuss your alcohol consumption with your healthcare provider.

Interactions of Lithium

Lithium also interacts with several other substances. These interactions can be both desirable and undesirable.

Desirable Lithium-Drug Interactions

Lithium's most prominent desirable interaction is with tryptophan, an essential amino acid that can be converted to serotonin. Researchers found that supplementing lithium treatment with tryptophan improved manic symptoms in schizophrenia [13].

Lithium has been favourable combined with anticonvulsant (anti-seizure) drugs, facilitating significant clinical improvements in bipolar patients. Nonetheless, this drug combination also increased the prevalence of side effects and reduced the willingness of patients to continue taking both medications [14].

Undesirable Lithium-Drug Interactions

Lithium interacts with diuretics, a class of drugs affecting the excretion of waste and water from the body in the kidneys. As lithium has a narrow therapeutic window, diuretics can improve the clearance of lithium from the blood but also increase its accumulation in the body. One such diuretic is thiazide, which increases lithium in the blood by 25% [15].

Nonsteroidal anti-inflammatory drugs (NSAIDs) and cardiovascular drugs have also been associated with lithium toxicity [15, 16]. On the other hand, the combination of lithium with certain psychotropic drugs can significantly decrease the lithium ratio in the blood and thereby reduce its therapeutic effect. This mechanism in humans is yet to be verified [17].

To summarise, it is not advised to drink alcohol while taking lithium due to the increased risk of lithium toxicity and increased risk of side effects. You should always consult your medical provider regarding any additional substances, supplements or drugs you intend to take while taking lithium.

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Klara Hatinova

Klara Hatinova

Klara is a postgraduate researcher in experimental psychology at the University of Oxford. She has worked across a spectrum of hot topics in neuroscience, including her current project measuring reinforcement learning strategies in Parkinson’s disease. Previously, she studied the efficacy of psilocybin as a therapy for critical mental health conditions and examined molecular circadian rhythms of migraine disorders. She completed her undergraduate degree in Neuroscience at the University of Glasgow and participated in a year abroad at the University of California, where she worked on a clinical trial for spinal cord injury.