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Lithium Carbonate (Lithium Carbonate) - Side Effects and Adverse Reactions



The occurrence and severity of adverse reactions are generally directly related to serum lithium concentrations as well as to individual patient sensitivity to lithium, and generally occur more frequently and with greater severity at higher concentrations.

Adverse reactions may be encountered at serum lithium levels below 1.5 mEq/L. Mild to moderate adverse reactions may occur at levels from 1.5 to 2.5 mEq/L, and moderate to severe reactions may be seen at levels of 2.0 mEq/L and above.

Fine hand tremor, polyuna and mild thirst may occur during initial therapy for the acute manic phase, and may persist throughout treatment. Transient and mild nausea and general discomfort may also appear during the first few days of lithium administration.

These side effects usually subside with continued treatment or a temporary reduction or cessation of dosage. If persistent, cessation of lithium therapy may be required.

Diarrhea, vomiting, drowsiness, muscular weakness and lack of coordination may be early signs of lithium intoxication, and can occur at lithium levels below 2.0 mEq/L. At higher levels, ataxia, giddiness, tinnitus, blurred vision and a large output of dilute urine may be seen. Serum lithium levels above 3.0 mEq/L may produce a complex clinical picture, involving multiple organs and organ systems. Serum lithium levels should not be permitted to exceed 2.0 mEq/L during the acute treatment phase.

The following reactions have been reported and appear to be related to serum lithium levels, including levels within the therapeutic range:

Neuromuscular/Central Nervous System - tremor, muscle hyperirritability (fasciculations, twitching, clonic movements of whole limbs), hypertonicity, ataxia, choreoathetotic movements, hyperactive deep tendon reflex, extrapyramidal symptoms including acute dystonia, cogwheel rigidity, blackout spells, epileptiform seizures, slurred speech, dizziness, vertigo, downbeat nystagmus, incontinence of urine or feces, somnolence, psychomotor retardation, restlessness, confusion, stupor, coma, tongue movements, tics, tinnitus; hallucinations, poor memory, slowed intellectual functioning, startled response, worsening of organic brain syndromes, myasthenia gravis (rarely);

Cardiovascular – cardiac arrhythmia, hypotension, peripheral circulatory collapse, bradycardia, sinus node dysfunction with severe bradycardia (which may result in syncope);

Gastrointestinal - anorexia, nausea, vomiting, diarrhea, gastritis, salivary gland swelling, abdominal pain, excessive salivation, flatulence, indigestion;

Genitourinary - glycosuria, decreased creatinine clearance, albuminuria, oliguria, and symptoms of nephrogenic diabetes insipidus including polyuria, thirst and polydipsia;

Dermatologic - drying and thinning of hair, alopecia, anesthesia of skin, acne, chronic folliculitis, xerosis cutis, psoriasis or its exacerbation, generalized pruritus with or without, rash, cutaneous ulcers, angioedema;

Autonomic - blurred vision, dry mouth, impotence/sexual dysfunction;

Thyroid Abnormalities - euthyroid goiter and/or hypothyroidism (including myxedema) accompanied by lower T3 and T4. I131 uptake may be elevated. (See PRECAUTIONS.) Paradoxically, rare cases of hyperthyroidism have been reported;

EEG Changes - diffuse slowing, widening of the frequency spectrum, potentiation and disorganization of background rhythm;

EKG Changes -reversible flattening, isoelectricity or inversion of T-waves;

Miscellaneous - fatigue, lethargy, transient scotomata, exophthalmos, dehydration, weight loss, leukocytosis, headache, transient hyperglycemia, hypercalcemia, hyperparathyroidism, excessive weight gain, edematous swelling of ankles or wrists, metallic taste, dysgeusia/taste distortion, salty taste, thirst, swollen lips, tightness in chest, swollen and/or painful joints, fever, polyarthralgia, dental caries.

Some reports of nephrogenic diabetes insipidus, hyperparathyroidism and hypothyroidism which persist after lithium discontinuation have been received.

A few reports have been received of the development of painful discoloration of fingers and toes and coldness of the extremities within one day of the starting of treatment with lithium. The mechanism through which these symptoms (resembling Raynaud's syndrome) developed is not known. Recovery followed discontinuance.

Cases of pseudotumor cerebri (increased intracranial pressure and papilledema) have been reported with lithium use. If undetected, this condition may result in enlargement of the blind spot, constriction of visual fields and eventual blindness due to optic atrophy. Lithium should be discontinued, if clinically possible, if this syndrome occurs.


Below is a sample of reports where side effects / adverse reactions may be related to Lithium Carbonate. The information is not vetted and should not be considered as verified clinical evidence.

Possible Lithium Carbonate side effects / adverse reactions in 58 year old male

Reported by a pharmacist from United States on 2011-10-03

Patient: 58 year old male

Reactions: Antipsychotic Drug Level Increased, Blood Urea Increased, Drug Interaction, Asthenia, Blood Creatinine Increased, Lethargy

Adverse event resulted in: hospitalization

Suspect drug(s):

Lithium Carbonate
    Start date: 2003-10-30
    End date: 2010-04-18


Possible Lithium Carbonate side effects / adverse reactions in 32 year old male

Reported by a health professional (non-physician/pharmacist) from United Kingdom on 2011-10-07

Patient: 32 year old male

Reactions: OFF Label USE, Renal Failure Acute

Suspect drug(s):
    Dosage: 120.00-mg/m2 / intravenous (not otherwise specified)
    Indication: Testicular Malignant Teratoma Stage III
    Start date: 2011-01-01

    Indication: Testicular Malignant Teratoma Stage III
    Start date: 2011-01-01

    Dosage: 240.00-mg/m2 / oral
    Administration route: Oral
    Indication: Testicular Malignant Teratoma Stage III
    End date: 2011-01-01

Lithium Carbonate
    Indication: Product Used FOR Unknown Indication

Possible Lithium Carbonate side effects / adverse reactions in 69 year old female

Reported by a consumer/non-health professional from United States on 2011-10-10

Patient: 69 year old female

Reactions: Malaise, Drug Ineffective

Suspect drug(s):
Lithium Carbonate
    Administration route: Oral
    Indication: Bipolar I Disorder
    Start date: 2011-09-01
    End date: 2011-09-01

Lithium Carbonate
    Dosage: 450 mg
    Administration route: Oral
    Start date: 2011-09-19
    End date: 2011-09-19

Other drugs received by patient: Pradaxa; Lamictal; Lipitor; Cardizem

See index of all Lithium Carbonate side effect reports >>

Drug label data at the top of this Page last updated: 2008-07-31

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