Lithium has been used to treat bipolar disorder for more than 60 years. Lithium can even out mood swings in either direction and it is not only limited to the treatment of acute manic attacks.
Lithium generally decreases manic symptoms in about 7-10 days, but sometimes it may take months for the symptoms to stabilize. In the first few days, one may need anti-psychotic or anti-depressant medication to control the symptoms until the lithium takes effect.
Some lucky individuals only get one episode of bipolar attack and may never get another attack or may remain free of symptoms for many years. However, the majority of individuals develop more then one episode and require maintenance treatments with lithium.
Some people do respond to lithium maintenance treatments, whereas others continue to develop varying degrees of mood swings that may lessen in severity with time. However, a fair number of individuals with manic depression do not respond at all to lithium. Who will respond and who won’t respond to lithium is difficult to predict.
All individuals on lithium also require regular blood tests. The lithium levels must be checked regularly. If the serum levels are not adequate, the symptoms of mania may not resolve. If too much lithium is on board, side effects may occur. Lithium is a difficult drug because the range between effective and toxic is very narrow.
Lithium levels are routinely checked at the beginning of treatment to determine the best lithium dosage for the patient. Once a person is stable and on maintenance dosage, lithium levels should be checked every few months. How much lithium a person needs to take may vary over time, depending on the severity of the symptoms, use of other medications, status of the kidneys and overall physical health.
Lithium does have a few side effects like nausea, drowsiness, fine hand tremors, weight gain, increased thirst and urination. These side effects generally appear at the start of therapy and disappear with time. However, the tremors may persist. Because lithium also interferes with the thyroid gland, most individuals are also placed on thyroid hormone at the same time.
Lithium is generally a safe drug when the levels are properly monitored. It does work well initially in most individuals with bipolar disorder, but with time, it fails to work or causes intolerable side effects in at last 40-70 percent of individuals.