Lithium

Pronunciation: pronunciation varies by local usage.

Generic name
lithium carbonate
Drug class
Mood stabilizer (antimanic agent)
Form
Tablet
Route
Oral

Availability and supply rules vary by country

Trade names by country: United States · Canada

Australia: · Full directory

What lithium carbonate is and how it works

Lithium carbonate is an oral mood-stabilizing medicine used as monotherapy for bipolar I disorder. It is indicated for the treatment of acute manic and mixed episodes and for maintenance treatment in patients 7 years of age and older. (1)

Lithium has a narrow therapeutic index; serum lithium levels must be monitored closely. Toxicity can occur at concentrations close to therapeutic levels. Patients must maintain normal salt intake and adequate hydration (2,500–3,000 mL of fluid daily) to reduce the risk of toxicity.

What lithium carbonate is used for

Bipolar I disorder

Lithium carbonate is indicated as mood-stabilizing monotherapy for the treatment of acute manic and mixed episodes and for maintenance treatment in patients 7 years of age and older. (1)

Before taking lithium carbonate

Do not take / not appropriate for

  • Tell your prescriber if you have a known hypersensitivity to any inactive ingredient in the product; the prescriber will determine whether lithium is appropriate for you. Check the specific product label for a list of ingredients. (all products) (1)
  • Tell your prescriber if you have severe kidney impairment (creatinine clearance less than 30 mL/min); the label advises avoiding lithium in this situation, and your prescriber will confirm whether it is appropriate for you. (all indications) (1)

Tell your clinician about

  • Any kidney problems or history of kidney disease.
  • Thyroid disorders or any condition that affects your sodium balance.
  • All medications you are taking, especially diuretics (water pills), NSAIDs (e.g., ibuprofen, naproxen), ACE inhibitors, ARBs, metronidazole, SSRIs, SNRIs, MAOIs, triptans, tramadol, St. John's Wort, or antipsychotics.
  • If you are pregnant, planning to become pregnant, or breastfeeding.
  • Symptoms of dehydration (excessive sweating, diarrhea) or infection.
  • If you are on a salt-restricted diet or have a condition that causes sodium loss.
(1)

How to take lithium carbonate

  • Take lithium carbonate exactly as prescribed by your healthcare provider.
  • Any change to the dose, treatment continuation, or product switch is decided by your clinician, as unsupervised changes can worsen your condition or cause toxicity.
  • Maintain a normal salt intake and drink 2,500–3,000 mL of fluid daily, unless your doctor advises otherwise.
  • Your doctor will regularly check your serum lithium levels. The first blood test is usually drawn 12 hours after the last dose, after 3 days of treatment, and then periodically until you are stable.
(1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)

Missed dose

Do not take an extra dose to make up for a missed one, because of the risk of toxicity. Contact your healthcare provider for guidance on a missed dose.

Overdose

If you suspect an overdose or experience symptoms of lithium toxicity, seek emergency medical attention immediately. Mild toxicity symptoms include fine tremor, lightheadedness, and weakness; moderate toxicity includes drowsiness, muscle twitching, blurred vision, and unsteady gait; severe toxicity can cause seizures, coma, and death. Severe toxicity (serum lithium level 3 mEq/L or higher) may require gastric lavage, hemodialysis, and supportive care. Contact the Poison Control Center at 1-800-222-1222 (US) for guidance. (1)

Side effects

Lithium has a narrow therapeutic window. Side effects are common and can be related to serum levels. The most frequently reported adverse effects are fine hand tremor, polyuria (excessive urination), mild thirst, nausea, and general discomfort during initial treatment. Children may experience additional effects.

Fine hand tremor

What to notice: Noticeable shaking of the hands.

What to do: Tell your treatment team if the tremor is bothersome, worsening, or interferes with daily activities. (1)

Polyuria (frequent urination) and mild thirst

What to notice: Increased urine output and a persistent need to drink fluids.

What to do: Maintain adequate fluid intake. Report if the thirst is excessive or urination is disruptive or accompanied by other symptoms. (1)

Nausea and general discomfort

What to notice: Mild nausea, stomach upset, or a feeling of being unwell.

What to do: These symptoms often improve with time. If they persist or are severe, discuss with your clinician. (1)

Pediatric adverse effects (7–17 years)

What to notice: In addition to the above, nausea/vomiting, polyuria, thyroid abnormalities, tremor, thirst, dizziness, rash, unsteady gait, decreased appetite, and blurred vision are common.

What to do: Report any new or worsening symptoms to the prescriber. (1)

Symptoms of lithium toxicity (mild to moderate)

What to notice: Drowsiness, muscle twitching, blurred vision, unsteady gait (ataxia), worsening tremor, or lightheadedness.

What to do: Contact your clinician immediately; you may need a dose adjustment or a blood test. (1)

Serotonin syndrome

What to notice: Not established from the sources reviewed: a detailed patient-facing symptom list was not established in the sources reviewed for this page beyond the named risk.

What to do: Seek urgent medical attention, especially if you are also taking other serotonergic drugs. (1)

Neuroleptic malignant syndrome-like symptoms

What to notice: Not established from the sources reviewed: a detailed patient-facing symptom list was not established in the sources reviewed for this page beyond the named risk. Particularly relevant when taking an antipsychotic.

What to do: Seek emergency medical evaluation. (1)

Serious warnings

Lithium toxicity — emergency

Symptoms: Mild: fine tremor, lightheadedness, weakness. Moderate: drowsiness, muscle twitching, blurred vision, unsteady gait. Severe: seizures, coma, death.

Action: Seek emergency medical help immediately if you experience moderate or severe symptoms; the clinician providing urgent assessment will advise on ongoing lithium treatment. Lithium toxicity can occur at concentrations close to therapeutic levels. (1)

Serotonin syndrome — emergency

Symptoms: Not established from the sources reviewed: a detailed patient-facing symptom list was not established in the sources reviewed for this page beyond the named risk.

Action: Seek immediate medical attention. This risk is higher if you are taking SSRIs, SNRIs, MAOIs, triptans, tramadol, or St. John's Wort. (1)

Neuroleptic malignant syndrome / encephalopathic syndrome — emergency

Symptoms: Not established from the sources reviewed: a detailed patient-facing symptom list was not established in the sources reviewed for this page beyond the named risk. Reports have occurred with concurrent antipsychotic use.

Action: Seek emergency medical evaluation. (1)

Dehydration and sodium depletion — warning

Symptoms: Excessive sweating or diarrhea, or signs of toxicity (tremor, weakness, drowsiness).

Action: Maintain normal salt intake and drink 2,500–3,000 mL of fluid daily. Contact your clinician about any illness that affects your ability to do this. (1)

Interactions

Medicine or testEffectAction
Diuretics, NSAIDs, ACE inhibitors, ARBs, metronidazoleThese medications can increase serum lithium concentrations, raising the risk of toxicity.Your doctor will need to monitor lithium levels more frequently and may adjust the dose. Tell your clinician before starting or stopping any of these drugs so they can manage this. (1)
Serotonergic agents (SSRIs, SNRIs, MAOIs, triptans, tramadol, St. John's Wort)Concomitant use increases the risk of serotonin syndrome.Be alert for symptoms of serotonin syndrome and seek immediate medical help if they occur. Inform your prescriber of all serotonergic medications you are taking. (1)
AntipsychoticsThere have been reports of an encephalopathic syndrome and neuroleptic malignant syndrome with concurrent use.Report any new neurological symptoms promptly. Your doctor will assess the combined treatment. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Children and adolescents (7 years and older)

Lithium is approved for patients 7 years of age and older. Dosing is weight-based: for those over 30 kg, starting dose is 300 mg three times daily; for those 20–30 kg, starting dose is 300 mg twice daily, titrated weekly. Serum levels are monitored as in adults. Children may have additional adverse effects such as nausea/vomiting, thyroid abnormalities, dizziness, rash, ataxia, decreased appetite, and blurred vision. (1)

Pregnancy

Lithium may cause fetal harm. If you are pregnant or planning pregnancy, discuss the risks and benefits with your doctor. Serum lithium levels must be monitored closely during pregnancy. Your clinician will determine any treatment changes around delivery and postpartum. (1)

Breastfeeding

Breastfeeding is not recommended during treatment with lithium. Discuss alternative feeding options with your healthcare provider. (1)

People with kidney impairment

Mild-to-moderate kidney impairment (creatinine clearance 30–89 mL/min) requires lower starting doses and slow titration. Severe kidney impairment (creatinine clearance less than 30 mL/min): lithium should be avoided; the prescriber determines whether it is appropriate. (1)

People at risk of dehydration or sodium depletion

Conditions that cause excessive sweating, diarrhea, vomiting, or fever can increase the risk of lithium toxicity. Maintain normal salt and fluid intake (2,500–3,000 mL daily) unless instructed otherwise. Notify your doctor during illness or if you cannot keep fluids down. (1)

Monitoring

Before starting

  • Assess kidney function, electrolytes, thyroid function, and vital signs.
  • Verify that the patient is 7 years of age or older.
  • Evaluate for conditions that alter sodium balance, interacting medications, and pregnancy status.
  • Ensure that facilities for prompt and accurate serum lithium determinations are available.

During treatment

  • Obtain a serum lithium level 12 hours after the last dose, after 3 days of treatment, then regularly until stable. Recheck after any dose change, after starting or stopping interacting medications, after changes in strenuous physical activity, and during concomitant illness.
  • Monitor thyroid function every 3 months initially, then every 6–12 months. Monitor calcium levels regularly.
  • Reassess kidney function periodically and watch for signs of lithium toxicity.
(1)

Storage

Store lithium carbonate tablets at 20°C to 25°C (68°F to 77°F) in a tight, child-resistant, moisture-protected container.

Study the drug class: Mood stabilisers

Professional information

Clinician-facing context only. Use the current local prescribing information and clinical guidelines. Lithium dosing must be individualized based on serum levels, renal function, and clinical response.

United States

Indication: Bipolar I disorder – acute manic/mixed episodes and maintenance

Dose summary: Adults and pediatric patients >30 kg: starting dose 300 mg three times daily. Target serum level for acute treatment: 0.8–1.2 mEq/L; for maintenance: 0.8–1.0 mEq/L. Pediatric patients 20–30 kg: starting dose 300 mg twice daily, titrated by 300 mg weekly. Serum lithium levels should be obtained 12 hours after the last oral dose, after 3 days of treatment, then regularly until stable.

Renal context: Mild-to-moderate impairment (CrCl 30–89 mL/min): use lower doses and titrate slowly. Severe impairment (CrCl <30 mL/min): avoid use. (1)

Overdose note

Overdose and toxicity management, including any decision about ongoing lithium treatment, requires urgent clinician-directed assessment. Severe toxicity (serum level ≥3 mEq/L) is managed with gastric lavage, hemodialysis (treatment of choice), and supportive care. Contact Poison Control (1-800-222-1222 in the US) for guidance. (1)

Frequently asked questions

What should I do if I miss a dose of lithium?

Do not take an extra dose to make up for the missed one because of the risk of toxicity. Contact your healthcare provider for guidance on a missed dose. (1)

How often do I need blood tests while taking lithium?

A serum lithium level is checked after 3 days of treatment, then regularly until you are stable. After that, levels are monitored after any dose change, when starting or stopping other medications, during illness, or after changes in physical activity. Thyroid function is checked every 3 months initially, then every 6–12 months, and calcium levels are monitored regularly. (1)

Can I take lithium if I am pregnant or breastfeeding?

Lithium may cause fetal harm. If you are pregnant or planning pregnancy, discuss the risks and benefits with your doctor. Your dose may need to be adjusted near delivery. Breastfeeding is not recommended during lithium treatment. (1)

Why do I need to drink plenty of fluids and eat a normal amount of salt?

Maintaining adequate hydration and normal salt intake helps prevent lithium toxicity. This is especially important if you are sweating excessively, have diarrhea, vomiting, or fever. Aim for 2,500–3,000 mL of fluid daily unless your doctor advises otherwise. (1)

What is the generic name of Lithium?

The generic name is lithium carbonate. (1)

What class of drug is lithium carbonate?

Lithium is classed as: Mood stabilizer (antimanic agent). (1)

References

  1. LITHIUM CARBONATE tablet prescribing informationU.S. Food and Drug Administration · United States · dated Not specified in research notes · accessed 2026-08-05 · source 1
  2. LITHIUM CARBONATE CAPSULE [COUPLER LLC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
  3. Lithium — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
  4. lithium carbonate — FDA approval record (Drugs@FDA ANDA090702)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
  5. lithium carbonate — RxNorm normalized drug concept (RXCUI 42351)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5

Brand names by country

Single-ingredient lithium carbonate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Lithium carbonicum6 [hp_C], 30 [hp_C]/30[hp_C], 12 [hp_C], 1 [hp_M], 200 [kp_C]/200[kp_C], 30 [hp_C], 100 [hp_C], 200 [hp_C] · hahnemann laboratories, inc.
  • Lithium Phosphoricum200 [hp_C], 12 [hp_C], 500 [hp_C], 30 [hp_C], 10 [hp_M], 1 [hp_M], 1 [hp_Q], 6 [hp_C] · hahnemann laboratories, inc.
  • Lithium Metallicum100 [hp_C], 10 [hp_M], 30 [hp_C], 6 [hp_C], 1 [hp_Q], 200 [hp_C], 1 [hp_M], 500 [hp_C] · hahnemann laboratories, inc.
  • Lithium Bromatum1 [hp_Q], 12 [hp_C], 500 [hp_C], 1 [hp_M], 100 [hp_C], 200 [hp_C], 6 [hp_C], 30 [hp_C] · hahnemann laboratories, inc.
  • Lithium Sulphuratum1 [hp_M], 12 [hp_C], 200 [hp_C], 6 [hp_C], 100 [hp_C], 30 [hp_C], 1 [hp_Q], 500 [hp_C] · hahnemann laboratories, inc.
  • Lithium Muriaticum12 [hp_C], 1 [hp_Q], 1 [hp_M], 500 [hp_C], 30 [hp_C], 100 [hp_C], 200 [hp_C], 6 [hp_C] · hahnemann laboratories, inc.
  • BM Lithium chloride (Lith Mur)6 [hp_X]/60mg · bm private limited
  • Lithium Carb12 [hp_X]/mL · energique, inc.
  • Bestmade Natural Products Lithium Chloride (Lith Mur)6 [hp_X]/6[hp_X] · bestmade natural products
  • LITHOBID300 mg · ani pharmaceuticals, inc.

Canada

  • CARBOLITH
  • LITHANE
  • LITHMAX
View brands in additional countries.