Quick Summary:
- Lithium withdrawal does not usually cause classic drug withdrawal symptoms, but stopping suddenly increases the risk of bipolar relapse.
- Symptoms can include anxiety, sleep problems, irritability, tremors, and increased urination.
- Withdrawal effects and relapse risk are highest within the first 1–2 weeks after stopping Lithium.
- Always consult a psychiatrist before changing or discontinuing Lithium treatment.
There are several things to know about safely coming off Lithium without experiencing withdrawal effects. Lithium is a medication used to treat bipolar disorder and mania. It works by acting on your central nervous system, although we don’t fully understand how it stabilizes mood. For some people, the medication may not be the right fit, or the side effects (like Lithium weight gain) might be affecting you too much. In either case, you might consider stopping the medication.
However, when discontinuing Lithium or any other drug, there can be potential risks due to a drastic alteration in body chemistry. While typical drug withdrawal symptoms aren’t as common with Lithium as with other medications, there is a real risk of bipolar episodes returning upon stopping the medication.
Learning what to expect is essential if you discontinue using Lithium. Symptoms can range from mild to severe, depending on how long you took the drug and how quickly you stopped taking it.
Keep reading as we explore the emotional and physical symptoms of Lithium withdrawal so you can safely stop taking your medication if needed.
Can Lithium Be Stopped Cold Turkey?
Lithium should not be stopped cold turkey without medical supervision, as abrupt discontinuation significantly increases the risk of manic or depressive relapse.
Research suggests that withdrawal from Lithium can be less intense than when stopping other drugs. However, there can still be side effects as your body adjusts to not having the medication in your system.
“Lithium should not be stopped cold turkey. Depending on the dosage, the kind of Lithium — immediate-release or extended-release — should be considered. Speak with your doctor before stopping this medication.”
– Talkspace psychiatrist Dr. Muhammad Munir
What Are the Symptoms of Lithium Withdrawal?
Lithium withdrawal symptoms are different from bipolar relapse. While some people experience physical or emotional discomfort after stopping Lithium, the most serious risk is the return of manic or depressive episodes related to bipolar disorder.
Lithium withdrawal symptoms can vary from person to person, but some people report experiencing sleep disturbance, increased anxiety, and irritability.
Physical symptoms
Physical symptoms of Lithium withdrawal can include:
- Increased and excessive urination
- Hand tremors
- Excessive thirst
- Weak muscles
- Dry mouth
It’s important to note that extended use of Lithium can result in Lithium toxicity, so staying on it long-term isn’t always the best course of maintenance treatment.
Emotional symptoms
In addition to the physical withdrawal symptoms of stopping Lithium, there are also emotional side effects to be aware of. One of the most significant points to be mindful of is that research shows stopping Lithium therapy suddenly increases the risk of returning episodes of depression or mania.
How Long Does Lithium Withdrawal Last?
Lithium withdrawal symptoms and relapse risk are most likely to occur within the first 1–2 weeks after discontinuation, though timelines vary by individual.
Research shows, the risk of mania returning after stopping Lithium treatment increased during the first couple of weeks. Everyone’s recovery timeline differs slightly, so patience is key.
“Duration of the medication and other medicines taken with Lithium are factors to be considered before getting off. Lithium discontinuation abruptly can cause withdrawal symptoms, like heightened anxiety, irritability, agitation, tremors.”
– Talkspace psychiatrist Dr. Muhammad Munir
When does Lithium withdrawal peak?
As mentioned, Lithium withdrawal can differ from other medication withdrawal symptoms. That said, remember that within the first week or 2 of discontinuing use, there’s a higher likelihood that manic episode recurrences might occur. Remember that a manic relapse is possible even if you just stop taking Lithium concentration for a few days.
More research must be done to understand the implications of Lithium withdrawal fully. The bottom line is that symptoms can vary significantly.
How to Cope with the Effects of Stopping Lithium
There are safer ways to stop taking this medication and avoid severe drug withdrawal from Lithium symptoms. Discuss with your doctor any risks of stopping Lithium treatment so that you know of any possible mental or physical side effects.
To help manage the effects of Lithium discontinuation, self care techniques like eating nutritiously, exercising, getting enough sleep, and avoiding illicit substances or alcohol can be beneficial.
Talk therapies like cognitive behavioral therapy (CBT) can help manage psychological symptoms associated with withdrawing from Lithium therapy.
If you struggle during this time, seek additional support from friends or family members willing to listen without judgment or criticism. You could also consider joining a support group where people meet and discuss mental health conditions like bipolar or depression that may have been managed using Lithium.
How Do I Safely Come Off Lithium?
Work closely with your doctor or psychiatrist to manage Lithium withdrawal effects. They can help you create a plan that minimizes symptoms as they monitor your progress and adjust medication dosages if necessary.
Before you decide to come off Lithium, you and your doctor should consider your current mental health status. If you saw improvement in your condition since starting Lithium maintenance treatment, your doctor might discuss tapering down the dosage instead of discontinuing it altogether.
Talk with a Licensed Psychiatrist
By consulting a psychiatrist, you can receive a personalized diagnosis and treatment plan to address your specific Lithium withdrawal symptoms. Talking with a qualified professional, like an online psychiatrist, about your symptoms and the challenges you’re facing in life can be instrumental in getting a new treatment plan in place that’s tailored to your needs. Whether you got your prescription for Lithium online or in person, Talkspace can help walk you through your options and help you find an alternative treatment online.
Sources:
- Balon R, Yeragani VK, Pohl RB, Gershon S. Lithium discontinuation: Withdrawal or relapse? Comprehensive Psychiatry. 1988;29(3):330-334. doi:10.1016/0010-440x(88)90056-9. https://pubmed.ncbi.nlm.nih.gov/2897893/#:~:text=Withdrawal%20symptoms%20following%20lithium%20discontinuation,a%20well%20documented%20serious%20complication. Accessed March 23, 2023.
- Christodoulou GN, Lykouras EP. Abrupt lithium discontinuation in manic-depressive patients. Acta Psychiatrica Scandinavica. 1982;65(5):310-314. doi:10.1111/j.1600-0447.1982.tb00852.x. https://pubmed.ncbi.nlm.nih.gov/6810653/. Accessed March 23, 2023.
- Faedda GL. Outcome after rapid vs gradual discontinuation of lithium treatment in bipolar disorders. Archives of General Psychiatry. 1993;50(6):448. doi:10.1001/archpsyc.1993.01820180046005. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496212. Accessed March 23, 2023.
- Verdoux H, Bourgeois M. Short-term sequelae of lithium discontinuation. Encephale. 1993;19(6):645-650. https://pubmed.ncbi.nlm.nih.gov/12404784/. Accessed March 23, 2023.
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