Lithium has a narrow safety margin. Regular blood tests to check your lithium level are not optional, they are what keeps you safe on this medicine. Your doctor sets the monitoring schedule.
What it treats
Which conditions is Lithium Carbonate used for?
Overview
What is Lithium Carbonate?
Lithium has been used in psychiatry since the late 1940s and remains the most evidence-backed long-term treatment for bipolar disorder. No other mood stabiliser has a comparable body of evidence spanning more than seven decades.
Beyond stabilising mood cycles, lithium is the only psychiatric medicine with strong evidence for reducing the risk of suicide in people with mood disorders. This benefit, combined with its effectiveness for both mania prevention and depression prevention, makes it uniquely important.
It is listed in Kenya's Essential Medicines List 2023. Its affordability makes it among the most cost-accessible mood stabilisers in the public health system. However, it requires regular blood tests to monitor its level in the body. This is not a formality but a genuine safety measure, because the gap between a helpful level and a harmful one is relatively small.
How it works
What does it do in the brain?
Formulations in Kenya
How is it available?
Availability across Africa
Where is it available in Africa and what is it called?
| Country | Common Brand Name(s) | Notes |
|---|---|---|
| Uganda | Priadel, Lithium (generic) | Available at Butabika Hospital; blood monitoring required, which limits rural access. |
| Tanzania | Lithium Carbonate (generic) | Available at Muhimbili National Hospital; requires laboratory support for level monitoring. |
| Ethiopia | Lithium Carbonate (generic) | Available at Amanuel Mental Specialised Hospital and referral hospitals with lab capacity. |
| South Africa | Priadel, Camcolit, Lithium (generic) | Widely available in public and private sectors; blood level monitoring routinely available at public clinics. |
| Nigeria | Priadel, Lithium (generic) | Available at federal teaching hospitals; monitoring infrastructure determines access. |
| Ghana | Lithium Carbonate (generic) | Available at Korle-Bu and Accra Psychiatric Hospital with monitoring support. |
| Rwanda | Lithium Carbonate (generic) | Available at King Faisal Hospital with laboratory monitoring. |
Side effects
What might you feel while taking it?
These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.
- Fine tremor of the hands, very common and usually mild
- Passing more urine and feeling thirstier than usual
- Nausea or loose stools, especially at the start, taking lithium with food helps
- Weight gain
- Mild mental slowing or difficulty concentrating at higher blood levels
- The thyroid gland can slow down over time. Your doctor will monitor this
- Swelling of the ankles or fingers
- Signs that lithium levels may have risen too high: coarse uncontrollable tremor, severe nausea and vomiting, diarrhoea, dizziness, slurred speech, confusion, or muscle twitching. Seek emergency medical care immediately if these occur
- Dehydration from any cause, illness, excessive sweating, not drinking enough water, can raise lithium to harmful levels very quickly. Take this risk seriously.
Who should not take it
Important warnings before starting
- Significant kidney disease (your doctor will check kidney function before starting)
- Significant heart disease affecting the heart's rhythm
- Situations causing severe dehydration or very low salt levels
Special care needed
Situations that need extra attention
- Drink adequate water every day. Dehydration raises your lithium level
- During fever, vomiting, diarrhoea, or heavy sweating, contact your doctor
- Do not significantly change your diet by eating much less salt
- Elderly patients are more sensitive to lithium and require more frequent monitoring
- Tell your doctor about any new medicines before taking them
Lithium requires careful specialist management during pregnancy. The risks of untreated severe bipolar disorder must be weighed with a specialist. Do not start, stop, or adjust without medical guidance.
Lithium levels in breast milk can be significant. Specialist guidance is required before breastfeeding while taking lithium.
Other medicines
Medicines and substances that can interact with it
- Anti-inflammatory medicines (ibuprofen, diclofenac): Can raise lithium levels considerably, increasing the risk of toxicity. Paracetamol is a safer choice for pain.
- Blood pressure medicines, particularly ACE inhibitors and ARBs: Can also raise lithium levels. Close monitoring is needed if both medicines are required.
- Diuretics (water tablets): Can significantly affect lithium levels. Always tell your prescriber about any water tablets.
- Salt intake changes: Reducing salt in your diet substantially can raise lithium levels. Do not start a very low-salt diet without telling your doctor.
Tests and follow-up
What your doctor will monitor
- Blood lithium levels checked after starting, after dose changes, and regularly, typically every three to six months when stable. Sample taken approximately 12 hours after last dose.
- Kidney function checked regularly, lithium is processed entirely by the kidneys
- Thyroid function checked periodically, lithium can cause hypothyroidism
- Calcium levels checked annually
- Weight and BMI at each visit
Stopping this medicine
What happens if you stop taking it?
In Kenya
What you should know about this medicine in Kenya
Lithium carbonate is the most cost-effective mood stabiliser available in Kenya. Its affordability and KEML listing make it accessible in public facilities, which is significant given the long-term nature of bipolar disorder treatment.
The main practical challenge in Kenya is ensuring reliable access to blood monitoring. Patients and families should know that seeking blood tests is as much a part of treatment as taking the tablet.
Kenya's warm climate means dehydration is a real, everyday risk for people on lithium. Patients should keep water accessible, be particularly careful during hot seasons and illness, and contact a healthcare provider if they are unwell and unable to keep fluids down.
Sources
References
- Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
- Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
- Cipriani, A., et al. (2013). Lithium in the prevention of suicide in mood disorders. BMJ, 346, f3646.
- World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.