Lithium is a mood stabiliser used mainly for bipolar disorder — treating mania and, more importantly, preventing the swings from returning. In South Africa it is sold as Camcolit and Quilonum tablets. It requires regular blood tests, because the effective dose and the toxic dose are unusually close together.
What is Lithium?
Lithium is a naturally occurring element, given as a salt. The South African Medicine Price Registry lists it as Schedule 5 tablets:
| Product | Form | Strength |
|---|---|---|
| Camcolit | Tablet | Lithium 250 mg |
| Camcolit | Tablet | Lithium 400 mg |
| Quilonum | Tablet | Lithium carbonate 450 mg |
Different salts and different formulations deliver different amounts of lithium, and slow-release and standard tablets behave differently in the body. For that reason, brands are not freely interchangeable. If a pharmacy offers you a different brand from the one you have been stabilised on, check with your doctor before accepting the substitution — this is one of the few medicines where that caution genuinely matters.
Nobody fully knows how lithium works. It affects several signalling systems inside brain cells and appears to have protective effects on neurons. What is not in doubt is that it works: lithium has been used for over seventy years and remains the most effective long-term treatment for bipolar disorder, with the best evidence of any agent for reducing suicide risk.
It is also the medicine that demands the most from the person taking it, because of monitoring.
What is Lithium commonly used for?
- Bipolar disorder — this is the main use. Lithium treats acute mania, and it is used long term to prevent both manic and depressive episodes returning. Prevention is where it performs best.
- Treatment-resistant depression, added to an antidepressant when that has not been enough on its own. This is called augmentation and is well established.
- Recurrent depression, to prevent relapse in some people.
- Reducing suicide risk, which lithium does independently of its mood effects — an effect not clearly shown for other mood stabilisers.
- Schizoaffective disorder and, occasionally, severe aggression or impulse control problems, under specialist care.
The searches that bring people here — “lithium tablets used for” — are usually from someone newly prescribed it, or a family member trying to understand a prescription. The short answer is that it stabilises mood over time.
The important point about lithium is that it is a preventive medicine, not a rescue one. It does not work like a sedative on a bad day. Its benefit comes from taking it consistently, month after month, and it takes weeks to establish. Stopping it — especially stopping abruptly — carries a high risk of relapse, and the relapse can be more severe than the episodes that preceded treatment.
How Lithium fits into this medicine category
| Group | Examples | Role |
|---|---|---|
| Mood stabilisers | Lithium, sodium valproate, lamotrigine, carbamazepine | Preventing bipolar mood episodes |
| Antipsychotics | Quetiapine, olanzapine, risperidone | Acute mania; also used as maintenance |
| Antidepressants | SSRIs, amitriptyline (Trepiline) | Depression; used cautiously in bipolar disorder |
| Benzodiazepines | Oxazepam, lorazepam | Short-term agitation and anxiety |
| Sleep agents | Zolpidem, related medicines | Short-term insomnia |
Lithium is often combined with an antipsychotic, and sometimes with an antidepressant — though antidepressants alone can destabilise bipolar disorder, which is one reason lithium’s role is central. See the mental health and neurology medicines hub.
What to check before using Lithium
Blood tests are not optional. Lithium has a narrow therapeutic range: the level that works and the level that poisons are close. You will need blood tests to check the lithium level — frequently at first, then every few months — plus periodic kidney and thyroid checks. Keep every appointment. This monitoring is what makes lithium safe.
Blood for a lithium level is usually taken about twelve hours after your last dose, so ask when to take your tablet on test days.
Tell your doctor or pharmacist if you:
- Take anti-inflammatories — ibuprofen, diclofenac, and similar. These raise lithium levels and are a very common cause of toxicity. Do not buy them over the counter without asking. Paracetamol is generally the safer choice for everyday pain.
- Take blood pressure medicines, particularly ACE inhibitors (enalapril, perindopril), ARBs and diuretics — all can raise lithium levels.
- Have kidney disease, thyroid disease or heart problems.
- Are pregnant, planning pregnancy or breastfeeding. Lithium carries risks in pregnancy, but stopping it also carries serious risk. This needs a planned discussion, ideally before conception, never a unilateral decision.
- Are starting any new medicine, including herbal products.
Day-to-day precautions:
- Keep your fluid and salt intake steady. Dehydration concentrates lithium and raises the level. Take extra care in hot weather, during vomiting or diarrhoea illness, with heavy exercise, and with alcohol.
- Do not suddenly change how much salt you eat, in either direction.
- Take it at the same time each day and do not double up on a missed dose.
- Do not stop suddenly. Abrupt discontinuation substantially raises the risk of relapse.
Possible cautions and when to ask a pharmacist or doctor
Common effects, particularly early on, include mild tremor of the hands, increased thirst, passing more urine, nausea, a metallic taste, weight gain and sometimes loose stools. Many settle.
Longer term, lithium can affect the thyroid (usually underactive, and treatable), the kidneys’ ability to concentrate urine, and, over many years, kidney function — which is exactly what the monitoring is there to detect early.
Lithium toxicity is a medical emergency. Learn its signs:
- Coarse trembling — shaking that is more than a fine tremor
- Persistent vomiting or diarrhoea
- Unsteadiness, slurred speech, muscle twitching
- Marked drowsiness, confusion, blurred vision
- Seizures
If any of these appear, stop taking lithium and get medical help immediately, taking your tablets with you. Toxicity most often follows dehydration, a stomach bug, a new interacting medicine, or a dose error — not a deliberate overdose.
Contact your doctor sooner rather than later if you develop a vomiting or diarrhoea illness, become unable to drink normally, are started on a new medicine by another prescriber, notice increasing tiredness or cold intolerance, or find your mood destabilising.
Do not stop lithium because you feel well. Feeling well is the medicine working.
Related medicine guides
Frequently asked questions
What are lithium tablets used for? Mainly bipolar disorder — treating mania and preventing mood episodes returning. It is also added to antidepressants in treatment-resistant depression.
Why do I need blood tests? Because the effective and toxic lithium levels are close together. Tests confirm the level is right and check thyroid and kidney function.
Can I take ibuprofen with lithium? Not without asking. Anti-inflammatories raise lithium levels and are a common cause of toxicity. Paracetamol is usually the safer alternative.
How long before it works? Weeks for its full mood-stabilising effect, and its main benefit — preventing relapse — is only apparent over months.
Can I stop when I feel better? No. Stopping, especially abruptly, carries a high risk of relapse. Any change should be planned with your doctor.
Is Camcolit the same as Quilonum? Both deliver lithium, but the salt, strength and release characteristics differ. Do not switch brands without your doctor’s agreement.
What should I do if I get a stomach bug? Contact your doctor. Vomiting and diarrhoea cause dehydration, which can push lithium into the toxic range.