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Lithium
The prescription drug lithium is a mineral with antidepressant and antimanic actions. It is used to treat bipolar disorder (manic-depression) and severe depression.
Summary of Interactions with Vitamins, Herbs, & Foods
 May Be Beneficial: Depletion or interference—This medication may deplete these substances from the body or interfere with how they work; extra intake may help replenish them. | none |
| May Be Beneficial: Side effect reduction and/or prevention—These substances may help reduce the likelihood and/or severity of a potential side effect caused by the medication.
| Essential Fatty Acids* |
| May Be Beneficial: Supportive interaction—These substances may help this medication work better. | Folic Acid L-Tryptophan* |
 Avoid: Reduces drug effectiveness—When taking this medication, avoid these substances as they may decrease the medication's absorption and/or activity in the body. | none |
| Avoid: Adverse interaction—When taking this medication, avoid these substances, as the combination may cause undesirable or dangerous interactions. | none |
 Check: Explanation needed—When taking this medication, read the article details and discuss them with your doctor or pharmacist before taking these substances. | Coffee Inositol Psyllium Sodium |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Also indexed as:
- Eskalith,
- Eskalith-CR,
- lithium carbonate,
- Lithobid,
- Lithonate,
- Lithotabs
About this treatment
Interactions with Vitamins
Essential fatty acids
In one report, supplementation with essential fatty acids in the form of safflower oil (3–5 grams per day) reversed symptoms of lithium toxicity such as tremor and ataxia (an abnormality of gait). Controlled studies are needed to confirm the benefit of a lithium-essential fatty acid combination.
Folic acid
Some studies have found that people taking lithium long term who have high blood levels of folic acid respond better to lithium. Not all studies have confirmed these findings, however.
A double-blind study was conducted combining 200 mcg folic acid per day with lithium therapy. Even though the volunteers in this study were doing well on lithium alone before the study, addition of folic acid further improved their condition, whereas placebo did not. There is no evidence that folic acid reduces side effects of lithium. Based on the available evidence, it is suggested people taking lithium also take at least 200 mcg of folic acid per day.
Inositol
Lithium therapy has been shown to deplete brain stores of inositol. While it has been suggested that inositol supplementation (e.g., 500 mg three times daily) could reduce adverse effects of lithium therapy without reducing the drug’s therapeutic effectiveness, the safety and efficacy of this combination has not been proven.
Treatment with lithium can trigger or worsen psoriasis. In a double-blind study, supplementing with inositol (6 grams per day) for ten weeks significantly improved lithium-induced psoriasis, but had no effect on psoriasis in people who were not taking lithium.
L-tryptophan
A small double-blind study found that combining 2–4 grams three times per day of L-tryptophan with lithium significantly improved symptoms in people with bipolar disorder or a mild form of schizophrenia. L-tryptophan is only available from doctors. It should be taken several hours before or after meals.
Sodium
Lithium may cause sodium depletion, especially during initial therapy until consistent blood levels are achieved. A low-sodium (salt-restricted) diet can decrease lithium elimination, leading to increased lithium levels and risk of toxicity in lithium users who reduce their salt intake. Changing to a higher salt intake may cause increased losses of lithium, resulting in the return of mood symptoms. People using lithium therapy should maintain adequate water intake as well as a normal diet and salt intake. Sodium loss due to diarrhea, illness, extreme sweating, or other causes may alter lithium levels.
Interactions with Herbs
Psyllium (Plantago ovata)
Addition of psyllium husk two times per day to the regimen of a woman treated with lithium was associated with decreased lithium blood levels and lithium levels increased after psyllium was stopped.
Interactions with Foods & Other Compounds
Food
Lithium should be taken with food to avoid stomach upset.
Foods that alkalinize the urine may increase elimination of lithium from the body, potentially decreasing the actions of the drug. Urine-alkalinizing foods include dairy products, nuts, fruits, vegetables (except corn and lentils), and others.
Coffee
Mild hand tremor is a common side effect of lithium therapy. Two cases of women treated with lithium who experienced increased tremor when they stopped drinking coffee have been reported. Lithium levels increased almost 50% in one of the women, who had been drinking 17 cups of coffee per day, requiring a 20% reduction in her lithium dose. In 11 people treated with lithium who drank four to six cups of coffee per day, two weeks without coffee resulted in increased lithium blood levels, anxiety, and depression. Lithium levels, anxiety, and depression ratings returned to base line two weeks after resuming coffee consumption. Until more is known, people taking lithium should avoid abrupt changes in their coffee consumption.
Last Review: 05-11-2011
Copyright © 2011 Aisle7. All rights reserved. www.Aisle7.net
Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Aisle7 knowledgebase does not contain every possible interaction.
Learn more about Aisle7, the company.
The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.
© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
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