Lithium awareness campaign promotes safer use of mood stabiliser

Medics believe many prescribed ‘highly effective drug’ unaware of potential harm if used incorrectly

Lithium pill: Leaflets to pharmacists will help Ireland’s estimated 10,000 lithium users better understand the mood stabiliser. Photograph: iStock
Lithium pill: Leaflets to pharmacists will help Ireland’s estimated 10,000 lithium users better understand the mood stabiliser. Photograph: iStock

Leaflets are being distributed from Monday to pharmacists to help Ireland’s estimated 10,000 lithium users better understand the mood stabiliser.

Lithium has been used since about the 1950s to treat bipolar affective disorder, mania and severe depression.

While it is a “highly effective drug”, medics believe many who are prescribed it are unaware of the potential harm it can cause if mixed with other drugs like blood pressure tablets, over-the-counter pain relievers such as aspirin or ibuprofen as well as antacids.

Everyday medications can increase the levels of lithium in the bloodstream potentially leading to toxicity or poisoning.

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‘Gold standard’

Audrey Purcell, pharmacy dispensary services manager at St John of God Hospital, which is publishing the leaflet along with the Health Service Executive, said there is “a lot of anecdotal evidence of people ending up in hospital with lithium toxicity” and that “deaths have been reported”.

However, she said that lithium, when used safely, remained a “gold standard” medication for the disorders it treats and was “really highly effective once patients are well-supported”.

“The purpose of this leaflet is to help empower patients, support them and provide education on lithium.”

As well as other medications, getting dehydrated – through hot weather, too much caffeine or using a sauna, for example – and big changes to the level of salt in a patient’s diet can also increase lithium levels in the blood.

The leaflet includes charts for patients to record their use of lithium, lithium blood levels and other blood tests to monitor thyroid and kidney functioning as well as calcium levels.

It has been devised with the help of the College of Psychiatrists of Ireland, the Irish Medication Safety Network and the Irish Pharmacy Union.

Brian Hutton

Brian Hutton is a freelance journalist and Irish Times contributor