Interaction

Lithium interacts with many other drugs. In the following, we will discuss the interactions with what we consider to be the most important ones: Do you suffer from depression? And how can it be treated?

The combination of lithium with other drugs and alcohol can lead to numerous interactions, some of which are not yet known. The exact mechanisms of action are not known. However, since even slightly increased amounts of lithium in the blood can lead to sometimes considerable and life-threatening side effects, the combination with other preparations should always be discussed with the treating physician.

Lithium is absorbed into the blood in the form of tablets and excreted from the body via the kidneys. It is not metabolized by the liver and therefore has no influence on liver function. For this reason, there is no interaction with alcohol during metabolism in the liver.

Nevertheless, lithium reduces the tolerance of alcohol via a mechanism that has not yet been clarified. For this reason, even a small consumption can lead to sometimes considerable side effects. Patients often report clouding of consciousness (film tear, fainting). Conversely, however, no increased lithium concentrations are to be feared due to the stress on the liver caused by alcohol.

Contraindication

It is not recommended to take lithium in patients with:

Disorders affecting sodium levels
Addison’s disease
Kidney dysfunction or diseases that lead to it, such as arterial hypertension
Thyroid gland disorders (must be discussed individually)

Lithium in pregnancy

If lithium is treated with medication during pregnancy, the active ingredient can enter the baby’s bloodstream via the placenta. Therefore, the same concentrations of lithium are found in the blood of the child as in the blood of the mother. The exact effects of the high lithium levels in the infant’s circulation have not yet been clarified.

For this reason, therapy with lithium should be avoided during the first trimester of pregnancy. As studies have shown, there is an increased risk of malformations. Among other things, malformations of the heart (Ebstein anomaly) have frequently occurred.

Only in a few exceptional cases is it possible to administer lithium during this period – in which case the treating physician must weigh up the benefits and risks. In addition, lithium should be discontinued in the period prior to birth (approximately 10 to 30 days). During birth, the elimination of lithium from the human body is altered. As a result, significantly increased lithium levels can occur in maternal and child blood. Since lithium has only a narrow therapeutic range (i.e. even slightly increased concentrations can lead to severe side effects), typical symptoms of lithium intoxication are possible.