Lithium and alcohol – is it compatible?

Lithium is a drug from the field of psychotropic drugs used in the context of mental illness. It is used in the treatment of mania, as part of the prevention of so-called bipolar affective disorders, in the treatment of certain forms of depression or for a certain type of headache, namely the so-called cluster headaches. Mania is a mental disorder in which the patients have an extremely cheerful and brightened mood, which is rather disproportionate considering the situation.

It can be considered the opposite of depression. The regular alternation of depression and mania characterizes the bipolar affective disorder. To be fully effective in treatment, lithium needs a certain level of active substances in the blood.

This level is 0.5-1.2 mmol/l. It should be noted that lithium has a so-called narrow therapeutic range. This means that the dose at the onset of action and the dose that leads to lithium poisoning are very close to each other and therefore the lithium level in the blood must be checked at regular intervals. It is also important to start treatment with lithium in creeping doses.

Interactions

Since the drug lithium has a particularly small width from the beginning of the spectrum of action until intoxication with the active substance, it is particularly important to pay attention to interactions with other drugs that are taken in parallel. On the whole, it can be said that when taking lithium, special care should always be taken when taking other drugs. The lithium level can be both raised and lowered by various medications, neither of which is good for the patient.

If the lithium level is lowered, the patient does not feel any effect and the intake is therefore pointless. If the lithium level is raised, there is a risk of poisoning and the resulting symptoms and their consequences. The lithium level in the blood is raised by a whole range of different drugs.

These drugs include the antibiotic metronidazole and some drugs that are normally used to lower blood pressure. The group of so-called ACE inhibitors and angiotensin-2 receptor antagonists are particularly noteworthy. Painkillers from the group of non-steroidal anti-inflammatory drugs, which include indomethacin as well as diclofenac, which are very frequently taken in the population, can also raise the lithium level.

Water tablets, medically called diuretics, alter the excretion of water from the body and thus also influence the excretion of lithium from the body. They reduce excretion and thus increase the lithium level. The medications that lower the lithium level in the blood when taken simultaneously with lithium include osmotically effective water medications and preparations containing xanthine.