Lithium withdrawal: The alternatives and effects

I'm 49. For the past 23 years, I have been taking lithium carbonate (Priadel), which has helped me greatly in managing my mood swings. But now my kidney function may be impaired and I may have to withdraw from lithium. Could you please give me your guidance? What alternatives are there? What will happen to my mood swings when I stop taking lithium?

Dr Fred Kavalier answers your health question:

Lithium carbonate is the most widely used treatment for bipolar disorder and manic depression. It helps to stop mood swings, and people who take it are less likely to become seriously ill with either depression or manic episodes. Lithium has been used for many decades and most people who take it do not get serious side-effects. But about one in five people who take lithium begin to show a deterioration in their kidney function. It is not certain if lithium is directly damaging the kidneys, or if the kidneys of these people were slightly inadequate to begin with. When the kidneys start to show a deterioration, it is important to monitor the levels of lithium in your blood. Kidneys that are not working do not excrete lithium effectively, and the levels in the bloodstream can become dangerously high. If you have to stop taking lithium, it is important to do so under the supervision of a psychiatrist. Do not stop suddenly, as this can cause serious problems of depression and mania. There are alternative drugs for bipolar disorder. Two commonly used ones are sodium valproate and carbamazepine. But they have side-effects, and need to be carefully monitored.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.

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