The Dangers of Mixing Lithium and Alcohol

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Lithium citrate and lithium carbonate are prescription medications used to treat mood disorders. Lithium should be taken as prescribed, with all medication instructions closely followed. If you have been prescribed lithium, you may be wondering whether or not it is safe to simultaneously consume alcohol. It is important that you discontinue alcohol use when taking lithium as there may be adverse effects.

Ceasing alcohol use may be difficult if you consume alcohol regularly. The Substance Abuse and Mental Health Services Administration defines excessive alcohol use as 4 or more standard drinks a day for women, and 5 or more standard drinks a day for men. (1) If you consume more alcohol than intended, spend excessive time thinking about alcohol, have to consume more alcohol than you did in the past to get the same effect, have tried to stop drinking in the past, or continue drinking even if you experience negative physical, social, or emotional effects, you may be experiencing alcohol use disorder.

Contact us today if you suspect that you or a loved one may be experiencing alcohol use disorder. Guardian Recovery provides individualized, evidence-based treatment to aid individuals in developing healthy coping strategies to combat their substance use and begin their sobriety journey.

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Mixing Lithium & Alcohol

Alcohol affects the brain and its natural functions by depressing the central nervous system and destroying brain cells. (4) When taken separately, both lithium and alcohol can cause dehydration. When combined, the enhanced effects can cause extreme dehydration and even lead to hospitalization.

What is Lithium?

Lithium is a psychiatric, mood stabilizer, mainly used for bipolar I disorder treatment. Lithium has been approved by the U.S. Food and Drug Administration (FDA), as a psychiatric medication, since the 1970s. (5) Lithium can be prescribed to individuals ages 7 years or older. Lithium works by protecting neurons in the brain, modifying the release of chemicals in the brain, and decreasing negative brain activity. Lithium can be taken in tablets, capsules, or liquid form (6). Common side effects when taking lithium may include: (7)

  • Nausea
  • Drowsiness
  • Diarrhea
  • Headache
  • Muscle weakness

Before being prescribed lithium, your doctor will initiate assessments regarding vital signs, blood work, and other bodily functions to ensure that this medication is right for you. It is important that you do not discontinue your lithium medication without consulting with your doctor first.

Lithium & Alcohol Side Effects

There are various side effects that may occur if lithium and alcohol are combined. It is important to understand these side effects as you can be better prepared, better equipped to cope if they arise, or reduce your chances of experiencing them. These side effects include: (8)

  • Confusion
  • Drowsiness
  • Dizziness
  • Difficulty concentrating
  • Impairments in coordination
  • Impairments in judgment

Though some of the side effects listed above are common when taking lithium exclusively, they can be worsened and intensified when alcohol is added into the equation.

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The Risks of Drinking Alcohol on Lithium

There are several risks involved when drinking alcohol while on lithium. The symptoms associated with bipolar disorder can be heightened when alcohol and lithium are combined. This can cause mental health declines or trigger manic episodes. Dehydration can also occur when drinking alcohol on lithium. When dehydration occurs, lithium rises in the bloodstream, which can become toxic to the body. In addition to negative side effects, lithium is less effective when taken with alcohol. Those who drink alcohol while on lithium are more likely to experience more frequent hospitalizations, and to be less effective with treatment options. (9)

Alcohol, Lithium & Dehydration

When taking lithium, it is important to consume adequate water throughout the day. Taking lithium when dehydrated can lead to lithium toxicity, even when not combined with alcohol. (10) Alcohol is a diuretic, meaning that it increases urination and reduces hydration in the body. Ingesting two substances known to dehydrate the body, even when taken separately, can lead to dangerous health effects. (11)

Alcohol & Bipolar Disorder

Alcohol use disorder and bipolar disorder are two, often co-occurring, mental health disorders. Bipolar disorder is a chemical imbalance in the brain that causes mood fluctuations from low to high moods. Low moods, or depressed moods, are characterized by feelings of sadness and loss of enjoyment in previously pleasurable activities for 2 weeks or more. (12) High moods, or mania, are characterized by an elevated mood, rapid speech, racing thoughts, impulsivity, and grandiosity for 1 week or more. (13) Since alcohol depresses the central nervous system, drinking alcohol when diagnosed with bipolar disorder can exacerbate depressive symptoms, increasing bipolar symptoms.

Taking Lithium After Alcohol

Alcohol filters through the liver every hour for every ounce of alcohol consumed for an average individual. Alcohol can last in one’s system for hours, and even days, depending on the individual. The more alcohol you consume, the longer it remains in the body. Due to their interactions and time spent in the body, taking lithium after alcohol has not been proven to be safe. (14)

Drinking After Taking Lithium

Lithium has a half-life of 18-30 hours. (15) Meaning that it takes 18-30 hours for half of this medication to clear from the body. In order to be effective, lithium must be taken as prescribed, daily. Lithium can stay in the body for days following its ingestion, and weeks when taken long-term. There has been no research found regarding a safe period to drink alcohol following a dose of lithium.

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Can You Overdose on Alcohol & Lithium?

If taken in excess, lithium can be harmful. Overdosing becomes increasingly likely when lithium is combined with alcohol. Drug overdose is dangerous and can be fatal. Overdosing on lithium can lead to lithium toxicity.

Signs of Lithium Toxicity

If you have been prescribed lithium, it is important to be able to identify the signs of Lithium toxicity. Lithium toxicity is defined as lithium levels being too high in the bloodstream. Lithium toxicity can lead to hospitalization or be fatal. Lithium toxicity can be categorized as mild, moderate or severe. (16) Signs of mild Lithium toxicity include nausea, shakiness, abdominal pain, and lightheadedness. (17) Moderate lithium toxicity symptoms include muscle weakness, lack of coordination, confusion, drowsiness, and an increase of thirstiness. (18) Severe signs of lithium toxicity include symptoms such as blurred vision, kidney failure, seizures, and coma. Seek out immediate help if you are experiencing any symptoms of lithium toxicity. (19)

If prescribed lithium, it is important to understand its interactions with alcohol. Due to the adverse side effects, it is best to avoid alcohol when taking lithium. It may be difficult to discontinue alcohol use if you have recently been prescribed lithium. With 14.5 million individuals, ages 12 years and older, and 414,000 individuals, ages 12 to 17 diagnosed with alcohol use disorder in the U.S., treatment may be necessary in order for many to begin an alcohol free life. (20)

Guardian Recovery provides detoxification and dual diagnosis treatment for individuals experiencing alcohol use disorder and any co-occurring mental health diagnoses. (21) Contact us today to begin your road to mental health recovery and a substance free life. (22)

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.samhsa.gov/sites/default/files/alcohol-use-facts-resources-fact-sheet.pdf
  2. https://guardianrecovery.com/contact/
  3. https://guardianrecovery.com/addiction-treatment/individual-focus/
  4. https://pubmed.ncbi.nlm.nih.gov/23713737/​​
  5. https://psychopharmacologyinstitute.com/publication/lithiums-mechanism-of-action-an-illustrated-review-2212
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712976/
  7. https://www.rxlist.com/lithium-carbonate-drug.htm
  8. https://www.drugs.com/interactions-check.php?drug_list=1034-0,1477-0
  9. https://pubs.niaaa.nih.gov/publications/arh26-2/103-108.htm
  10. https://www.drugs.com/cg/lithium-toxicity.html#:~:text=Dehydration%20can%20increase%20your%20risk,your%20risk%20of%20lithium%20toxicity
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537780/
  12. https://www.psychiatry.org/patients-families/depression/what-is-depression
  13. https://www.ncbi.nlm.nih.gov/books/NBK519062/
  14. https://www.medicalnewstoday.com/articles/319942#what-affects-the-rate-that-alcohol-is-processed
  15. https://www.ncbi.nlm.nih.gov/books/NBK493168/
  16. https://www.drugs.com/cg/lithium-toxicity.html#:~:text=Dehydration%20can%20increase%20your%20risk,your%20risk%20of%20lithium%20toxicity
  17. https://www.drugs.com/pro/lithium-carbonate.html

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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