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Lithium is a medication that requires careful monitoring due to the potential for serious side effects. It's essential to maintain the correct balance of lithium in your body. Below are important safety considerations to be aware of when using lithium:

• Lithium Toxicity: High levels of lithium in the blood can lead to toxicity, which presents with symptoms such as nausea, diarrhea, vomiting, abnormal eye movements, shaking, muscle weakness, impaired speech, confusion, and breathing difficulties. This risk increases if you are on other medications that elevate lithium levels. Regular blood tests will be conducted to ensure safe lithium levels. Seek immediate medical attention if you notice these symptoms.

• Kidney Health: Lithium can affect kidney function, potentially causing irreversible damage. It may increase urination and thirst. Maintain consistent fluid and salt intake, avoid dehydration, and stay cool in hot conditions. Your healthcare provider will monitor your kidney function and may adjust or discontinue lithium if necessary. Report any signs of kidney issues, such as bloody or foamy urine, lower back pain, or fatigue.

• Serotonin Syndrome: This rare but serious condition can occur from excessive serotonin in the brain, especially if lithium is combined with certain medications like antidepressants or migraine treatments. Symptoms include fast heartbeat, sweating, muscle stiffness, fever, and confusion. Inform your healthcare provider of all medications you are taking and seek immediate medical help if symptoms arise.

• Thyroid Issues: Lithium can impact thyroid function, leading to either hypothyroidism or hyperthyroidism. Your thyroid levels will be monitored, and any symptoms like fatigue, weight changes, or temperature sensitivity should be reported to your provider.

• Heart Conditions (Brugada Syndrome): Lithium may exacerbate symptoms of Brugada syndrome, a potentially life-threatening heart rhythm disorder. Those with a personal or family history of this condition should discuss risks with a cardiologist before starting lithium.

• Low Blood Sodium Levels: Lithium can lower sodium levels, leading to symptoms such as weakness, confusion, and headaches. This is more likely in older adults or those taking diuretics. It requires immediate medical attention.

• High Blood Calcium and Parathyroid Hormone Levels: Long-term lithium use may raise blood calcium levels due to increased parathyroid hormone. Symptoms include tiredness, muscle weakness, and digestive issues. Regular monitoring is necessary.

• Neurological Side Effects: Combining lithium with certain antipsychotics may increase the risk of brain-related side effects, such as tremors and confusion. If these occur, seek medical help promptly.

• Contraindications: Do not use lithium if you have an allergy to lithium-containing products.

Always consult your healthcare provider with any concerns and before making changes to your medication regimen.

Common side effects:

• Drowsiness
• Dizziness
• Tiredness
• Increased thirst
• Increased frequency of urination
• Mild hand trembling
• Weight gain
• Nausea
• General discomfort

Less common but important to monitor:

• Diarrhea
• Vomiting
• Unsteady walk
• Confusion
• Trouble speaking
• Blurred vision
• Joint pain or swelling
• Muscle weakness
• Severe hand tremors
• Changes in vision
• Cold hands or feet
• Pain or discoloration in fingers or toes

Serious side effects:

• Serotonin syndrome
• Allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• MDMA
• St. John's wort
• Fluoxetine
• Paroxetine
• Duloxetine
• Venlafaxine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Captopril
• Enalapril
• Losartan
• Valsartan
• Ibuprofen
• Celecoxib
• Hydrochlorothiazide
• Furosemide
• Chlorpromazine
• Haloperidol