Extreme Thirst: A Facet Impact of Lithium I Psych Central – PsychCentral.com
Lithium may cause extreme unwanted effects, together with kidney issues. In some instances, that is referred to as nephrogenic diabetes insipidus, however there’s hope for therapy.
Lithium may help ease signs of bipolar dysfunction, however maybe with just a few attention-grabbing unwanted effects.
You’ll have an insatiable must quench your thirst and extra frequent journeys to the toilet.
This can be a widespread response to lithium, and also you’re not alone. Extended therapy with lithium can result in kidney points equivalent to power kidney illness or kidney cysts.
It may possibly additionally result in a situation referred to as nephrogenic diabetes insipidus.
Your physique is of course adept at stabilizing your hydration ranges, balancing the quantity of water you soak up versus how a lot you urinate. That is referred to as water homeostasis.
Taking lithium might scale back your kidneys’ potential to hold onto water, which doesn’t give your urine sufficient time to develop into concentrated (that mild yellow coloration).
In consequence, chances are you’ll want to make use of the restroom extra usually and see that your urine seems to be extra diluted (clear) than earlier than taking this remedy.
Research from 2016 discovered that roughly 70% of individuals taking lithium expertise elevated thirst and, consequently, extreme urination.
You might begin to discover signs of extreme urination, also referred to as polyuria, as early as 2 to 4 months into therapy with lithium.
Within the early phases, this situation is reversible while you scale back the dose or taper off lithium (underneath the steerage of a medical skilled).
Nephrogenic diabetes insipidus (NDI) happens when your kidneys can now not protect and focus your urine, which might result in dehydration and require medical help.
Extreme thirst is commonly one of many first indicators that you could have this situation.
A 2018 review reveals that the chance of growing this situation will increase with explicit components. These embrace:
The overview means that NDI impacts an estimated 12% of people that have been on lithium for greater than 15 years.
Analysis is inconclusive about precisely when this situation turns into irreversible, however to this point, the proof factors to a number of years into therapy.
The earlier you search help from a healthcare skilled and obtain a prognosis, the higher your therapy outlook.
Nephrogenic diabetes insipidus is taken into account a progressive situation — the signs might improve over time. However therapy choices can be found.
For those who’re within the early phases, NDI could also be reversible by swapping out lithium for one more mood stabilizer, equivalent to lamotrigine (Lamictal).
Limiting your salt consumption could also be advisable, as sodium causes your physique to retain extra water.
Screening twice a 12 months may be urged. Testing for the situation might embrace measuring your electrolyte ranges and checking your renal and thyroid capabilities.
One therapy choice features a diuretic referred to as amiloride (Midamor) for gentle to average instances. It really works by serving to your kidneys produce urine whereas retaining your potassium ranges secure.
A 2016 study discovered that lithium will be continued with a supportive dose of amiloride, which can be helpful for folks with bipolar disorder who reply greatest to lithium therapy.
One other diuretic, hydrochlorothiazide (Microzide), may be advisable. However extra analysis is required on its effectiveness for NDI.
Analysis remains to be ongoing about the perfect therapy choices.
A 2021 study discovered that the diuretic triamterene (Dyrenium) successfully managed a case of NDI for an 81-year-old lady with bipolar dysfunction handled with lithium. She had no historical past of diabetes insipidus.
For those who’re experiencing extreme signs of dehydration from taking lithium, it’s important to hunt rapid medical consideration. You might want remedy and intravenous (IV) fluids to stop extreme or life threatening signs.
Indicators of extreme dehydration embrace:
Lithium has lengthy been thought of the gold customary of treatment for bipolar disorder.
A standard facet impact is elevated thirst and extra frequent urination. For those who’re simply starting lithium, this situation could also be reversible.
Nephrogenic diabetes insipidus (NDI) can develop in some instances, normally after a number of years of lithium therapy. NDI might require extra medical help equivalent to diuretic remedy and frequent monitoring of your renal perform.
The earlier you go to a healthcare or psychological well being skilled about NDI, the earlier you’ll discover a therapy plan that helps you are feeling higher.
Final medically reviewed on April 20, 2022
7 sourcescollapsed
OUR BRANDS