What Happens If You Stop Taking Lithium Cold Turkey?

Lithium is a medication commonly prescribed to treat bipolar disorder. It helps stabilize mood swings and prevent extreme highs (mania) and lows (depression). Some people take lithium long-term while others use it for short periods.

If you’ve been taking lithium, you may wonder what happens if you suddenly stop without slowly tapering off. Quitting lithium abruptly is known as “going cold turkey” Here’s a look at the potential effects.

Why People Stop Taking Lithium

There are a few common reasons someone might want to stop lithium:

• Side effects – Lithium can cause side effects like increased thirst, frequent urination, tremors, and thyroid problems. These may make you want to quit.

• Pregnancy/breastfeeding – Lithium can harm a developing fetus and pass through breastmilk. Your doctor will advise stopping lithium if you become pregnant or want to breastfeed.

• Bipolar symptoms improve – If your bipolar disorder has been stable for a long time, you and your doctor may decide to taper lithium to see if it’s still needed.

• Wanting to manage bipolar without medication – Some people want to control their bipolar symptoms with psychotherapy, lifestyle changes, etc. instead of medication.

• Cost – Lithium is inexpensive, but the lab tests required to monitor blood levels can get costly over time.

No matter the reason for stopping, it’s essential to consult your doctor first. Never change or quit a psychiatric medication on your own.

Is Lithium Addictive?

Lithium is not addictive and does not produce a “high.” It’s not in the same class as drugs, alcohol, or medications prone to abuse like opioids or benzodiazepines.

Therefore, lithium does not cause withdrawal symptoms or drug cravings when stopped suddenly like addictive substances. However, research shows abruptly quitting lithium can trigger other problems.

Risks of Stopping Lithium Cold Turkey

While lithium itself doesn’t produce withdrawal effects, quitting lithium abruptly does carry risks:

1. Bipolar relapse

This is the biggest concern. Lithium helps prevent extreme highs and lows in bipolar disorder. When stopped suddenly, these episodes can return quickly and severely.

Studies show the risk of relapse, especially manic episodes, is much higher when lithium is stopped abruptly rather than tapered slowly. Up to 75% of people experience a manic or depressive relapse within 6 months of quitting lithium cold turkey.

2. Discontinuation symptoms

Some research indicates abruptly stopping lithium may cause mild physical and psychological symptoms like:

• Hand tremors
• Headache
• Nausea
• Diarrhea
• Dizziness
• Confusion
• Irritability
• Insomnia

However, it’s debated whether these effects are directly from lithium withdrawal or other factors. Symptoms tend to be temporary, resolving within a couple weeks.

3. Suicidal thoughts

Studies link abrupt lithium discontinuation to increased risk of suicidal thoughts and behavior, especially for those with severe bipolar disorder. Sudden recurrence of extreme mood episodes can trigger these impulses.

4. Pregnancy risks

If you abruptly stop lithium upon learning you’re pregnant, it could be dangerous for both you and baby. Quitting lithium without medical supervision may trigger relapse that harms fetal development. It’s critical to consult your doctor about safely managing bipolar disorder during pregnancy.

Dangers of Repeated Lithium Starts and Stops

Quitting lithium cold turkey once may not cause long-lasting problems beyond temporary side effects. However, the risks grow with each successive sudden stop.

Research shows that repeatedly starting and stopping lithium can make it less effective over time. This may occur because stopping lithium allows neurochemical changes from bipolar disorder to recur.

Over time, these repeated biochemical changes make it harder for lithium to restabilize the brain. You may need higher doses or additional medications.

Repeated sudden lithium discontinuation also increases odds of severe manic or depressive relapse with each stop. To maintain lithium’s benefits long-term, it’s important to take it consistently under medical supervision.

How to Stop Taking Lithium Safely

Work with your psychiatrist to create a gradual lithium tapering schedule, which may take 2-8 weeks depending on your dosage. Never attempt to stop lithium on your own. A safe tapering plan will help avoid risks like mood episode relapse.

Your doctor can also advise you on managing bipolar disorder without medication through psychotherapy, lifestyle changes, etc. Stopping lithium does not necessarily mean stopping all bipolar treatment.

In some cases, lithium may be switched to another maintenance medication like an atypical antipsychotic. Your doctor can help determine the best treatment options for you based on your symptoms, history, and preferences.

What to Expect When Stopping Lithium

Everyone responds differently when coming off lithium. With gradual tapering under medical supervision, potential side effects are usually mild. However, you may experience:

• Increased bipolar symptoms, even with tapering. Your doctor can adjust medications and treatment to help manage this.

• Temporary headache, nausea, tremors, or diarrhea for 1-2 weeks. Stay hydrated and rest to help alleviate physical discomforts.

• Anxiety, irritability, or trouble sleeping related to bipolar symptoms returning. Practice stress management and good sleep hygiene.

• A period of adjustment as your body regulates without lithium. Patience and working closely with your doctor helps smooth this transition.

The majority of symptoms are manageable and resolve within a few weeks. With your psychiatrist’s guidance, you can safely taper off lithium while keeping bipolar symptoms under control. The key is gradual reduction and comprehensive treatment.

The Bottom Line

Stopping lithium abruptly can potentially cause bipolar relapse, mental and physical side effects, and complicate future treatment. Tapering off slowly and carefully under medical supervision is vital for protecting your health and preventing dangerous mood swings.

With the right professional help, you can safely transition off lithium when needed. Don’t hesitate to communicate all your concerns, questions, and preferences to your psychiatrist. Finding the most effective treatment plan for your situation and goals is a collaborative process.