Quick answer
Lithium works only when the level in your blood is “just right”. healthdirect warns that it can rise to a dangerous level if you get very dehydrated (for example with fever, vomiting or diarrhoea) or take it with some other medicines, especially anti-inflammatories (NSAIDs) and some blood pressure medicines. In an emergency the signs of lithium toxicity — confusion, unsteadiness, slurred speech — can be hard for a stranger to read. A lithium medical ID tells responders what they are looking at.
Lithium has helped many Australians with bipolar disorder stay well for years. It also asks a lot of the person taking it: regular blood tests, steady fluid and salt intake, and a habit of checking every new medicine. Most of the time that routine keeps things safe. The risk comes when something unexpected happens — a gastro bug, a heatwave, a hospital admission for something unrelated — and the people around you do not know you take lithium.
What lithium is used for
healthdirect describes lithium as a mood stabilising medicine. It is used to treat mental health conditions including bipolar disorder, mania and hypomania, schizophrenia and some types of depression. It is not addictive. It can take several weeks to months to start working, the dose varies from person to person, and many people take it for months, years or for life.
Lithium is not a cure. healthdirect advises continuing treatment even when you feel well, and never stopping suddenly without talking to your doctor.
Lithium toxicity: why the level matters
healthdirect explains that the amount of lithium in your blood needs to be just right. If the level is too low it will not work properly; if it is too high it can cause serious side effects. A dangerously high level is called lithium toxicity.
Lithium toxicity symptoms (healthdirect)
- stomach pain, vomiting or diarrhoea
- increased muscle weakness, shaking or twitching
- confusion, severe drowsiness or dizziness
- trouble walking or slurred speech
- feeling very thirsty
- blurred vision or ringing in the ears (tinnitus)
- swelling of the face, mouth or tongue, which may cause trouble breathing or swallowing
See your doctor straight away or go to the nearest emergency department if you notice these signs. In very severe cases high lithium levels can lead to seizures, coma or death. If someone is seriously unwell, call Triple Zero (000).
Several of these signs — unsteadiness, slurred speech, drowsiness, confusion — look like many other things to a passer-by. And the person affected may be too confused to explain. That is the gap a medical ID fills.
What can push lithium too high
healthdirect lists four ways lithium toxicity can develop:
| Cause | Everyday example |
|---|---|
| Taking too many tablets at once | A double dose by mistake, or an overdose |
| Combining lithium with some other medicines — especially NSAIDs and some blood pressure medicines | Anti-inflammatory pain relief bought for a sore back or given after an injury |
| Getting very dehydrated | Fever, vomiting or diarrhoea; hot weather; exercise without enough fluid |
| Not having enough salt in your diet | Starting a low-salt diet without telling your doctor |
If you take too much lithium, healthdirect says to get advice straight away: call the Poisons Information Centre on 13 11 26, speak to your doctor, or go to the nearest emergency department. Our poisoning first aid guide explains when to call 000 instead.
Lithium and ibuprofen: medicines to check first
healthdirect’s advice is clear: before you take any new medicine, check with your doctor or pharmacist whether it is safe with lithium. That includes over-the-counter medicines, vitamins and supplements from supermarkets and health food shops.
Where interactions happen
Anti-inflammatory pain relievers are among the most common medicines people take without a prescription. In an emergency they may be offered by a friend, a workplace first aid kit or a busy clinic. A line on your record — “on lithium: check before NSAIDs or blood pressure medicines” — puts the question in front of the person about to give them.
Tell your doctor too if you have heart or kidney problems, have been told to reduce your salt intake, or are pregnant, planning a pregnancy or breastfeeding. For a system that keeps your list accurate, see tips to manage your medication.
Lithium and dehydration: hot days and gastro
healthdirect asks people on lithium to eat and drink normally, not to follow a low-salt diet, and to drink plenty of fluids in hot weather and during exercise. Australian summers, a long day outdoors or a bout of gastro can all tip the balance. If you are vomiting or have diarrhoea and cannot keep fluids down, contact your doctor. Our guide to heat exhaustion and heatstroke covers the heat warning signs for everyone.
Lithium blood tests and check-ups
Your doctor will arrange regular blood tests to check your lithium level, and also your kidney, thyroid and parathyroid function. Once your dose is settled you may only need to see your doctor every few months, but healthdirect says you will need to see them more often if you are unwell or have new symptoms. Recording your most recent level and the date it was taken helps an emergency team compare.
Who reads a lithium medical ID
ANZCOR Guideline 2 includes checking for “physical (eg. alert jewellery) or electronic alert devices (eg. smartphone application) that may be relevant to assessment or management”. For someone on lithium, that means the paramedic deciding why you are confused or unsteady, the emergency doctor choosing pain relief or fluids, and the pharmacist checking a new prescription.
What a lithium medical ID should say
On the band
- ON LITHIUM
- CHECK BEFORE NSAIDS
- Your membership number, so the full record can be read
In the profile
- Your lithium brand, strength and the times you take it.
- Your last lithium level and the date, and who orders your blood tests.
- The instruction to check new medicines, especially NSAIDs and blood pressure medicines.
- Your other medicines and any kidney or thyroid conditions.
- Your psychiatrist or GP and emergency contacts — ideally someone who knows your usual self.
You choose what is shown. A profile can say “on lithium” without naming your diagnosis on the band; the record behind your membership number holds the detail for the clinicians who need it.
Confused, unsteady, slurring — and on lithium. Make sure the first person to help knows.
A MedibandPlus profile keeps your lithium dose, last blood level, medicines to check and your doctor’s details behind a membership number on a band you wear. No app, no login, from $19 a year.
Set up your profilePart of the Mediband family. Designed in Australia since 2004.
Keeping it current
Update your profile after each dose change and each blood test result you are given. Add any new medicine the same day. If you are going somewhere hot or travelling, check the record before you leave; our guide to protecting your health while travelling has a checklist.
If you or someone you know is in immediate danger of hurting themselves or others, call Triple Zero (000). For support, Lifeline is available on 13 11 14.
FAQs
What is lithium used for?
healthdirect describes lithium as a mood stabilising medicine used to treat conditions including bipolar disorder, mania and hypomania, schizophrenia and some types of depression. It is not addictive and is often taken long term.
What are the symptoms of lithium toxicity?
healthdirect lists stomach pain, vomiting or diarrhoea; increased muscle weakness, shaking or twitching; confusion, severe drowsiness or dizziness; trouble walking or slurred speech; feeling very thirsty; blurred vision or ringing in the ears; and swelling of the face, mouth or tongue.
What causes lithium toxicity?
According to healthdirect: taking too many tablets at once, combining lithium with some other medicines (especially NSAIDs and some blood pressure medicines), getting very dehydrated through fever, vomiting or diarrhoea, and not having enough salt in your diet.
Can you take ibuprofen with lithium?
healthdirect lists non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, among the medicines that can contribute to lithium toxicity. Always check with your doctor or pharmacist before taking any new medicine, including over-the-counter products.
What should I do if I take too much lithium?
healthdirect advises getting advice straight away: call the Poisons Information Centre on 13 11 26, speak to your doctor, or go to your nearest emergency department. If someone is seriously unwell, call Triple Zero (000).
Why do people on lithium need blood tests?
Because the level needs to be just right to work without causing serious side effects. healthdirect says doctors also check kidney, thyroid and parathyroid function.
What should a lithium medical ID say?
On the band: “on lithium”, “check before NSAIDs” and a number that opens your record. In the record: your lithium dose and times, last blood level and date, medicines to check, other conditions, your doctor and emergency contacts.
Sources
- healthdirect — Lithium — (last reviewed October 2024) uses, side effects, toxicity, interactions and blood tests.
- healthdirect — Bipolar disorder — overview and support.
- ANZCOR Guideline 2 — Managing an Emergency — checking for alert jewellery and devices.
- Lifeline Australia — 24-hour crisis support on 13 11 14.
Disclaimer: This article is general information about recording lithium treatment for emergencies, not medical advice. Your dose, target blood level and which medicines are safe for you are set by your own doctor; never stop or change lithium without their advice. In an emergency, always call Triple Zero (000). For non-urgent health advice, call healthdirect on 1800 022 222 (NURSE-ON-CALL 1300 60 60 24 in Victoria, 13 HEALTH 13 43 25 84 in Queensland).
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