bipolar disorder
5 interactions related to bipolar disorder
lithium + ibuprofen
Ibuprofen and other NSAIDs inhibit renal prostaglandin synthesis, reducing renal blood flow and lithium clearance. This raises serum lithium by approximately 15 to 60 percent, with multiple published cases of clinically significant lithium toxicity after NSAID introduction.
lithium + sodium
Lithium and sodium are handled by the same renal transporters and compete for reabsorption in the proximal tubule. A low-sodium diet causes the kidneys to retain sodium and lithium, raising lithium levels and the risk of toxicity; a sudden high-sodium load can drop lithium below the therapeutic range.
lithium + caffeine
Caffeine increases renal clearance of lithium by promoting natriuresis and increasing glomerular filtration, so chronic caffeine intake lowers lithium blood levels. A sudden reduction in caffeine intake can raise serum lithium into the toxic range, while abruptly increasing caffeine can lower levels and worsen mood symptoms.
lithium + ace inhibitors
ACE inhibitors reduce glomerular filtration rate and decrease sodium delivery to the distal nephron, which lowers renal lithium clearance and can raise serum lithium by approximately 36 percent. Toxicity may emerge with delayed onset 3 to 5 weeks after starting the ACE inhibitor, particularly in older adults and those with reduced renal function.
chocolate + lithium
The caffeine in chocolate increases renal lithium clearance through its diuretic effect, lowering serum lithium levels. A sudden change in chocolate or caffeine intake — especially abrupt cessation — can cause serum lithium to rise into the toxic range, while sudden additions can push levels sub-therapeutic.