mood stabilizer

alcohol + lithium

Lithium has a narrow therapeutic window and is cleared almost entirely by the kidneys. Alcohol promotes urination and dehydration, which can reduce renal lithium clearance and push serum lithium levels higher — toward the toxic range (tremor, confusion, unsteadiness, vomiting). Alcohol also independently destabilizes mood in bipolar disorder, and its early intoxication signs can mask the early warning signs of lithium toxicity.