Drug & supplement interaction

Lithium + Piperacetazine

Piperacetazine brand name: Quide.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Lithium has a moderate interaction with Piperacetazine. Theoretically, taking lithium supplements with antipsychotic drugs might increase the risk of encephalopathic syndrome.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Lithium and Piperacetazine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIPSYCHOTIC DRUGS

Why this applies to Piperacetazine

Piperacetazine falls under ANTIPSYCHOTIC DRUGS — the group Lithium interacts with.

Theoretically, taking lithium supplements with antipsychotic drugs might increase the risk of encephalopathic syndrome.
Encephalopathic syndrome has been reported in multiple patients taking prescription lithium and antipsychotics concomitantly. Symptoms have included weakness and lethargy, fever, confusion, and extrapyramidal symptoms. In some patients, resulting brain damage was irreversible. Although there is no established causal relationship between these symptoms and the combination of lithium and antipsychotic medications, there is a theoretical relationship. It is unclear if this interaction would occur with the smaller doses found in lithium supplements.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the situation with piperacetazine (Quide), an older antipsychotic, taken alongside a lithium supplement. The concern isn't that one drug changes how the other is broken down. Instead, there are scattered reports of people on prescription lithium plus an antipsychotic developing what's called an encephalopathic syndrome. That can look like weakness, sluggishness, fever, confusion, and stiff or jerky muscle movements (extrapyramidal symptoms). In rare cases the damage didn't fully reverse.

I want to be honest about the evidence here: this is mostly theoretical and based on anecdotal reports, and it's unclear whether the small amounts in lithium supplements like lithium orotate would do this at all. Still, since both can stress the brain, I'd loop in your pharmacist or doctor before pairing them rather than guessing on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/017812s028,018421s027lbl.pdf. Accessed Nov. 21, 2018

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Lithium Also Interacts With Other Medications

Lithium has 259 major, 255 moderate known drug interactions in our database — the Piperacetazine one above is one of them. If you take anything else, check it against the full list below.

Major 259 Moderate 255 No known interaction 2,316 (incl. Piperacetazine)
Taking anything else?

Check Another of Your Medications Against Lithium

Covers the 2,830 medications we’ve checked against Lithium. Pick one to open its full report.

From our Q&A

Questions About Lithium or Piperacetazine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Lithium or Piperacetazine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Piperacetazine

This page covers Lithium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Piperacetazine page lists 25 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Indian Snakeroot (major), Rauvolfia Vomitoria (major), Coffee Charcoal (moderate) and Cowhage (moderate).

By severity: 3 major · 12 moderate · 10 minor.

From our pharmacist’s overview on the Piperacetazine page

“Indian snakeroot and Rauvolfia vomitoria sit at the top of my worry list for anyone taking piperacetazine (Quide), an older phenothiazine antipsychotic. Both herbs carry rauwolfia alkaloids that can intensify the drug's effects, and together with activated charcoal, which can strip the medicine from the body before it has a chance to a…”

Reviewed by 2 · Jul 18, 2026

Open the Piperacetazine interaction page

One more smart check

Taking Lithium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 330 real supplement products containing Lithium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lithium. Your product may carry other ingredients that interact with Piperacetazine too, on top of Lithium — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Lithium and Piperacetazine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Lithium
Top 25%

#255 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Piperacetazine
Top half

#739 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Lithium

What is Lithium?

Lithium
  • Mood support
  • Bipolar disorder (prescription)
  • Healthy mental function
  • Irritability or stress
  • Sleep support

Lithium is a naturally occurring metal that, in prescription form (lithium carbonate or citrate), is an FDA-approved, well-proven treatment for bipolar disorder. Low-dose supplement forms like lithium orotate are sold for mood support, but there is very little reliable evidence that they work, and even small amounts of lithium can be risky for some people. Always talk to a pharmacist or doctor before taking any lithium product.

Read the full Lithium monograph & all interactions
Keep checking

Other Drugs & Lithium

Browse every other medication we’ve checked against Lithium — both the ones with a known interaction and the ones without. Select any drug for the full detail.

259Major
255Moderate
0Minor
2,315No known interaction
259 Major 255 Moderate 2,315 No interaction
Major

259 interactions

Showing 60 of 259 major interactions — see all 259 on the Lithium page.

Moderate

255 interactions

Showing 60 of 255 moderate interactions — see all 255 on the Lithium page.

No interaction 2,315 drugs checked — show the list

We also checked Lithium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,315 medications checked with no known interaction — see the full Lithium list.

See the full Lithium interactions page
See every supplement checked against Piperacetazine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Lithium monograph › Uses, safety, and every drug interaction in one place Piperacetazine supplement interactions › Every supplement checked against Piperacetazine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Lithium and Piperacetazine Together: Common Questions

Can you take Lithium with Piperacetazine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Lithium and Piperacetazine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Piperacetazine and Lithium?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.