Herb & supplement monograph

Lithium Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Lithium interacts with medications. The heart of this page is the interaction list — every drug Lithium is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Lithium is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Lithium Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Lithium drug interaction is meaningful for many people, so this supplement deserves more caution than most. Roughly half of the listed interactions are rated major, the rest are moderate, and none are minor.

Interactions deserving the most attention

The strongest human-supported concerns are with diuretics and serotonergic drugs such as SSRIs. Diuretics, especially thiazide and loop types, can slow the body's removal of lithium, which may raise lithium levels and side effects. Combining lithium with serotonergic medicines has been linked to serotonin syndrome, and lithium may also mask its warning signs. Common pain relievers called NSAIDs can likewise reduce how well the kidneys clear lithium.

What the rest of the list means

Many of the other listed interactions are theoretical or come from experience with prescription-strength lithium, and it is often unclear whether the smaller amounts in lithium supplements would cause the same effects in people. Even so, lithium levels depend on how the kidneys handle it and on the body's sodium balance, which is why so many blood pressure and mood medicines appear on this list.

Check your medications against Lithium

Based on HelloPharmacist’s Lithium interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Lithium

515 medications have a known interaction with Lithium, graded by severity. Select any drug for the full evidence-based detail.

259 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Lithium.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Lithium using our pharmacist-reviewed interaction data.

AI summaries are generated from our Lithium interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Lithium combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Lithium affects

Every type of medication (drug category) Lithium is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 11 drug categories Lithium interacts with

Diuretic DrugsSerotonergic DrugsAce Inhibitors (aceis)AnticonvulsantsAntipsychotic DrugsCalcium Channel BlockersMethyldopa (aldomet)MethylxanthinesNonsteroidal Anti-inflammatory Drugs (nsaids)PhenothiazinesSkeletal Muscle Relaxants

Diuretic Drugs

Theoretically, taking lithium supplements with loop diuretics might increase lithium levels and adverse effects.
Thiazide diuretics and loop diuretics might reduce lithium excretion, particularly in sodium-restricted patients. If lithium is clinically indicated and other treatment options are unavailable or inadequate in patients using diuretics, lithium treatment can be initiated with extreme caution. Serum lithium should be measured frequently and the doses used should be the lowest dose ordinarily tolerated. It is unclear if this interaction would be clinically significant with the smaller doses found in lithium supplements.

Likelihood Probable Evidence D

Serotonergic Drugs

Theoretically, taking lithium supplements with serotonergic drugs might both mask and increase the risk of serotonin syndrome.
In a case report, a 67-year-old female with depression and bipolar disorder using lithium in combination with selective serotonin reuptake inhibitors (SSRIs) and other medications developed serotonin syndrome with symptoms of deep tendon hyperreflexia, muscle rigidity, tremor, and hyperthermia. However, agitation, one classical symptom of serotonin syndrome, was lacking. This was thought to be due to masking by lithium toxicity. Lithium can increase serotonin levels, thus, combining serotonergic drugs with lithium might increase the risk of serotonergic side effects including serotonin syndrome and cerebral vasoconstrictive disorders. It is unclear if this interaction would occur with the smaller doses found in lithium supplements.

Likelihood Probable Evidence D

Ace Inhibitors (Aceis)

Theoretically, taking lithium supplements with ACEIs might increase levels and adverse effects of lithium.
Concomitant administration of ACEIs with lithium may increase lithium concentrations. It is unclear if this interaction would be clinically significant with the smaller doses found in lithium supplements.

Likelihood Possible Evidence D

Anticonvulsants

Theoretically, taking lithium supplements with anticonvulsants might increase the risk of neurotoxicity.
Drugs such as carbamazepine and phenytoin seem to increase the risk of neurotoxicity. It is unclear if this interaction would occur with the smaller doses found in lithium supplements.

Likelihood Possible Evidence D

Antipsychotic Drugs

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.

Likelihood Possible Evidence D

Calcium Channel Blockers

Theoretically, taking lithium supplements with calcium channel blockers might reduce lithium levels and might also increase the risk of certain adverse effects.
Calcium channel blockers might reduce lithium concentrations. Monitor lithium levels with concurrent use. Calcium channel blockers might also increase the adverse neurological and gastrointestinal adverse effects of lithium. It is unclear if these interactions would occur with the smaller doses found in lithium supplements.

Likelihood Possible Evidence D

Methyldopa (Aldomet)

Theoretically, taking lithium supplements with methyldopa might increase the risk of lithium toxicity.
Concurrent use of methyldopa with lithium increases the risk of lithium toxicity. It is unclear if this interaction would be clinically significant with the smaller doses found in lithium supplements.

Likelihood Probable Evidence D

Methylxanthines

Theoretically, taking lithium supplements with methylxanthines might decrease lithium levels.
Xanthines such as aminophylline, caffeine, and theophylline (Theo-Dur, Theo-24, others) might increase the clearance of lithium. It is unclear if this interaction would be clinically significant with the smaller doses found in lithium supplements.

Likelihood Probable Evidence D

Nonsteroidal Anti-Inflammatory Drugs (Nsaids)

Theoretically, taking lithium supplements with NSAIDs might increase lithium levels and adverse effects.
NSAIDs can decrease the renal clearance of lithium and increase lithium levels. It is unclear if this interaction would be clinically significant with the smaller doses found in lithium supplements.

Likelihood Probable Evidence D

Phenothiazines

Theoretically, taking lithium supplements with phenothiazines might decrease the levels and clinical effects of phenothiazines.
Concomitant use of lithium with phenothiazines might reduce lithium concentrations. Lithium might also reduce phenothiazine concentrations, making the pharmacokinetic effect unpredictable. It is unclear if these interactions would occur with the smaller doses found in lithium supplements.

Likelihood Probable Evidence D

Skeletal Muscle Relaxants

Theoretically, taking lithium supplements with skeletal muscle relaxants might prolong neuromuscular blockade.
Lithium might prolong neuromuscular blockade. It is unclear if this interaction would occur with the smaller doses found in lithium supplements.

Likelihood Probable Evidence D

Monograph

Lithium: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

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.

Part used: Mineral element (not a plant); various lithium salts
Common forms: Capsules, tablets (lithium orotate, lithium aspartate in supplements; lithium carbonate and citrate as prescription drugs)

People commonly use it for

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

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

Lithium has a narrow safety margin and prescription forms require blood monitoring; supplement forms are not well studied.

PregnancyPossibly Unsafe

When lithium carbonate and lithium citrate are used orally. Lithium can cause fetal toxicity and increases the risk for cardiac and other abnormalitie...

Read the full pregnancy detail

BreastfeedingLikely Unsafe

When used orally. Lithium is secreted into breast milk and may cause adverse effects in the nursing infant. Prescription lithium may be used in circum...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Lithium is a soft, silvery-white metal and a natural chemical element (atomic number 3). It is found in tiny amounts in rocks, soil, drinking water, and many foods, so most people take in small amounts every day through their diet.

In medicine, lithium is best known as a prescription drug. Forms such as lithium carbonate and lithium citrate are FDA-approved to treat bipolar disorder and are among the oldest and most studied mood-stabilizing medicines.

Lithium also appears in dietary supplements, usually in much lower doses and in different forms like lithium orotate or lithium aspartate. These are marketed for general mood and mental wellness, but they are not the same as the carefully dosed and monitored prescription versions.

How it works

Scientists do not fully understand exactly how lithium works in the brain. It is thought to affect several brain chemical messengers (such as serotonin and dopamine) and to influence signaling pathways inside brain cells.

Lab and animal research suggests lithium may also protect nerve cells and affect enzymes and proteins involved in mood and brain cell health. Many of these ideas are based on laboratory or animal studies and may not directly apply to the low doses found in supplements.

Effectiveness

Does Lithium work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 24 uses evaluated

24 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Lithium, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 24 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Alcohol use disorder