Several medications may be used for people recovering from alcohol addiction. Lithium is a drug that has gotten attention. A study was conducted with 18 men with alcohol use disorder who were in withdrawal. 

It was found that in mild alcohol withdrawal, lithium reduces the visible symptoms of withdrawal and normalizes performance on a motor skills task. Individuals who start taking lithium while still drinking show improvement because it takes longer than 3 days for lithium concentrations in the blood to level off. 

Lithium for Alcohol Use Disorder (AUD)

In 1974, Kline and associates conducted the first study of lithium therapy for alcohol use disorder was done. The researchers found that those treated with lithium for a year showed fewer episodes of disabling drinking. They were also surprised to find that lithium therapy did not reduce symptoms of (nonpsychotic) depression any better than the placebo.

Later studies have also supported the theory that lithium therapy reduces the alcohol intake of people with co-occurring AUD and affective disorders, such as bipolar disorder, depression, and other mood disorders. Further studies found that lithium therapy reduced the individual’s sense of intoxication, his desire to continue drinking, and cognitive dysfunction related to intoxication. There was no difference between people with a mood disorder and those who didn’t.

The conclusion after an 18-month follow-up was: 

  • Lithium therapy promotes abstinence for people with AUD whether they have a co-occurring condition or not. 
  •  Those who were treated with lithium therapy were much less likely to be readmitted for AUD treatment.
  • Lithium therapy didn’t reduce the frequency of drinking for relapse drinkers.

What is Lithium?

Lithium is a naturally occurring element and is actually the lightest known metal. It’s used in building aircraft and in some batteries. It was discovered in the 1790s but wasn’t isolated from other elements until 1855. 

Lithium is found in the earth locked up in minerals and salts. Those salts have the ability to affect the brain. Its mood-stabilizing effects weren’t known until late in the 1800s. According to the National Institute of Mental Health, lithium salts were the first drugs the Food and Drug Administration approved to treat mania and depression and that happened in 1970.

How Does Lithium it Work?

These days, lithium carbonate is the compound usually sold as a pharmaceutical. Exactly how lithium works to stabilize mood is not known. But studies show several effects on the nervous system. 

In 2008 researchers reported in the journal, Cell, that lithium interrupts the activity of the neurotransmitter dopamine, a chemical messenger in the brain. Dopamine plays a part in how we feel pleasure. It is also thought to help strengthen nerve cell connections in brain regions that are involved in regulating mood, thinking, and behavior. This helps decrease abnormal activity in the brain.

What is Lithium Typically Used For?

Lithium is one of the most widely used and studied medications for treating bipolar disorder, sometimes known as manic-depressive illness. It might also help relieve or prevent bipolar depression. 

Lithium also helps prevent future episodes of manic and depressive behavior. Because of this, it can be prescribed for long periods of time as maintenance therapy. Studies show that lithium can considerably reduce suicide risk. 

It is also sometimes used to treat depression, schizophrenia, impulse control disorders, and certain mental illnesses in children. Lithium can be used to decrease anger and sudden impulse decisions in people who don’t have bipolar disorder.

What’s a Bipolar Disorder?

Bipolar disorder is a psychiatric disorder that features extreme shifts in mood, from excessively euphoric (mania) to desperately sad or hopeless (depression). It helps reduce the severity and frequency of mania

People who suffer from bipolar disorder frequently feel out of control or out of touch with their life. Being unsure of what to do or how to feel when a bipolar episode occurs makes using alcohol an appealing solution in relieving the symptoms.

The Link Between Alcohol and Bipolar Disorder

Alcohol and Bipolar disorder have a close relationship. Few mental health disorders are as closely related to alcohol use disorder (AUD) as bipolar disorder. They are commonly present together. 

Some studies have found that most individuals with bipolar disorder will develop an AUD of some kind during their lives. It has been estimated that up to 43% of individuals with bipolar disorder have some type of AUD at any given time. The Journal of Affective Disorders concluded that alcohol use disorder was the most prevalent substance use disorder (SUD) in people with Bipolar I and Bipolar II disorder.

Alcohol helps to calm nerves, particularly in social settings. It may relieve the negative symptoms of bipolar disorder temporarily. But it can increase the chances of making the disorder worse later on.

Complications of Alcohol Use Disorder and Bipolar Disorder

AUD can impair your judgment, make you more impulsive, and also increase your risk of suicide, injury, and sexually transmitted infections like HIV. Research from the Medical University of South Carolina found that suicide is nearly twice as high in people with bipolar disorder and AUD as it is in people with Bipolar alone.

In addition, the effect alcohol has on a person’s moods and judgment can make sticking to drug therapy more difficult, wrecking the very goals of treatment.

Does Lithium Have Any Side Effects?

Lithium has several side effects including:

  • Dry mouth
  • Metallic taste
  • Slight shakiness
  • Mild weakness
  • Diarrhea

As your body adjusts to the medication, these effects will subside.

Over the long term, it can cause thyroid issues and affect kidney and cardiovascular functions. Using it for withdrawal symptoms for AUD is a short-term usage and shouldn’t cause side effects that would interfere with the detoxification process. These problems typically disappear if lithium is reduced or stopped.

Is Lithium Addictive?

Lithium is not addictive. There is no craving if you stop. But when you stop taking it, it should be gradually reduced to minimize the chance of the illness coming back. People who misuse lithium will find that it doesn’t produce a “high” and might lead to some harmful side effects.

Treatment for AUD and Withdrawal

Detoxification

If you have an alcohol use disorder, you will probably need to undergo a detoxification process. Medically assisted detox is the safest way to rid your body of toxins. Withdrawal from alcohol can be extremely uncomfortable, painful, and even life-threatening, depending on the severity of your addiction. In a detox center, you will be monitored 24 hours a day by medical professionals.

Alcohol Withdrawal

Up to 71% of people who need alcohol detoxification display significant symptoms of alcohol withdrawal. Alcohol withdrawal is a medical syndrome that affects individuals who are used to regular intake of alcohol who have either decreased their alcohol intake or have stopped drinking completely.

Alcohol withdrawal symptoms may appear within hours of stopping or decreasing alcohol intake. The most common symptoms include:

  • tremor, 
  • craving for alcohol, 
  • insomnia, 
  • vivid dreams, 
  • anxiety, 
  • agitation, 
  • irritability, 
  • loss of appetite, 
  • nausea, 
  • vomiting, 
  • headache, 
  • sweating.

Of greater concern are hallucinations, delirium tremens (DTs), and seizures. Grand mal seizures can occur in up to 25% of alcoholics undergoing withdrawal.

Common Alcohol Withdrawal Medications

You will be prescribed medications that will help ease these symptoms. Some medications that help manage severe alcohol withdrawal include:

  • Benzodiazepines—Sedatives that are preferred for alcohol detoxification.
  • Anticonvulsants—May be necessary to prevent seizures.
  • Antipsychotics—May be given to treat hallucinations, delusions, and agitation.
  • Clonidine—Can help manage symptoms of high blood pressure and high body temperature.

Medically Assisted Treatment

After completing the detox process, certain medications can be used for the treatment of alcohol dependence. Common medications include:

  • Naltrexone—This medication dulls the rewarding effects of continued drinking.
  • Acamprosate—This helps with anxiety and restlessness and helps with cravings.
  • Disulfiram—Disulfiram causes unpleasant effects like nausea and heart palpitations if you drink alcohol.

After detoxification, you will get to the hard work of getting well. Controlling your drinking is only part of the solution. With the help of psychologists, social workers, and counselors you will learn new strategies to use in your everyday life. You will learn how to:

  • Change the behaviors that make you want to drink
  • Cope with stress and other triggers
  • Build a strong support system

Levels of Care

Depending on the severity of your disorder, the length of time you have been using alcohol, and your personal situation, you may receive treatment at different levels.

  • Residential–Some people will need care in a residential facility, where they are sheltered from situations and environments that may cause a relapse.
  • Intensive Outpatient—You may be able to live at home and attend therapy sessions during the day.
  • Outpatient— you live at home and attend therapy during the day but the sessions are not as long or frequent as Intensive Outpatient.

Discovery Institute Can Help You With Proven Treatment

Recovery can take a long time so you have no time to waste. At Discovery Institute, we use evidence-based treatments that can help you get your life back on track. Nobody ever regrets that they tried their best to live a full, rewarding life.

Our staff of professionals has one job—to help you improve your life. You should contact us now. We are available to you 24-hours a day.

Reviewed for Medical & Clinical Accuracy by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.