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Cardiac Side Effects of Lithium

author image Karla Casco
Karla Casco began writing in 2010, focusing her work on diseases and treatments and their side effects. She has also created patient handouts, PowerPoint presentations and journal clubs. Karla has a doctorate in pharmacy from St. John's University and holds a pharmacy license for the state of New York.
Cardiac Side Effects of Lithium
Depressed man stares out the window. Photo Credit: KatarzynaBialasiewicz/iStock/Getty Images

Lithium is a prescription medication used for the management of bipolar disorder. It is the most commonly prescribed mood stabilizer to treat both manic and depressive episodes. The drug exerts its action by blocking chemicals in the nerves and muscles that cause the manifestation of bipolar disorder. Lithium may produce many side effects including those that affect the cardiovascular system. Any concerns should be related to a health care professional.

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Lithium may cause arrhythmias, or irregular heartbeat, throughout the course of therapy. If the patient experiences heart palpitations or uneven heart beat, he should seek medical care right away. According to the “Drug Information Handbook,” lithium should be used with caution in patients who have mild to moderate cardiovascular disease and is contraindicated in individuals who have severe cardiovascular disease. Furthermore, a patient with a medical history of arrhythmias may develop a worsening of the condition. “Pharmacotherapy: A Pathophysiologic Approach” states that the patient should consult with a cardiologist and obtain the necessary exams before and during lithium therapy.


Hypotension, or low blood pressure, may also occur with the administration of lithium. The “Drug Information Handbook” states that lithium should be used with caution in patients on medication that lowers blood pressure; these include the medications that belong to the classes called the beta-blockers, ACE inhibitors, and diuretics. The combined use of these drugs could lead to a dangerously low blood pressure. If the patient experiences dizziness and drowsiness, he should be careful when climbing stairs or moving from a lying or sitting position to standing position. If the dizziness or drowsiness worsens, the patient should seek medical help immediately.


Lithium also has the potential to cause bradycardia, or slow heart beat. “Pharmacotherapy: A Pathophysiologic Approach” explains that this effect is not harmful and will not occur once the medication is stopped. The patient should inform the physician of all medical conditions, as well as all over-the-counter and prescription medications she is currently on. This will ensure that the patient is monitored properly. If the patient experiences extremely low heart rate or chest pain, she should seek emergency medical help right away.


Edema, which is the retention of fluids in the body, may be present in individuals on lithium. This may interfere with the use of medications that alter sodium release from the body. The “Drug Information Handbook” explains that any medication which alters sodium excretion should be used with extreme caution. The medications include diuretics, ACE inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib or naproxen. The patient should inform his physician if he is on any of these medications to be monitored appropriately.

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  • "Drug Information Handbook 15th Edition"; Lacy, Charles F., Armstrong, Lora L., et al; 2007
  • "Pharmacotherapy: A Pathophysiologic Approach"; Dipiro, Joseph T., Talbert,Robert L., et al; 2008
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