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Frequent urination and lithiumOne of the most irritating and persistent side effects is frequent urination and lithium. Yes - it can be annoying and inconvenient - but don't allow it to sabotage your treatment. There are some answers!
One answer is usually to drink more rather than to drink less. The lithium will increase your thirst and may dehydrate you - it is essential to maintain your water balance and keep replacing all that is lost. This is a bit like the paradox we all experience when we heed the recognized advice to drink more water - first of all when we start drinking the wise 8-12 glasses a day we make constant trips to the rest room - then our body adjusts. Remember - caffeinated drinks are diuretics that will add to the problem and may also compound other side effects such as hand tremors or weight gain, so drink water - not soda or coffee. Alcohol can also contribute to the problem. Excesive urination is a medical condition called polyuria. A 24 hour volume greater than 3 liters is usually considered clinically significant polyuria. Some of us get concerned that all those rest room visits will raise eyebrows in our workplace - PLEASE - don't be afraid to talk to your boss. Explain briefly and discretely that you take a medication that causes you to make a few extra rest room visits - BUT this will NOT effect your ability to go a good job! Another concern is the effect on sleep. Enough sleep is essential for bipolar people and disrupted sleep can trigger mania. Managing a few extra bathroom visits during the day is a price worth paying for your mental health, but if frequent urination is disrupting your sleep then find a solution! One strategy that works well is to take an extended release version of the drug, for example as a single once a day dose. Experiment with whether this works best taken in the morning or at bedtime. Important research has shown that taking lithium along with other drugs such as SSRIs is associated with up to 4 times more polyuria. Just as some substances can increase frequent urination and lithium, others can help prevent it. Good results have been found with taking extra potassium or inositol. (Inositol, as you will see elsewhere on this site, is a supplement that all bipolar people should take anyway!) Finally, talk to your doctor. It may be that you can decrease your dose, vanquish the side effects and still obtain enough lithium to stay well. Fine tuning dosage is a slow process of experimenting - but is SO worth it to be healthy. Never forget your goal - to be taking the minimum dose you need to stay well, and thereby experiencing the absolute least amount of side effects. It takes a while sometimes to find that sweet spot but it is one of the most worthwhile adventures you could ever embark on. Important tips
2. Avoid or eliminate caffeine, including soda and coffee. 3. Avoid or eliminate alcohol. 4. Switch to an extended release version of the drug. 5. Experiment with once a day dosing, either morning or bedtime. 6. Avoid taking lithium in combination with other drugs such as SSRIs, NSAIDS, and NaSSAs. 7. Check for diabetes. 8. Check for kidney malfunction, for example by checking creatinine levels. 9. Discuss potassium or inositol supplementation with your doctor 10. Discuss taking amiloride with your doctor 11. Talk to your doctor about certain medications that may help 12. Talk to your doctor about decreasing your dose.
Most important tip!Keep focused on the big picture! Stay positive and watch your self-talk. You can use these strategies to manage this side effect - don't lose perspective and let a few extra trips to the rest room become an excuse for abandoning treatment and turning your life into a bipolar train wreck!Take these articles to your doctor . . .You can't expect your doctor to know EVERYTHING about frequent urination and lithium. Stay involved in your own care. Take your doctor some of these articles explaining the tips on managing frequent urination and lithium:
1. Frequent urination and inositol
SourcesOur motto here at bipolar-lives.com is Fact NOT Fiction.the following authoritative texts were used to compile this page: - Frederick K. Goodwin & Kay Redfield Jamison Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, Oxford University Press, 2007. - James W. Jefferson & John H. Greist Lithium and Bipolar Disorder: A Guide, Lithium Information Center, Madison Institute of Medicine, 2004. - Ronald R. Fieve Moodswing, Bantam Books, 1997.
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