Lithium, a natural salt, is widely known as a prescribed mood modulator used for various illnesses. While there are several illnesses lithium can be used as treatment for, bipolar disorder is most commonly associated with the use of this medication. Other uses include suicide prevention, dementia, and unipolar depression (Marjan et al., 2023). It is prescribed by doctors to reduce and treat the severity of manic and hypomanic episodes. Lithium works better than standard depression medications because it maintains much better stability of mood over time.

Lithium is primarily taken in the form of oral ingestion such as tablets, capsules, and extended-release tablets. The administration of this medication is closely monitored through a physician, with blood tests being required initially every 5–7 days, and every 3 months for maintenance. The typical time period between first taking lithium and observed effects is between 10–15 days (Hart & Ksir, 2026). Once it is absorbed into the bloodstream, lithium is then distributed into the brain where it helps regulate the various signaling pathways involved in mood. Research also shows that many differences in gene expression between individuals can influence how lithium is processed and how it acts within the body (Bertollo et al., 2026).

Though there are quite a few regions within the brain that are impacted by the use of lithium, the most prominent are the hippocampus and amygdala. These areas are involved in memory, emotional regulation, and processing stress. These functions in particular are disrupted in individuals with bipolar disorder. Lithium interferes with the inositol pathway in the brain. This pathway acts as a backup messenger system that is blocked through its interaction with lithium. This blocking mutes the overactive intracellular signaling (Neurolaunch, 2024). When the signaling turns overactive, it can cause the extreme mood changes commonly seen during manic episodes in bipolar disorder. By reducing this, lithium helps to stabilize neuron communication, leading to a balanced mood.

The primary neurotransmitters affected by lithium are dopamine, glutamate, and gamma-aminobutyric acid (GABA). These transmitters play a crucial role in regulating mood, emotion, and overall activity within an individual (Marjan et al., 2023). It is not widely understood whether lithium acts as an agonist, antagonist, reuptake inhibitor, or releaser. Instead, lithium works by modifying numerous pathways in the brain. Studies show that reducing the GSK-3 enzyme in the brain, which helps regulate activity, helps regulate the systems that are important for lithium to have its full effects on the body (Neurolaunch, 2024). These changes help improve neurotransmitter activity and significantly reduce the extreme mood shifts that come with bipolar disorder.

The subjective effects of lithium vary between individuals. Instead of feeling the extreme senses of euphoria or sedation, lithium works to stabilize mood. Many patients taking this medication report feeling in control of their day-to-day lives. Research shows that inflammation could be a cause of the extreme mood swings. Lithium inhibits the enzyme GSK-3 to reduce inflammation, leading to more stability. This process is believed to contribute to lithium’s ability to significantly decrease aggressive behaviors and lower the chances of suicidal thoughts (Bertollo et al., 2026). As the inflammatory responses are reduced, communication in the brain becomes far more balanced, allowing mood to remain stable over time. Individuals taking lithium tend to experience improved emotional regulation, making it easier to maintain healthy relationships in their lives and complete daily responsibilities.

There are a wide range of observable behavioral effects related to the use of lithium, both positive and negative. More stability in high and low moods is an advantage of this medication. Mania and hypomania are better controlled, allowing for stable impulse control and fewer suicidal thoughts.

Alongside the behavioral effects observed during the course of taking this medication, a few physiological effects are also present. An increased urge to urinate is a common side effect individuals face. Additionally, tremors, thyroid issues, and weight gain may become present with higher doses or long-term use (Hailu et al., n.d.). Over half of the patients questioned in Hailu and associates’ survey experienced adverse effects such as these.

Unlike other drugs, lithium is not one that poses a threat in regards to dependence and addiction. However, lithium can produce withdrawal-like symptoms if stopped suddenly. This sudden absence of lithium can bring about manic episodes, suicidal thoughts, as well as thyroid issues. According to research done by Carmaciu and associates, lithium can interfere with the normal release of thyroid hormones by reducing iodine uptake in the body. Over time, if this continues, thyroid enlargement or hypothyroidism can become apparent (Carmaciu et al., 2003). Because of these potential problems arising with the use of lithium, regular blood tests are required to monitor thyroid function.

Short-term effects may include dehydration as well as increased urination. Long-term effects become more serious as the dosage increases, alongside duration. These long-term effects can present as renal and endocrine issues, tremors, and confusion. There is a chance of overdose while taking this medication, but this is combated by close monitoring from physicians through blood work. Overdose signs may include ataxia, tremors, seizures, cardiac arrhythmias, and renal complications (Prasad et al., 2026). Through weekly or tri-monthly monitoring, this can be avoided. One must be aware of the risks of taking lithium with NSAIDs as well as diuretics, as there are adverse interactions between these medications. While the side effects can be inconvenient, they are often manageable with monitoring from doctors and proper dose adjustments.

Evidence of the effectiveness of lithium on the brain and body of individuals with bipolar disorder is shown in numerous studies. One study in particular shows, through MRI images, that there are regional increases of grey matter in the hippocampus and amygdala (Germaná et al., 2010).

This is beneficial, as the grey matter helps with mood and emotion-regulating systems. In addition to treating manic episodes, lithium is a widely liked medication used as long-term maintenance. This allows individuals to consistently experience stable moods and improved daily function.

There are many misconceptions held against individuals with bipolar disorder and the use of lithium for treatment of such disorders. One of the most common stigmas is that people with bipolar disorder are always unpredictable or dangerous. In reality, the symptoms and behaviors can vary greatly from person to person. Research shows that individuals experiencing manic symptoms tend to be viewed as being more out of control and a danger than people with conditions like anxiety or depression (Na et al., 2025). These stereotypes commonly lead to fear, discrimination, and strong misunderstanding from others. Another common misconception is that taking lithium completely changes an individual’s personality or makes them feel numb. While some individuals do experience side effects, the purpose of lithium is to stabilize mood rather than take away mood altogether. Compared with other disorders, the label of bipolar disorder is still widely associated with a plethora of social judgment. Studies have shown that even people who are accepting of mental illness can sometimes be hesitant to pursue a relationship with someone who has bipolar disorder (Tatz et al., 2024). These stigmas can be detrimental to those who live with the disorder.

• Bertollo, A. G., Mingoti, M. E., Junior, S. A., Dallagnol, P., Tonin, P. T., & Ignácio, Z. M. (2026). Lithium therapeutic functions: An update on pharmacokinetics, pathophysiological mechanisms of action, toxicity, and side effects. Molecular Neurobiology, 63(1).
• Carmaciu, C. D., Anderson, C. S., & Lawton, C. A. (2003). Thyrotoxicosis after complete or partial lithium withdrawal in two patients with bipolar affective disorder. Bipolar Disorders.
• Germaná, C., Kempton, M. J., Sarnicola, A., Christodoulou, T., Haldane, M., Hadjulis, M., Girardi, P., Tata Relli, R., & Frangou, S. (2010). The effects of lithium and anticonvulsants on brain structure in bipolar disorder. Acta Psychiatrica Scandinavica.
• Hailu, A. E., Teferra, S., Engidawork, E., & Gurumallesh Prabu, P. (n.d.). Response and adverse effects to lithium treatment in patients with bipolar disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. BioMed Research International.
• Hart, C. L., & Ksir, C. J. (2026). Treatment of mental disorders. In Drugs, society, and human behavior (p. 88).
• Marjan, M., Fallah, H., Ghofrani-Jahromi, Z., Rahimi-Danesh, M., Shokouhi Qare Saadlou, M.-S., & Vaseghi, S. (2023). Mood and behavior regulation: Interaction of lithium and dopaminergic system. Naunyn-Schmiedeberg’s Archives of Pharmacology.
• Na, J., Kim, H., & Mikami, A. Y. (2025). Reducing public stigma toward bipolar disorder: I. Interventions and outcomes. Journal of Affective Disorders, 392.
• Neurolaunch Editorial Team (Ed.). (2024, September). Lithium’s impact on the brain: Mechanisms, effects, and therapeutic applications. Neurolaunch.com.
• Prasad, S., Sharma, V., Sosal, W., Mehta, P., Fatima, A., Milad Fekrat, S. M., Kolloju, S., Rocha, M., Matmusaeva, E., & Gunturu, S. (2026). Lithium: A review of its adverse effects, toxicity and discontinuation. Disease-a-Month, 72(4).
• Tatz, C., Ferrall, L., Deis, G., & Piatt, J. (2024). An examination of the barriers, stereotypes, and stigmas Bi+ and bipolar people encounter with respect to sexual health and wellness. Sexuality & Disability.