Reply To: alcohol and lithium

[Harvinder]

Here is what I will recommend but let’s hear others’ recommendations as well.

I will motivate the patient to not drink with lithium as the risk is high. If the patient is still drinking: aim for low alcohol (no specific amount is listed in literature) and maintain their hydration. If the patient has a history of alcohol use disorder or other addiction behaviors: I will not recommend even a low amount as the risk of them drinking more is high.

Here is the summary of lithium & alcohol interaction:

• Acute alcohol does not affect lithium absorption, elimination, distribution, or clearance, but alcohol can increase serum lithium concentrations when taken with alcohol. (1)
• Another concern is increased alcohol use induced diuresis by antagonizing ADH, which can indirectly place a patient at risk of high lithium levels.

Reference:

1. Clin Pharmacol Ther. 1985 Jul;38(1):52-5.