Lithium and Weight Gain
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Q:  Dear Dr. Phelps: I am a 56 year old female and I was diagnosed BP 24 years ago. I have been hospitalized several times and have been on Lithium ever since. For the last four years I nave not have any episodes and I am taking only 2 300mg lithium capsules daily( I used to take 6 per day) I have struggled with my weight and have gained 60 pounds.My thyroid was affected, I have a nodule and am taking Sinthroid 0.1. I have tried different diets and they do not seem to work for me. I lose 10 and gain them as soon as I stop the diet. I need your advise. Are those new drugs as good as Lithium? I have heard that they do not affect your weight. I have been thinking of stopping the lithium butI'm afraid. My level is o.3 I would like to benefit from your expertise, I am looking forward to hear from you soon. Thank you

Dear Ms. L – 
Ouch: good question.  “Ouch” because wow it would be a shame to give up such a great track record as lithium at 300 has yielded – for anything!  (i.e. given your history prior to that).  On the other hand, weight gain is  a terrible thing to have to live with, I know from my patients.   Yes there are definitely alternatives, but be very very careful and work closely with your doc’ if you switch: the first question should be “how do we know that lithium is the cause of this weight gain?”, as that dose is so low, I’d wonder about that first.   See the little essay on my site about how I warn people about losing what they’ve got and not being able to go back (, bipolar II section, patient version, treatment details, “Door #1” story).    Good luck. 
Dr. Phelps

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