Nov, 12 2025
Lithium and NSAIDs can dangerously interact, increasing lithium levels by up to 60% and raising the risk of kidney damage and toxicity. Learn how to avoid this life-threatening combination and what safer pain relief options exist.
Lithium Nephrotoxicity: What You Need to Know About Kidney Damage from Lithium
When you take lithium, a mood-stabilizing drug used primarily for bipolar disorder. Also known as lithium carbonate, it helps control manic and depressive episodes—but it doesn’t come without risks. One of the most serious, yet often overlooked, side effects is lithium nephrotoxicity, kidney damage caused by long-term lithium use. This isn’t rare—it affects up to 30% of people on chronic lithium therapy, and it can quietly worsen over years if unchecked. Unlike sudden liver damage from some antifungals, lithium nephrotoxicity creeps in slowly, often mistaken for normal aging or dehydration.
The kidneys filter lithium out of your blood, but over time, they get worn down. This leads to nephrogenic diabetes insipidus, a condition where the kidneys can’t concentrate urine, causing excessive thirst and frequent urination. It’s not just about peeing a lot—chronic fluid loss strains the kidneys further, raising the risk of chronic kidney disease. Some people end up with reduced kidney function, needing lifelong monitoring. Blood tests for creatinine and estimated glomerular filtration rate (eGFR) are non-negotiable if you’ve been on lithium for more than five years. Even if you feel fine, your kidneys might not be.
Who’s most at risk? Older adults, people with high lithium blood levels, those on long-term treatment, and anyone with pre-existing kidney issues or dehydration habits. Even something as simple as cutting back on water during a hot day or getting the flu can spike lithium levels and trigger acute kidney stress. It’s not just about the dose—it’s about how your body handles it over time.
Here’s the good news: this damage isn’t always permanent. If caught early, lowering the lithium dose, switching to extended-release forms, or adding amiloride (a kidney-protective diuretic) can stabilize things. Many patients stay on lithium safely for decades with regular checkups and smart hydration. But skipping blood tests or ignoring symptoms like constant thirst or swelling in the ankles? That’s when things turn serious.
The posts below cover real-world cases, monitoring protocols, and alternatives that reduce kidney strain—like how some doctors now use valproate or lamotrigine for patients with early kidney changes. You’ll also find guides on managing side effects, interpreting lab results, and when it’s time to consider other mood stabilizers. No fluff. Just clear, practical info from people who’ve been there.