Lithium

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Date: July 2022, Version 3

What is it?

Lithium is a mood-stabilising treatment used to treat bipolar disorder, mania, and recurrent depression.

Benefits

What are the benefits of using lithium in pregnancy?

Lithium can be an effective treatment for some mental health disorders, and sometimes works well when other medicines have not been effective. This is important both for a woman’s quality of life, and to ensure that she remains well in preparation for caring for her baby.

Risks

What are the risks of using lithium in pregnancy?

Lithium use in pregnancy may increase the chance of the baby being born with a heart defect. Approximately 1 in every 100 babies born in the UK has a heart defect. This is called the background rate. Some studies suggest that around 2 in every 100 babies exposed in the womb to lithium are born with a heart defect. This still means that the vast majority of babies (98 out of every 100) born to women taking lithium have a normal heart. There is no strong evidence that lithium causes any other problems in pregnancy.

Alternatives

Are there any alternatives to using lithium in pregnancy?

Possibly. Depending on the severity of the illness and whether other medications have been tried in the past, alternative medication can sometimes be used. Additionally, some women, together with their doctor, may decide that treatment can be safely withdrawn during pregnancy.

Women using lithium who are planning a pregnancy or become pregnant should consult their doctor or specialist so that their medication can be reviewed. They should not stop or reduce lithium treatment without medical supervision, as this could put their mental health at risk.

No treatment

What if I prefer not to take medicines during pregnancy?

Women with bipolar affective disorder, mania and depression are at high risk of relapse during pregnancy or in the weeks and months after the baby has been born. Continuing lithium is likely to be the safest option to keep you healthy and enable you to look after your baby. Your doctor will only prescribe medicines when necessary and will be happy to talk to you about any concerns that you might have.

Will I or my baby need extra monitoring?

As part of routine antenatal care, most women will be offered a detailed scan at around 20 weeks of pregnancy to check the baby’s development. Women who have used lithium in early pregnancy will not usually require any extra monitoring of the baby’s development.

If you continue lithium in pregnancy, you may be offered extra blood tests to check your lithium levels. Depending on the results, the dosage may be adjusted, especially in later pregnancy.

Are there any risks to my baby if the father has used lithium?

There is currently no evidence that lithium used by the father around the time of conception can harm the baby.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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