From the Guidelines
Lithium's washout period is typically considered to be around 5 to 7 days, but it can take up to 2 weeks for complete elimination from the body, and a gradual taper is recommended to minimize withdrawal symptoms and mood destabilization. When discontinuing lithium, it's crucial to consider the individual's current dose, treatment duration, and clinical status to determine the exact tapering schedule. The risk of relapse increases during lithium discontinuation, especially within the 6-month period following lithium discontinuation, as noted in the American Psychiatric Association's guidelines 1. Lithium has a half-life of approximately 24 hours, meaning it takes about 5 half-lives (5 days) to clear most of the medication from the system. However, complete elimination depends on kidney function, as lithium is primarily excreted through the kidneys. Patients with reduced kidney function may require a longer washout period. Some studies suggest that maintenance therapy is often needed for individuals with bipolar disorder, with some requiring lifelong therapy when the benefits of continued treatment outweigh the risks 1. The provided evidence from the study published in 2007 1 does not directly address the washout period for lithium but highlights the importance of gradual discontinuation and monitoring for relapse. In contrast, the 2016 study 1 provides information on medication withdrawal schedules for various medications but does not specifically address lithium. Given the available information, a gradual taper of lithium over a period of 5 to 7 days is recommended, with close monitoring for signs of mood changes and relapse. The exact tapering schedule should be determined by a healthcare provider based on the individual's current dose, treatment duration, and clinical status.
From the FDA Drug Label
The half-life of elimination of lithium is approximately 24 hours.
The washout period for lithium (lithium carbonate) is not explicitly stated in the drug label. However, based on the half-life of elimination, it can be estimated that 5 half-lives (approximately 120 hours or 5 days) may be necessary for the drug to be largely eliminated from the body.
- Key points:
- Half-life of elimination: approximately 24 hours
- Estimated washout period: approximately 5 days (5 half-lives) 2
From the Research
Washout Period for Lithium
- The washout period for lithium is not explicitly stated in the provided studies as a specific value for lithium itself.
- However, in the study 3, a washout period of one week was used for previously administered antidepressants before starting the treatment with venlafaxine and lithium carbonate.
- In the study 4, a minimum 3-day washout period was used before random assignment to divalproex, lithium, or placebo.
- It is essential to note that the washout period may vary depending on the specific context and the medications involved.
- There is no specific information available in the provided studies regarding the washout period for lithium (lithium carbonate) itself.