Initially your doctor's advice is likely to follow the National Institute for Health and Care Excellence (NICE) guidelines, which recommend that:
- If you have had an episode of bipolar disorder, you should continue with medication for at least 2 years.
- If you have a history of frequent relapses or severe psychotic episodes, or you take street drugs, have a lot of stress in your life, or poor social support, you may need to continue for up to 5 years.
- If you are just starting lithium treatment, you will probably need to stay on it for at least 6 months to find out whether it will be an effective treatment for you. If you've been completely free of relapses after taking lithium for 3–4 years, it may be appropriate to see if you can manage without it.
In the long term, it will depend on how much you feel your medication helps you, and what you and your doctor agree is best.
You might find that you prefer to carry on taking medication for many years, if it helps you remain stable and able to get on with your life. Alternatively you might take medication to start with, but then develop alternative strategies for coping without drugs. You may also have developed your own views about how long you will need to take medication for, based on your past experiences.
When I am taking lamotrigine, things are generally more stable. I feel calmer and less at the mercy of unpredictable and extreme mood changes. I find it hard to commit to taking medication on a long-term basis, but I know that I would find things easier if I did.
What if I want to stop taking my medication?
If you decide you want to come off your medication, it's important to do it safely. See our pages on coming off medication for key information and guidance.
Lithium and anti-convulsant mood stabilisers
When coming off mood stabilisers it is very helpful if you monitor your mood carefully, perhaps using a mood diary. See bipolar disorder and hypomania and mania for more information and support.
There do not appear to be physical withdrawal symptoms with lithium.
However, if you come off lithium too quickly you are very likely to have a rebound manic or psychotic episode and become quite ill, so you need to be cautious, reduce gradually – over at least one month, and much longer if you have been taking it for years.
If relapse occurs, it happens in the first few months after withdrawal and then tails off.
|Withdrawal effects associated with anticonvulsants include:
• mood swings, anxiety and irritability which may be very like the symptoms you were taking the medication for
• stomach and gut problems
• coughs and colds
• liver problems
|• difficulties with memory, learning and thinking
• eye and sight problems
• sensory disturbances
• abnormal menstrual periods
• difficulty sleeping and fatigue
• weight gain
• muscle spasms, twitches and shaking
• fits, even if you have never had one before.
For specific information about coming off a particular mood stabiliser, see our information on:
This information was published in February 2015. We will revise it in 2018.