What Is Lithium Carbonate? Uses, Dosage, and What You Need to Know in 2026

Lithium Carbonate is a mood-stabilizing medication that has been used in psychiatry since 1949 and approved by the FDA since 1970. It remains one of the most prescribed and most studied treatments for bipolar disorder in the world. Despite the emergence of many newer medications, Lithium Carbonate is still considered the gold standard for long-term bipolar disorder treatment by most clinical guidelines.

What Is Lithium Carbonate Used For?

Lithium Carbonate's FDA-approved uses are:

Treatment of acute manic and mixed episodes of Bipolar I Disorder (patients aged 7 and older)

Maintenance treatment of Bipolar I Disorder (patients aged 7 and older) to reduce frequency and severity of future episodes

It is also prescribed off-label for:

Augmentation of antidepressants in treatment-resistant major depressive disorder (MDD)

Bipolar disorder maintenance in patients without a history of mania

Cluster headaches and vascular headaches

Neutropenia (chemotherapy-induced low white blood cell count)

What Drug Class Is Lithium Carbonate?

Lithium Carbonate belongs to the class of medications called mood stabilizers (also called antimanic agents). Unlike antidepressants, which target one end of the mood spectrum, or antipsychotics, which primarily target psychosis, mood stabilizers work to smooth out the extreme highs and lows of bipolar disorder. Lithium is the only natural element used as a psychiatric medication and has been on the WHO's List of Essential Medicines since 1977.

Available Forms and Dosage

Lithium Carbonate is available as:

Immediate-release tablets: 300 mg (most common)

Capsules: 150 mg, 300 mg, 600 mg

Extended-release (ER) tablets: 300 mg (brand Lithobid), 450 mg — slower absorption, may cause less GI upset

Oral solution: 8 mEq per 5 mL (equivalent to 300 mg lithium carbonate); used for patients who cannot swallow pills

Typical adult dosing:

Acute mania: Typically 900–1800 mg/day in divided doses; titrated to serum level 0.8–1.2 mEq/L

Maintenance: Typically 600–1200 mg/day; titrated to serum level 0.6–1.0 mEq/L

Children/adolescents (7+): Start 300 mg TID if >30 kg; titrate based on serum levels

How Should You Take Lithium Carbonate?

Take it with food or milk to reduce nausea

Swallow ER tablets whole —never crush, chew, or break them

Stay well-hydrated: Drink 8–10 glasses of water per day; avoid dehydration from heat, exercise, or illness

Maintain consistent salt intake: Sudden low-sodium diets can cause dangerous lithium retention; do not start a very low-sodium diet without telling your doctor

Never skip doses or double up: If you miss a dose, call your prescriber for guidance—do not take a double dose

Is Lithium Carbonate a Controlled Substance?

No. Lithium Carbonate is not a controlled substance and has no DEA scheduling. It can be prescribed by any licensed prescriber, called in electronically, and refilled without the restrictions that apply to controlled medications. It can also be prescribed via telehealth in all 50 states.

What Monitoring Is Required?

Because lithium has a narrow therapeutic index, regular blood monitoring is essential:

Serum lithium levels: Every 1–2 weeks when starting; every 2–3 months when stable. Always drawn 12 hours after last dose (trough level).

Renal function: Creatinine, BUN, eGFR — every 6 months

Thyroid function (TSH): Every 6–12 months; hypothyroidism develops in up to 40% of long-term users

Serum calcium: Annually; lithium can cause hypercalcemia

For detailed information on side effects, see Lithium Carbonate Side Effects: What to Expect and When to Call Your Doctor. To understand how lithium works, see How Does Lithium Carbonate Work? Mechanism of Action Explained. If you need help finding your prescription at a local pharmacy, visit medfinder.