Lithium vs. stimulants: why lithium is a better medication for ADHD

Why use lithium over stimulants for ADHD

I talked extensively about lithium for ADHD in my previous post. But of course, lithium isn't the only available medication out there; stimulants are the most widely used medication for ADHD and have been in use for decades.

Stimulants are believed to work by increasing dopamine, a neurotransmitter that stimulates a network of neurons in the brain so that they work more effectively together. For people with ADHD, this may lead to improved concentration while reducing hyperactivity and impulsiveness.

However, several pieces of evidence suggest that lithium is better than stimulants when it comes to treating ADHD.

We discuss them below.

Key Takeaways:

• While stimulants increase the risk of addiction, lithium may do the opposite
• Stimulants are toxic to the nervous system but Lithium protects the brain and may prevent dementia
• Stimulants may cause the heart to age prematurely, leading to cardiovascular problems.
• The efficacy of stimulants usually wanes over time as the body grows tolerant.

Stimulants increase addiction risk - Lithium may do the opposite

People with attention-deficit/hyperactivity disorder (ADHD) generally have a high risk of forming addiction due to their low impulse control. And the common medications for treating ADHD, such as Adderall, Vyvanse, and Ritalin, all stimulants, may lead to addiction when abused.

So, when you think about it, it's usually not the best choice to expose ADHD patients to a potentially addictive drug, especially when they have to use them throughout life.

This is not to say that every ADHD patient will develop an addiction to whatever stimulant they're using. Of course, when under a good medically supervised treatment plan, the risk drops. But if there's a risk at all, it becomes worrisome.

And now that stimulant addiction is approaching the level of opioid addiction, it is indeed something to worry about.

There's an alternative: Lithium. So how does lithium measure up?

Lithium has been shown to not only be as effective as Ritalin for ADHD but it has been suggested that low-dose lithium may help patients exit the cycle of addiction.

So, while stimulants may expose patients to the risk of addiction, it's the opposite with lithium. 

Lithium protects the brain, but stimulants are toxic

In this blog post, we talked about lithium's neuroprotective powers. Lithium may slow down thinning of the prefrontal cortex, thereby keeping the brain younger and more functional as the person ages, potentially preventing dementia.

But stimulants work in reverse in that they may lead to cognitive decline. Stimulants speed up activity in the central nervous system, thereby interfering with the brain's delicate chemical balance. In short, stimulants can be toxic to the brain.

And due to its high metabolic activity, the brain is particularly sensitive to substance-induced toxicity.

Stimulants may cause premature aging of the heart

Stimulants may prematurely age the heart, especially when abused or used long-term, as is the case with ADHD patients. This goes hand in hand with how stimulants work.

As a stimulant drug moves through the blood vessels, it increases heart rate, blood pressure, and respiration, all of which interfere with normal heart function. As a result, it may speed up the cardiovascular system's aging process and cause untimely damage to the heart.

Perhaps, this may contribute to why the risk of cardiovascular disease is higher (38%) in ADHD patients than in people without ADHD (23.5%).

Tolerance to stimulant medication

As one would expect, tolerance for stimulants grows over time, and the ADHD patient may experience less and less reduction in their ADHD symptoms the longer they use the drug. Chronic tolerance may occur in adults treated for up to 26 weeks (6 months).

And here's something that may be even more worrisome.

In one study, there were significant improvements in ADHD symptoms early into the research. But as time wore on, it started diminishing. And during the last three months of treatment, hyperactivity had worsened. Although the researchers weren't sure of the cause, one possible — and likely — explanation is tolerance.

So if you've been using Adderall or any other stimulant for ADHD and feel as though it has stopped working, It's possible that your body has developed a tolerance for the drug.

As of now, there is no evidence of lithium tolerance in ADHD.

Final Words

Although lithium has its side effects, they may be limited — if not eliminated — by using subtherapeutic doses. And thankfully, you may get the optimum benefits of lithium even in such low-doses.

In many ways, lithium scores over stimulants when it comes to ADHD medication.

If you're battling with ADHD symptoms, come, let's talk. At Hope Mental Health, we'll assess your personal situation to find the best remedy that's just right for you.

Reach out to us now and begin your journey to better mental well-being.

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.