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Lithium dosage: how much lithium do you need to treat mental illness?

Lithium dosage is a worrisome topic for most patients. Ideally, use lithium in as low a dosage as does the job. For most people, using subtherapeutic doses of lithium, i.e., below 0.6 mmol/L, can be substantially effective in treating psychiatric issues while reducing the risks of adverse effects.

Just how low can you go to benefit from lithium without the side effects of higher doses?

Lithium is the most effective medication for curbing suicidal behavior. It's also a great solution for managing ADHD and mania. But it's hardly ever prescribed.

One reason lithium is underutilized is because of its low profitability in the pharmaceutical industry. The other reason is the side effects you may experience when lithium becomes too much in your blood, therefore needing close monitoring.

But the truth is, you don't need lithium in high doses.

There is a bunch of evidence that subtherapeutic doses of lithium do not only promote constructive behavior but also delay destructive behavior and protect cognitive function.

So the question is, what's the lowest lithium dosage you can take to retain the effect while avoiding the side effects of higher doses?

Research is still advancing on the subject. Currently, findings show that low-dose lithium (less than 0.6mmol/L) may be beneficial for the brain, heart, and other processes throughout the body.

Benefits of using lithium in a low dosage

The standard therapeutic dose of lithium falls between 0.6mm and 1.2mm serum concentrations.

It's true that most drugs work best when used within their standard dosage. But when it comes to lithium dosage, less is more. Below are 3 reasons why:

1. Low dose lithium reduces the risks of adverse effects

Common side effects of standard lithium use include nausea, diarrhea, and frequent urination among others. Long-term use of lithium (over decades) may also lead to thyroid and kidney issues. But when used in low doses, the risk of side effects plummets.

2. Lithium blood tests may be less frequent at low doses

It's recommended to go for regular blood tests when on lithium therapy. This is so you'll know when your blood lithium levels are rising so you can cut down on your use. This is true for standard doses. And many people quit lithium treatment because of the hassle of frequent blood tests.

When on subtherapeutic lithium dosage though, the frequency of blood tests may be less. Ensure you talk to your provider to figure out what the safest frequency is for you. Your provider may also run a test at the beginning of your lithium therapy to establish the low dose.

3. You get safe low-dose lithium from food

Did you know that the US Environmental Protection Agency estimates the daily lithium intake of an adult to be about 0.65-3mg? Sources of lithium include potatoes, eggs, tea, and even drinking water!

Notably, the amount of lithium you get from your diet is usually below the therapeutic dose. But investigations indicate a beneficial effect of dietary lithium on mood.

Additionally, studies show that lithium present in drinking water may protect against suicide.

So if this low amount can provide you with the benefits of lithium, there's no reason to use the drug in high doses.

Let us help you

Lithium is well-known for its mood-stabilizing effects in treating bipolar disorder, ADHD, and depression. If you've been hesitant due to the side effects, or you're uncertain if it's right for you, we can help.

At Hope Mental Health, your safety and well-being are top priority. We'll always access your mental health situation to determine the right treatment for you.

Come, let's talk.

Satu H. Woodland, PMHCNS-BC, APRN 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.

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