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Have you ever heard of using low-dose lithium as a supplement for mental health disorders, including ADHD? Well, you're not alone. Many people are unaware of this concept.
But, did you know that high-dose pharmaceutical lithium was approved by the FDA for treating mania in the 1970s? It was once the standard treatment for bipolar disorder, then known as manic-depression.
However, in the 1990s, new medications for bipolar disorder were introduced, and pharmaceutical lithium became less popular. But did that mean lithium lost its therapeutic potential? Absolutely not. What is traditionally considered subtherapeutic doses of lithium remains an effective treatment option for ADHD.
Numerous studies show that lithium effectively reduces symptoms of ADHD, such as anger, aggression, focus, and concentration. These studies focus on pharmaceutical (high-dose) lithium.
But in my practice, Iithium may be taken in smaller subtherapeutic doses to achieve similar but much safer results.
So, what exactly does research tell us about lithium and ADHD?
If you're living with ADHD or have a child who is, you most likely have heard about Ritalin. It's a pretty effective drug. Well, from studies and even my clinical practice, lithium has proven to be more effective.
One such study conducted by a team of psychiatrists and neurologists compared the effects of lithium and Ritalin in young adults with ADHD. Both treatments showed improvement in symptoms, but results showed that lithium was better in several areas.
For example, lithium decreased aggressive outbursts by 71% compared to 26% for Ritalin. It also reduced irritability by 42% compared to Ritalin's 35%. For antisocial behavior, lithium beat Ritalin 28% to 20%.
Conduct disorder is prevalent in people with ADHD, occurring in about 50% of such kids. Conduct disorder is characterized by antisocial behavioral patterns like truancy, bullying, lying, destroying things, and cruelty to animals. Here comes anger and aggression again.
One study conducted at the New York University Medical Center examined the impact of lithium on children with conduct disorder. The study involved 81 children who were given either lithium or Haldol, an antipsychotic medication.
Results showed that while both drugs reduced symptoms, lithium was found to be more effective in reducing aggression, hostility, and hyperactivity compared to Haldol.
But arguably the best part about it all was that, while Haldol mostly sedates the child, lithium solved the problem by reducing the child's explosiveness.
Hence, lithium helped the children feel that they had more control over themselves.
And there is the 2014 study that focused on an 8-year-old girl diagnosed with ADHD, disruptive behavior disorder, and mood disorder. Despite trying various medications like stimulants, antidepressants, and antipsychotics, none of them improved her behavior, which included aggressive outbursts and low frustration tolerance.
The girl was then moved to a psychiatric clinic at the University of Arkansas for Medical Studies, and her psychiatrist put her on lithium as a last resort.
The results were remarkable. The girl's symptoms greatly improved, with a reduction in irritability by over 60%, better sleep, improved academic performance, and better mood regulation.
There was also another study on lithium on 50 children aged 5 to 12. They were divided into two groups, with half taking lithium. After 6 weeks, the results showed that those taking lithium had less aggression, restlessness, and an improved attention span.
Agreed, these were studies using pharmaceutical lithium. But then, using low-dose lithium, I have witnessed some outstanding results in my clinical practice that were similar to the study results.
But how does it work?
We still don't fully understand how lithium works in ADHD, but we do have a general idea of why it might be helpful.
You can think of lithium as a sort of brain tonic that boosts and protects your brain cells and balances the levels of neurotransmitters that let these cells communicate with each other.
Lithium helps increase serotonin, a neurotransmitter that keeps your mood and behavior in check. It may also help boost dopamine levels, which is a key player in ADHD symptoms like hyperactivity and mood swings.
Not only that, but lithium is believed to reduce glutamate, a neurotransmitter that can harm your brain cells if there's too much of it. It may also increase the action of monoamine oxidase, an enzyme that regulates neurotransmitters. Low levels of monoamine oxidase have been linked to aggression.
Lithium can also protect your brain cells from damage caused by too much stimulation and helps activate proteins that keep your brain cells healthy.
But that's not all - lithium may even affect genes in the frontal cortex, the part of your brain that controls aggression. It may also combat neuroinflammation in the brain, which is a factor in many mental health disorders.
And to top it all off, it helps move vitamin B12 and folate into your nerve cells, which is crucial for a healthy brain and nervous system.
It's incredible! And that's why I typically consider lithium a miracle in psychiatry. And that's not just being melodramatic; I've seen the wonderful results in some of my patients time and time again.