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Lithium for Mental Illness: Uses, Dosage, Side Effects and More

lithium in mental illness

Who would have thought that a monovalent cation such as lithium would become such a powerful weapon against a wide range of mental illnesses? Well, that seems to be the case. And if you're living with bipolar disorder or any other mood disorder, adding lithium into your prescription plan wouldn't be a bad idea. Why?

Lithium is a mood stabilizer used in treating several mental illnesses, especially mood disorders like depression and bipolar, and may serve as an incredible solution for people with suicidal ideation. Lithium is also particular effective for managing ADHD. But that's just the tip of the iceberg.

Lithium protects neurons in the brain and may slow down aging, thereby preventing Dementia.

You may wonder. Doesn't all this sound a bit too fantastic? Not exactly, there is a ton of research behind those claims.

Let's look at a few.

Lithium's effectiveness in treating mood disorders

Lithium has become a go-to drug for treating mood disorders like depression and mania in bipopla disorder, as it works as a mood stabilizer.

Lithium may be particularly effective in treating treatment-resistant bipolar disorder, as it may stabilize your mood midway between the high (mania) and low (depression). It's also great for ADHD as it may help curb hyperactivity. Lithium may even be a better alternative to stimulants for ADHD.

But arguably the best part about lithium and mental health is its impact on suicidal ideation. Patients with suicidal thoughts can greatly benefit from lithium as it can help reduce the tendency of self-harming behavior.

You see, suicidal thoughts usually manifest as a symptom of mental illnesses, and not because the individual really has a genuine reason for wanting to hurt themselves. And it's good to know that lithium may help restore mood, reducing risks of suicide.

Lithium may protect the brain and prevent dementia

Brain tissue shrinks over time as a person gets older. What results is a gradual, irreparable decline in cognition, social and communication skills, and loss of memory, i.e. dementia. OK, hold that thought for now.

In people who suffered manic episodes over time, the outer part of the brain, known as the prefrontal cortex (responsible for executive control, memory, learning, and emotion), shrinked significantly. Of course, the brain, including this prefrontal cortex, may shrink as one gets older.

But the shrinking is usually accelerated in people with bipolar disorder. And this may contribute to why dementia risk is about 3 times higher in bipolar disorder patients.

But interestingly, the cortex of bipolar disorder patients on lithium medication didn't thin much -- not even as much as that of healthy people. One possible explanation for why their cortex didn't thin was the presence of lithium, which is known to have neuroprotective effects. This helps to keep the brain younger and more functional as the patient ages, thereby preventing dementia.

Whether you're suffering from bipolar disorder or not, the study suggests that by using lithium throughout the years, you may push dementia further away.

 

Notably, that wasn't the first research on lithium and cognitive function.

It all started when researchers noticed a pattern among patients with bipolar disorder: those on lithium medications had lower rates of cognitive decline than those on other medications. So they went ahead to confirm their suspicion. The results were staggering.

Bipolar disorder patients on lithium therapy had an Alzheimer's risk of just 5% compared to the 33% of patients on non-lithium medications. (Nunes et al., 2007).

Excited by the findings, researchers would go on to try low-dose lithium on Alzheimer's patients, to see if it could be a cure or at least, a treatment. The results were rather disappointing. Apparently, lithium was more about preventing Alzheimer's than curing it when the brain had already degenerated.

To verify that hypothesis, there was another research on individuals with high risks of Alzheimer's (Forlenza et al, 2011). The disease wasn't already established, and neither had their nervous system started declining. But destructive tau proteins, associated with Alzheimer's disease, were already high in their system.

One group was put on lithium therapy, the other served as a placebo. After a year, the group on lithium had far lower tau protein present, whereas the tau protein in the placebo group had increased over those 12 months, increasing their Alzheimer's risk. Besides, cognitive function improved significantly in the lithium group.

This suggested that lithium has a significant impact on preventing dementia when used early enough before the decline had progressed.

Antiaging effects of Lithium

Here, the effects of lithium on bipolar disorder come into play yet again. We know that BD has consistently been associated with age-related diseases such as Alzheimer's, heart problems, type 2 diabetes, and malignancies. It doesn't stop there though.

BD patients also show accelerated aging at the molecular level, from increased oxidative stress to epigenetic aging (your rate of aging influenced by your genetics).

Lithium has proven useful in slowing down these aging processes on occasions, typically by reversing the destructive effects of bipolar disorder.

How much lithium should you take?

US Environmental Protection Agency estimates the daily lithium intake of an adult is about 0.65mg to 3mg. You can get lithium from grains and vegetables, eggs, and milk. WHO has even added lithium to its list of nutritionally essential trace elements alongside zinc and iodine. But are these amounts from food enough to offer you the benefits? Studies show that the little lithium present in drinking water is associated with lower rates of suicide.

Lithium, like all drugs, comes with its fair share of side effects, including diarrhea, nausea, thyroid, and kidney problems. But when used at low-dose or subtherapeutic levels (below 0.6 mmol/L), the risks plummet.

Ideally, you should take lithium as low a dose as does the job. 

Thankfully, additional studies have shown that low doses of lithium such as naturally present in water and food or supplements are also effective. So, the risk of side effects may lower when you minimize your doses.

Using high doses of lithium for long term may result in lithium toxicity, which usually comes with symptoms like nausea and muscle spasms, so you want to avoid having too much lithium in your blood at any given time. Importantly, your doctor or psychiatrist should conduct a blood test at the beginning of your lithium therapy to establish low dose levels.

At standard therapeutic doses of lithium (0.6mm-1.2mm serum concentrations), you would need regular blood tests throughout the treatment to monitor your blood lithium levels in order to avoid lithium toxity. This regular tests is one reason some patients quit lithium treatment as it can become inconvenient.

Why do psychiatrists not prescribe lithium more often?

Lithium was first used by psychiatrists in the mid 1800s. In 1968, scientists conducted the first controlled trial of lithium for unipolar depression (i.e. depression without any history of mania). After researchers proved the benefits of lithium in bipolar disorder, the drug became FDA-approved.

Lithium was seen as the gold standard in treating mood disorders for a while, until it was replaced by other more financially profitable alternatives.

Pharmaceutical companies don't make as much money from lithium, given that it's a naturally occuring element, as they generate from conventional drugs. So they don't sell it to doctors. Newer alternative drugs bring in hundreds of thousands monthly.

Still, lithium remains one of the most effective drugs for mania and ADHD, and if safety recommendations are followed diligently, some patients may even experience better results than from other common medications.

How does litium make you feel?

Lithium can make you feel nauseous after use, with some people experiencing diarrhea and dry mouth with a metallic taste. These are some of the common side effects of lithium.

Does lithium help with anxiety?

From findings, lithium may have an impact in treating comorbid anxiety in bipolar disorder, whether used alone or as an adjunctive medication. Again, effects are perceived at low doses of lithium.

What does lithium do to a normal person?

Studies show that when a normal healthy person takes lithium, it can cause changes in their mood and slow down their psychomotor movements. These effects are not strongly related to the plasma or RBC lithium concentrations in their blood.

How does lithium work in mental health?

The exact mechanism of action of lithium in psychiatric patients is not fully understood. However, it is believed to involve the modulation of neurotransmitters and intracellular signaling pathways, which can help stabilize mood, reduce excitability, and regulate certain brain functions associated with mood disorders like bipolar disorder.

Lithium's drug class

Lithium is a class of drugs known as mood stabilizers. Hence, lithium is particular effective in managing mood disorders.

Lithium's use in mental illness: An option you may not want to ignore

Given the potentials of lithium, it isn't difficult to see why one may deem this naturally occuring mineral a miracle in the world of psychiatry.

So, what's the bottom line in all of these? Knowing the remarkable effects of lithium in treatment-resistant depression, bipolar disorder, suicidal ideation, ADHD, and even cognitive decline, it's worth considering adding lithium to your treatment plan.

Are you suffering any mental health challenge and need help? Come, let's talk. At Hope Mental Health, we can help evaluate your unique situation, diagnose the problem, and provide the best-suited treatment plan. Begin your journey to better mental well-being today.

Author
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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