Lithium, a medication derived from lithium salts, is a useful but underutilized drug, at least in the United States. It is most often prescribed for treating the mood spectrum disorder bipolar disorder (at one time better known as manic depression), as well as general depression when traditional antidepressants won’t do the job satisfactorily.
It does not seem to be addictive or even habit-forming. Lithium does not produce any of the classic withdrawal symptoms associated with substance use disorder, and it is inexpensive.
Since lithium is a medication, it must be used with a prescription and according to a physician’s instructions. Even taken as directed, there can be side effects that may require adjustments, but it seems to have none of the side effects of benzodiazepines (benzos).
So, why isn’t it prescribed more often?
What Is Lithium?
Lithium is an element, a metal and one of the lightest. It is used in batteries but in far smaller doses, found in naturally occurring salts such as lithium carbonate, it is also a mood stabilizer. It was used for this purpose in mineral springs before the element was isolated.
Lithium was also used to treat gout, a type of arthritis, by reducing concentrations of uric acid, in the mid-1800s. It was first suggested for the treatment of psychiatric disorders in the United States in the 1870s, and in Denmark in 1894, but disappeared from the literature in the United States until the 1950s.
It’s not immediately obvious why, because lithium is a very effective drug.
Benefits of Lithium
Among the benefits of lithium are:
- It controls both mania and depression. Lithium has the best track record for preventing bipolar disorder in the long term of any medicine.
- It works in concert with antidepressants.
- Almost uniquely among mood stabilizers, it reduces suicidal thoughts. When small amounts of lithium were added to drinking water, it reduced overall rates of suicide, crime, and arrests for drug use.
- It may improve cognitive function. It not only lowers the risk or slows the rate of mental deterioration, including dementia, but individuals treated with lithium have a better visual memory.
- It decreases the incidence of illnesses including seizures, heart attacks, ALS (amyotrophic lateral sclerosis or Lou Gehrig’s disease), dementia, and other neurological disorders, as well as some cancers.
- It extends lifespan.
- It improves the effects of psychotropic and antipsychotic drugs.
No drug works the same way for every individual, and lithium is no different. It can be ineffective or have negative side effects that outweigh its benefits.
Is Lithium Addictive?
Despite its strength as a mood stabilizer, and the reluctance to prescribe it in the United States, lithium is not addictive except in the sense that anything can become psychologically addictive.
One of the key signs of addiction is that when an individual stops taking the drug, they begin to go through withdrawal, experiencing sweats, anxiety, pain, and above all, a craving to take the drug again. In advanced dependence or addiction, all the individual wants to do is get more of the drug.
Lithium provokes no such craving, and any symptoms felt after use of the drug is stopped are symptoms of the underlying cause, the mania or depression that prompted the use of the drug in the first place.
While Lithium may be required for life, like insulin, to avoid a return of mania alternating with depression, this is not addiction. If individuals with diabetes stop taking insulin, they will suffer symptoms, but they are not addicted to insulin.
Since there is no such thing as lithium addiction, neither are there lithium addiction symptoms. But lithium abuse is still possible.
The substance can also be toxic if one takes too much at one time, and that amount can change due to circumstance. But that doesn’t mean they need a lithium detox like a heroin addict needs a heroin detox, or like someone with alcohol use disorder needs an alcohol detox.
On the other hand, one reason that physicians may have been reluctant to prescribe lithium in the past is that lithium can be or can become toxic.
Lithium toxicity occurs when individuals take too much lithium, either way too much on one occasion or a little too much over a long period of time. This isn’t necessarily on purpose, because other factors can contribute to how lithium affects them. Other contributing factors include the body’s water and sodium levels and what other medications people are using.
According to some researchers, lithium has a narrow range of safety, making a lithium overdose or lithium toxicity all too easy. But others claim that any such toxicity is easily correctable by lowering the dose. According to most, side effects from lithium are rare, especially the severe ones. Some possible symptoms of taking too much lithium at one time include:
Side Effects of Lithium Toxicity
If someone you love experiences these problems, call Poison Control (800-222-1222) even if you’re not sure it’s an emergency.
Some possible symptoms of taking too much lithium at one time include:
Lithium, Pregnancy, and Breastfeeding
Lithium can also be of concern when one is pregnant. This may be due to an abundance of caution rather than likely harm.
While there seems little evidence now, lithium has been associated with birth defects or other harm to the baby when taken during pregnancy, and perhaps during breastfeeding.
Since this is now considered a remote possibility, some observers feel this should be only one of the factors considered when deciding whether or not to stop taking lithium when pregnant or trying to become pregnant.
Lithium and Big Pharma
Another possible reason that lithium is less often prescribed may be profit. Since it is a naturally occurring salt, no pharmaceutical company can hold a patent on it.
Other synthetic remedies for bipolar disorder have been developed that do not have that drawback. Some may be better in some cases–though lithium is undeniably better than some–but the new drugs had the perceived benefits of being newer and improving on nature.
(Similarly, many women have been persuaded that infant formula is better than breast milk.)
Any drug can have too little, too much, or no effect on some people. That’s why medications are meant to be prescribed by a doctor and follow-up visits are encouraged to make sure there are no bad effects. There should always be a risk-benefit analysis. If the harm is too great, another medication should be tried.
In a majority of cases, however, lithium works great. It has helped keep some individuals’ moods stabilized safely, sometimes for decades.
Newer isn’t necessarily better.
- ncbi.nlm.nih.gov – The New News about Lithium: An Underutilized Treatment in the United States
- livescience.com – What Is Lithium?
- ncbi.nlm.nih.gov – The history of lithium therapy
- webmd.com – Gout Pictures Slideshow: Causes, Symptoms, and Treatments of Gout
- ncbi.nlm.nih.gov– Lithium Toxicity
- inverse.com – The Last Sane Drug On Earth Fights For Survival
- ncbi.nlm.nih.gov – Barriers to Breastfeeding in the United States
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.
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