Got Lithium?

…research says Lithium reduces suicide, inhibits herpes and boosts the brains grey matter, so why isn’t it the first thing we’re prescribed?

“The product, originally named “Bib-Label Lithiated Lemon-Lime Soda”, was launched two weeks before the Wall Street Crash of 1929. It contained lithium citrate, a mood-stabilizing drug. It was one of a number of patent medicine products popular in the late-19th and early-20th centuries; they made claims similar to today’s health foods. Specifically it was marketed as a hangover cure. The product’s name was soon changed to 7 Up.”
Wikipedia entry for 7UP.

“In his formulation Grigg had included lithia, a naturally-occurring substance found in minute quantities in bubbling waters fed by underground springs. (Lithia is better known as lithium, a drug used to even out mood swings.) Grigg had the notion that the chemical’s presumed healthful aspects would be a selling point with the soda-buying public, hence the “Lithiated” in the name.”
Urban Legends Reference Page: 7UP.

“Many drugs need to be in the form of a salt to be stable. Lithium, the kind that actual doctors prescribe, is usually in the form of lithium carbonate. The lithium molecule is combined with a molecule of carbonic acid, to form lithium carbonate. It would be unwise to take pure lithium as adding lithium to water results in what chemists like to call a “brisk exothermic reaction”. To put it another way, you’d end up with no tongue.”
Lithium Orotate: Just a dietary supplement, not a drug at all, oh no.

Saying “no one knows how Lithium works” is like saying no one knows how a bumblebee flies… or humans only use ten percent of our brains, or Evolution is only a theory whose ideas haven’t progressed since Darwin. Mostly those assumptions are based on misconceptions and urban legends.

The bumblebee, whose body seems too large for its wings, gets around because “its wings encounter dynamic stall in every oscillation cycle”. Darwin has as much to do with Evolution as Galileo does with NASA. Several charlatans, psychics and “mentalists” have used the ten percent myth to convince their marks of the “powerful potential” in the other 90%, but we use every single cell in our brains… and Lithium’s effect on those cells can be specifically quantified. And has been.

It may be true researchers once had very little idea how Lithium worked to control the manics and depressions of bipolar, but it’s also true that not too long ago if we wanted to watch the brain as it functioned we had to cut our skulls open and poke at chunks of grey matter and watch for the twitching. In fact, until the development of Next Generation technologies such as fMRI, MRI and PET scans, which allow researchers to watch the effects of medications directly on specific parts of the brain, all of the brain sciences have been stuck in the pre-rubber glove era of medicine.

So of course Mental Illnesses have been misdiagnosed for the past six thousand years, until this moment the only way to prove we’re sick is to have people believe we’re crazy based on our behaviour. And now using technology we can see how medications work to get those behaviours under control.

Researchers at the UCLA Laboratory of NeuroImaging used three-dimensional magnetic resonance imaging to map the brain in people diagnosed with bipolar disorder. In their 2007 report, when the “bipolar brains with Lithium” were compared to “bipolar brains without Lithium” they found “the volume of grey matter in the brains of those on lithium was as much as 15 percent higher in areas that are critical for attention and controlling emotions.”

Several studies published since 2003 show the effects Lithium has on the brain. An article published in 2006 on About.com reviewing research published the previous year stated:

“Inositol monophosphate is a chemical in the brain that works as a switch – turning the activity of certain genes on and off. In some cases the presence of inositol causes a gene to activate, and in other cases it causes a gene to shut down. Specifically, inositol seems to be the switch for genes that produce a hormone called PACAP (which, for the scientists among you, is the neuropeptide hormone pituitary adenylate cyclase activating polypeptide). A shortage of PACAP in mice brains has been linked to hyperactivity and defects in circadian (day-night) behavior, which are both also characteristic of humans with bipolar disorder.

Lithium is known to inhibit production of inositol. Therefore, these researchers “hypothesized that depletion of brain inositol levels is an important chemical alteration for lithium’s therapeutic efficacy in bipolar disorder”

In a study published in the Canadian Journal of Psychiatry in 2003, looking back over fifteen years worth of research, Lithium was found to have “a response rate of 45%, in stark contrast to a response rate to placebo of 18%” on reducing the symptoms of manic depression:

“[…] it is the most severely ill patients who are more likely to be treated early and in whom the change in frequency or severity of episodes is most dramatic. Less severely ill patients, who may wait longer before receiving treatment, appear to do as well on lithium, but the difference is not as dramatic (naturally, this is not an argument for delaying prophylactic treatment). The theoretical implications of these findings are intriguing: bipolar illness may be associated with functional and structural changes resulting from cumulative damage during episodes of the illness.”

Lithium is a mood stabilizer. The best way to understand how it works is to think of moods on a scale of zero to 100 with the range between 40 and 60 as “typical”. Manic depression pushes and pulls us on average into the 20 to 80 range. Lithium puts a cap on the ups and downs so we function in the 30 to 70 range. It doesn’t prevent manics or depressions, someone with manic depression who is only taking Lithium will still go high and low. Lithium is generally prescribed in the beginning to simply get the person under control, then the doctor will add something like Seroquel or Wellbutrin later on…

Lithium is sometimes prescribed for “clinical depressions” or “unipolar depressions”, but it’s still not common.

A German study released in 1981 , for example, said “Lithium induces rapid relief of depression in tricyclic antidepressant drug non-responders” and found “lithium augmentation is recognized as a useful, but infrequently used, treatment modality. [I]n Germany alone, lithium prevents approximately 250 suicides yearly. The actual number could be much higher, given that lithium is currently underused in the treatment of mood disorders.”

Either way it takes about two weeks of dosing to get the Lithium level in your body to optimum levels, then a few months for the beneficial effects to start showing but in the between-time the side effects can be… not nice. Going the other way it only takes missing four to six doses for the Lithium levels in your body to go away.

Finding the proper dose is critical, which means frequent and routine blood tests to find the appropriate level. There are several side effects, which range from annoying to coma-inducing. Taking Lithium is not replacing something missing in your body, it’s adding something which is potentially toxic.

Side effects include nausea, loss of appetite, and mild diarrhoea, but these generally go away after the first month. Dizziness and hand tremors are common as well… both of which suck large if you’re a photographer. Drinking water is critical, and this is where the “Lithium weight” comes in… but it’s a relatively stable weight gain. If someone taking Lithium does gain a large amount of weight there may be hypothyroidism involved, which is a rare side effect.

But if you want to avoid gaining weight don’t turn to sugar drinks as a water substitute. If you need a “taste” in your water the best thing I’ve found is a chunk of lemon squeezed and dropped into 2L of water.

If the dose you’re taking is too high for too long there is a very rare risk of permanent damage to your kidneys. The best way to avoid this is to have the blood work done often and keep your Family Doctor and psychiatrist in the loop.

Without a proper liquid diet, including lots of water, and little to no caffeine and alcohol it is possible to “go toxic”, which means a lack of coordination, muscle weakness, slurred speech, nausea, vomiting, diarrhoea, confusion, and an increase in tremors or shaking. This is dangerous and you should contact your doctor, but start drinking water.

Prolonged toxicity, or an extreme overdose, can drop you into a coma… but the amounts needed for an overdose would be, like I said, Extreme. Taking so many pills would have to be one of the dumbest fucking things anyone could ever do… like on par with eating two pounds of sand.

It’s also important not to cut out the salt we usually eat… it sounds counter-intuitive to add 1000mg of Lithium to our diet, but still maintain our regular salt intake, but the regular salt in our body prevents the Lithium from being drawn in as a replacement and another way the toxicity thing can take hold.

The three biggest myths about Lithium:

1) Lithium can, in very rare cases, cause renal / kidney failure… but, really, it’s an extremely rare, albeit permanent and tragic side effect and mostly caused by taking large amounts over a really long time. Basically your doctor would have to be pretty freaking retarded to give you a prescription for such an amount over such a period of time.

2) Lithium mouth… Lithium will not rot your teeth away. But having a really dry mouth is not good for your teeth, and could result in really crappy teeth, so when your mouth feels dry drink a lot of water.

3) Weight gain… Lithium weight is probably the most common myth. The pills require you to drink a lot of water, which will make you swollen, but drinking a lot of sugary juices, glucose and fructose filled “juice” substitutes (Sunny D) and pop instead of water will Definitely make you fat. So drink water.

Bonus Fact: Lithium has been found to “inhibit the replication of herpes simplex virus types 1 (HSV-1) and 2 (HSV-2)”…

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