“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.
…anyway, I just felt like exercising a couple of muscles I haven’t used in a while and just enough people have been asking me about Lithium and what it does… so, yeah.
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)”…
I’m with you for most of what you said. But…
It takes just five days for lithium to hit its max concentration given a steady dose -even starting from zero, patients are known to use that to their advantage being non-compliant then the five days before a blood test starting taking it again.
As for it taking months to see an effect. Us what take it aren’t looking for an effect are we – we are waiting on nothing happening so we it can start working after a couple of weeks but take months before we can conclusively say.
Both of those are minor argumentative points. This isn’t. I disagree on the little to no caffeine thing – provided you aren’t pissing about with the caffeine levels you are fine. If you keep the levels roughly similar then the lithium is affected by a systematic error (affected the same way each time) so you can compensate. If you are going days without then have a triple shot latte for breakfast and chug two litres of pepsi then sure.
Final piece of advice – start low and work up – it is chronic treatment, those two weeks you skipped to get to the higher dose quicker will bite you in the ass
University of Maryland Medical Center: Caffeine may lower lithium serum concentrations by increasing urinary lithium excretion… diuresis can increase lithium toxicity.
Sometimes it’s just better to say “none” instead of listing the host of “possibles”. Caffeine is a diuretic, albeit not as bad as the anti-caffeine lobby would have us believe. Taken in a liquid — sports drink, coffee — it’s not too bad. But, personally, I think the point of trying to get better is to avoid the stuff which has the potential to make us feel like shit.
I actually drink a lot of Diet Pepsi, which is loaded with caffeine. It’s something I’ve tried to stop doing, but when I do stop I start feeling like shit… so I’ve completely given up tea, coffee and a few other things.
Definitely stay away from the Red Bull-type of drinks… especially if you’re downing it in Litre form.
Alcohol is something I didn’t mention in this piece, but I should have. Alcohol is definitely diuretic and should never be taken with Lithium… or anti-depressants.
With the starting dose of any medication the idea should be to start low and work higher in a gentle manner, but when someone is presenting with full-blown manic depression I’d think the Lithium would be given higher and worked lower.
The effects of any medication used to treat manic depression takes months for the effects to become clear to the person taking the pills… they start to have an effect right away, hence all the nasty side effects, but the person taking them will start to notice the behavioural changes later on in most cases.
Lithium has changed things for me so much that I wonder why I was scared of it in the first place. (well, I know WHY….a toxic relationship in high school with a manic depressive on lithium who liked to hit me now and then…but that’s a story I don’t like to tell)
I found relief started for me within 2 weeks. It wasn’t perfect, and we’re now on dose adjustment 2, but after years of swimming through murk, anything clear was awesome.
Either I’ve gained weight, or there’s a shit load of bloating I can’t drink off. I have found my desire for caffeine has limited. I try to avoid diet drinks since aspartame and it’s friends worry me. (not a HUGE sample, but it worries me all the same http://www.mcmanweb.com/article-110.htm ) and I hate the taste.
I really wish they would have insisted on lithium out of the gate 2 years ago instead of trying new fangled anticonvulsants. I gain weight regardless, so no point trying to avoid it. Breathe after eating a poptart near me, and I’ll gain a pound.
Just meant if you caffeine dose is variable it is more of an issue than a steady dose, (unless you are drinking litres of red bull a day)
I am willing to confess to being addicted to caffeine, I gave it up for lent five years ago and got hellish withdrawal, sweats, nausea and tremor – lovely. I am much more sensible about it now. Still can’t bring myself to completely ditch it or alcohol but I am not a big drinker
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This is a cool website and I love the name,ode to my dear sweet Lithium!
I’m going to ask my doctor about lithium for my BP2. He hasn’t even suggested it and skirts around the topic, stating that the newer meds are better.
But I would love to feel better, and if it works I want it.
Thanks for this.
I have a family history of B.P Goes back to my moms mother and my mom. It may go back further but they are not around to ask anymore. My grandmother was on Lith over 30 years and my mother 15 years. I have been on it for 8 months. I hate knowing I have to take pills to function 300 mg Wellbutrin in the morning and 900 mg lith at night. I feel better most days but found out that if something or someone really piss me off/or on me, no pill can control me. I go from calm to freak in 1 second. It takes me weeks to come back down. I do drink a lot of water about 3 quarts a day, makes me pee a lot. So not sure if I am sending the good stuff down the drain. It makes me thirsty! Gave up booze and Marry Jane and smokes when I started this life change thought I would loose weight put I have maintained so I can’t complain. You know what they need to come out with? The NORMAL pill, and as soon as they figure out what NORMAL is I wish they would tell the rest of us! KEEP TAKING THE MEDS OR ELSE YOU BACK SLIDE.
I don’t know anything of lithium so this is a non-comment comment. Though, I was offered it once by a pallid psychiatrist with an infuriatingly bland manner. He only offered it because there was nowhere else to go after SSRI’s.
I declined on the basis that I thought it caused weight gain (erroneous though this may have been) and due to the psychiatrist’s complete indifference to whether I tried it or not.
Anyway, I am ending this non-comment comment now. Just liked the set out of this blog so thought I’d stay for a minute.
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Lithium has basically saved my life. I know, I know, overly dramatic. But a decade or more ago, I was put on easily a dozen different meds by a half-dozen pdocs and very nearly ended myself out of sheer blank frustration. Finally, a sane pdoc asked me how I’d done on lithium. I said I’d never been on lithium.
After she picked her jaw up off the floor, we got started, and it’s been better ever since. From a low point of taking probably a half-dozen assorted anti-depressants, mood stabilizers and god knows what else, I’m now on daily lithium and a low dose of generic prozac. I still go up and down, but it’s a mild ride rather than a wild one.
Sometimes I miss some aspects of my manias, but all told, I’m happier being alive and fairly mellow than Superwoman and dead, y’know? Thanks for such an excellent website! I look forward to reading much more here.
Hi Rain, welcome and thanks for commenting. I don’t think you’re being dramatic at all, I managed to survive my years without Lithium, but only barely. With Lithium, and proper supervision, my life has improved to the point where my suicide plans are barely a memory.
It’s the most effective solution in the fight against manic depression, so I’m still at a loss as to why it’s not the first thing they hand us as after we’ve been diagnosed… the second being a sleep-aid of some kind.
Congratulations on finding a treatment plan that works for you, and thanks again for taking part in my blog.
Finally, some answers!
Thank you for taking the time to share that information.
I would most definately be interested in low dose lithium therapy as an adjunct to my antidepressants.As I have read many trials to its effectiveness ,although not perfect but what is when your treatment resistant depression is getting old and I am ready to give up soon.I know that lithium in all those trials there were NO suicides and an increase in grey matter to15 percent as compared to those who continue to suffer.studies in areas where there is mor lithium in the drinking water resulted in less crimes less suicides and less mental difficulties.know I am not naive to the side effects but I’d rather take LDL instead of a brain damaging antiphsycotic that make me herky jerky man.I’ll take the chance with possible neuroprotection action this has been proven by mri’s cat’ and the like I am all for it if it doesn’t work for me then so be it.I would like an MRI now and another after 4 months of lithium therapy just to qualify my studies.Remeber I am talking low dose here.FACT lithium therapy prevents suicides.I have a 9 year old son who needs me alive I have been waiting for a phsyciatrist for 5 months now and soon will order it or go to the US and get the orotate or aspartate form and judge for myself .
Okay… ‘Zens’, I have no idea if you’re a troll or you’re serious, but really, based on the number urban myths in what you wrote, it’s pretty much the same thing. “Lithium therapy” does not mean picking up some random lithium powder and taking a dose based on how you’re feeling that day. In order for lithium to work as a mood stabilizer it must be at a fairly precise concentration in your blood… which means having regular blood work done — in a clinic, not by you — and adjustments to the dose until the optimum numbers are found.
The blood work continues after that because seasonal changes, and even changes to your exercise regimen, can have an effect on the concentration — dehydration is very bad.
So, too much for too long, and kiss your kidneys goodbye. Too little, and you might as well be eating sand. The studies proving the effectiveness of lithium in treating manic depression have all been done on the lithium carbonate version. That’s the medicinal version. Despite what you might have heard, just because it says lithium on the bottle, does not mean it’s safe, or tested, or will have any benefit to you.
Otherwise it wouldn’t matter which ‘lithium’ you received… and yet, to your doctor and the people who study this stuff, it does.
There are no (NO) studies showing oratate or aspartate having any benefit to you whatsoever.
“FACT lithium therapy prevents suicides.” Yes, lithium carbonate does prevent suicides. But all those urban myths about lithium in the water are bullshit. The concentration has to be high enough for the lithium to work, the minuscule amount of lithium in water would mean people would have to drink barrels of water every morning just to get a testable concentration in their blood… and even then, there are no studies linking lithium-water to reduced crime rates.
Find a doctor. If you’re feeling suicidal, go to the ER and tell them. They will put you into an observation for 48-hours, then you’ll be able to see a doctor / psychiatrist as an out-patient.
If you feel as though your anti-depressants are not working, and you have a family doctor, tell her. Or, go to the ER and tell them you need to try something else. They might resist, because you need to be monitored for months to make sure the new pills are working, but give it a shot.
All of these medications need monitoring, if not, you’ll be stuck with unwanted side effects and lose months and years of time when you could have been getting better.
My advice: go to the person who prescribed the anti-depressants to you; ask them to start you on lithium; schedule the blood work; give the process at least six months.
I learned alot, thanks for alot of information.