Lithium - the Miracle Metal

   Lithium - the Miracle Metal

 Professor B.V. Ramanan

 Consultant Microbiologist & Medical Content Provider

 

Introduction

Lithium, well known for its extensive use as ‘lithium batteries’ in mobile phones, laptops, electric cars, and solar power packs, is little known as an essential biological entity.

The trace element plays an active role in the neurophysiology, oxidative metabolism, and cellular signal transduction mechanisms.

The biological use of lithium dates to the 14th century ‘Lithium Water Spas’, where the affluent had a mood enhancing bath. The more recent ‘Lithia Springs’, in Georgia, is worth a mention. The medical use of lithium as ‘salts of lithium’ has been prevalent since the early 19th century for the treatment of gout, depression, sleep, mood, and manic disorders.

Though, most of the treatments were abandoned due to reports of lethal side effects at that point of time, the prescriptive use of lithium for the treatment of mental disorders began again in 1948 in Australia (Sneader and Walter, 2005).

The use of lithium in treating manic illness was subsequently approved by the United States Food and Drug Administration in 1970 (Mitchell et al, 2000) and today, it is classified as an essential medicine in the ‘World Health Organization model list of essential medicines’ (WHO, 2019).

Dietary Sources of Lithium

The major dietary sources of lithium include cereals, potatoes, tomatoes, and cabbage (Dlugaszek et al, 2012). Nutmeg, coriander seeds, and cumin are minor sources (Jathar et al, 1980). Meat, fish, mushrooms, and water are other sources of lithium (Liaugaudaite et al, 2017 and Schrauzer, 2002). Green tea, black tea infusion and red tea also have lithium in diminutive quantities (Dlugaszek et al, 2015). The mean lithium content in all these food sources runs from 0.19 to 8.8 micrograms/ gram dry weight (Goldstein, 2016).

Lithium in the form of soluble salts, is absorbed in the small intestine through sodium channels and elimination of excess lithium after oral intake is through the renal cutaneous and faecal route within twenty-four hours. Lithium orotate and lithium aspartate are the low-dose forms of lithium available (OTC) over the counter (Marshall, 2015).

Any exposition on dietary lithium would be incomplete without the mention of "Bib-Label Lithiated Lemon-Lime Soda" containing lithium citrate formulated by Charles Leiper Grigg in the 1920s. It was later rebranded as ‘7 Up’ and was available as a popular drink till the American beverage industry were legally obliged to stop production of lithiated drinks in 1948 (Mišak, 2005).

Metal Therapy for Mental Diseases?

It is indeed astounding to note that lithium stands strong as the best therapeutic bet today as a mood stabilizer for the treatment of bipolar disorder. It is also a preventive and acute treatment regimen for manic and violent episodes (McKnight et al, 2019).

Lithium has been employed for the treatment of refractive schizophrenic disorders ("Lithium Salts", 2015). Since 1980s, lithium has been prescribed as an augmentation agent along with other antidepressants to treat major depressive disorder (Bauer et al, 2014). Last but not the least, lithium has been found to reduce the risk of suicides amongst the mentally afflicted cohort (Cipriani et al, 2013).

Research evidence has shown that lithium could retard the progression of Alzheimer's disease (Forlenza et al, 2012 and Wilson, & Edward, 2020). The potential of lithium for the treatment of amyotrophic lateral sclerosis has also shown some evidence (Ludolph et al, 2012). Numerous studies are underway to determine the efficacy of lithium for the treatment of Impulsive aggressive behavior associated with attention-deficit hyperactivity disorder (ADHD), eating disorders, such as anorexia nervosa and blood disorders like neutropenia.

Lithium has been further shown to have neuroprotective characteristics such as increasing cell longevity and preventing cell death. (Malhi, 2013).

Reduction in cellular oxidative stress, alteration of the dysfunction of certain subunits of the dopamine associated G-protein, modulation of glutamate levels, interactions with cellular signal transduction mechanisms, and increase in the level of GABA are some of the postulated mechanisms of the ‘lithium miracle’ in the treatment of mental disorders (Brunello et al, 2003).

Conclusion

Lithium carries with it the risk of lithium toxicity with overdose. Numerous therapeutic drugs such as thiazides, non-steroidal anti-inflammatory drugs (NSAIDs), and ACE inhibitors such as captopril, enalapril, and lisinopril adversely increase lithium plasma concentrations. Concurrent use of lithium with haloperidol, fluphenazine, and flupenthixol is not advisable. It is good to take the advice of a health care provider before going for a lithium supplement.

 

 

 

 

Reference

1.      World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization.

2.      Sneader, Walter (2005). Drug discovery: a history (Rev. and updated ed.). Chichester: Wiley. p. 63. ISBN 9780471899792. Archived from the original on 2017-09-08.

3.      P. B. Mitchell, D. Hadzi-Pavlovic; Hadzi-Pavlovic (2000). "Lithium treatment for bipolar disorder" (PDF). Bulletin of the World Health Organization. 78 (4): 515–7. PMC 2560742. PMID 10885179.

4.      Szklarska D, Rzymski P. Is Lithium a Micronutrient? From Biological Activity and Epidemiological Observation to Food Fortification. Biol Trace Elem Res. 2019;189(1):18-27. doi:10.1007/s12011-018-1455-2

5.      Dlugaszek M, Klos A, Bertrandt J. Lithium supply in the daily food rations of students. Probl Hig Epidemiol. 2012;93(4):867–870.

6.      Liaugaudaite V, Mickuviene N, Raskauskiene N, Naginiene R (2017) Lithium levels in the public drinking water supply and risk of suicide: a pilot study. J Trace Elem Med Biol:197–143, 201

7.      Jathar VS, Pendharkar PR, Pandey VK, Raut SJ, Doongaji DR, Bharucha MP, Satoskar RS Manic depressive psychosis in India and the possible role of lithium as a natural prophylactic. II—Lithium content of diet and some biological fluids in Indian subjects. J Postgrad Med 1980, 26:39–44.

8.      Schrauzer GN. Lithium: occurrence, dietary intakes, nutritional essentiality. J Am Coll Nutr. 2002;21(1):14–21.

9.      Dlugaszek M, Kurpiewska Z, Mierczyk J. Lithium content in the tea and herbal infusions. Eur Food Res Technol. 2015; 241:289–293.

10.  Goldstein MR, Mascitelli L. Is violence in part a lithium deficiency state? Med Hypotheses. 2016 Apr; 89:40-2.

11.  Marshall TM. Lithium as a nutrient. J Am Phys Sur. 2015;20(4):104–109.

12.  Mišak A. Instability of carbolith (lithium carbonate) CMAJ. 2005;172(2):183.

13.  McKnight, RF; de La Motte de Broöns de Vauvert, SJGN; Chesney, E; Amit, BH; Geddes, J; Cipriani, A (1 June 2019). "Lithium for acute mania". The Cochrane Database of Systematic Reviews. 6: CD004048.

14.  "Lithium Salts". The American Society of Health-System Pharmacists. Archived from the original on 2015-12-08. Retrieved Dec 1, 2015.

15.  Bauer, M; Adli, M; Ricken, R; Severus, E; Pilhatsch, M (April 2014). "Role of lithium augmentation in the management of major depressive disorder". CNS Drugs. 28 (4): 331–42.

16.  Cipriani, A; Hawton, K; Stockton, S; Geddes, JR (27 June 2013). "Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis". BMJ (Clinical Research Ed.). 346: f3646.

17.  Forlenza, OV; de Paula, VJ; Machado-Vieira, R; Diniz, BS; Gattaz, WF (1 May 2012). "Does lithium prevent Alzheimer's disease?". Drugs & Aging. 29 (5): 335–42.

18.  Wilson, Edward N. (2020). "NP03, a Micro dose Lithium Formulation, Blunts Early Amyloid Post-Plaque Neuropathology in McGill-R-Thy1-APP Alzheimer-Like Transgenic Rats". J Alzheimers Dis. 73 (2): 723–739.

19.  Ludolph, AC; Brettschneider, J; Weishaupt, JH (October 2012). "Amyotrophic lateral sclerosis". Current Opinion in Neurology. 25 (5): 530–5.

20.  Malhi GS (2013). "Potential mechanisms of action of lithium in bipolar disorder. Current understanding". CNS Drugs. 27 (2): 135–53.

21.  Brunello, Nicoletta; Tascedda, Fabio (June 2003). "Cellular mechanisms and second messengers: relevance to the psychopharmacology of bipolar disorders". The International Journal of Neuropsychopharmacology. 6 (2): 181–189.

Note: The statements made herein have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure, or prevent disease. If you have any concerns about your own health, you should always consult with a physician or healthcare professional.

Note: This is not medical advice and these statements have not been evaluated by the FDA, if you have any concerns about your health please speak with your doctor

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