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Lithium Revolution2024-12-02

Lithium is an inexpensive mineral that not only sparks the current electric car revolution, but can spark a revolution in mental health as well.

It has been used in psychiatry for decades, but mostly for specific indications such as bipolar disorder (manic-depressive illness), and at high doses that often border on toxicity, and always lead to side effects in the long run. At much lower doses, it is safe, well tolerated, and the best single medication we have in psychiatry, in my clinical opinion (as a psychiatrist who has seen over 10,000 patients in my career so far). It is also one of the only two FDA approved medications for suicide prevention, the other being the antipsychotic clozapine.

My teams have also done genomic and biomarker research in psychiatry over the years. A consistent top match to biomarkers is lithium- across disorders. It matches to panels for stress, anxiety, mood disorders, even memory, and pain. As such, it may be a transdiagnostic neuronal function optimizer, that should be considered as an add-on and preventative. There are some medical counter-indications to being on it (should not be taken during pregnancy), but most of the others can often be avoided by a low dose strategy. Notably, parts of the world that have lithium in the soil and drinking water have less suicides, violence, and mood disorders.

Our default question and strategy as a field, moving forward, needs to be not why somebody should be on lithium, but why somebody should not be on (low dose) lithium.

And here is an upcoming invited special article for Psychiatric News, the newspaper of the American Psychiatric Association, on Precision Psychiatry: https://psychiatryonline.org/doi/10.1176/appi.pn.2024.12.12.27