Lithium: benefits, dosage, contraindications
Other name(s)
Li
Scientific name(s)
Li
Family or group:
Minerals and trace elements
Indications
Rating methodology
EFSA approval.
Bipolar disorder ✪✪✪✪✪
As the first psychotropic, lithium is also the first mood stabilizer. In the international guidelines of the Canadian Network for Mood and Anxiety Treatments-International Society of Bipolar Disorders (CANMAT-ISBD), monotherapy or lithium combined with an atypical antipsychotic according to severity is recommended as first-line treatment for manic phases. For prophylactic purposes, it is prescribed in the maintenance treatment of bipolar disorder and in the prevention of suicide risk.
Posologie
Orally
500 mg
Emotional balance ✪✪✪✪✪
While lithium has consistently shown effectiveness in the treatment of acute mania, its efficacy in treating acute depression has been controversial since the first clinical observations. Initial studies suggested that lithium was not effective against chronic depression. However, it is commonly prescribed to manage behavioral disorders, including emotional instability, often in association with magnesium to enhance its efficacy.
Posologie
Orally
500 mg
Synergies
Seborrheic dermatitis ✪✪✪✪✪
The topical use of lithium in seborrheic dermatitis is associated with beneficial effects such as reduced burning sensation and dryness and may even occasionally induce complete remission. The use of topical lithium in a placebo-controlled trial showed that it is more effective than ketoconazole in achieving complete remission.
Posologie
Cutaneously
lotion
Alzheimer's disease ✪✪✪✪✪
Researchers have explored the preventive potential of lithium against Alzheimer's disease. In a randomized double-blind clinical trial, 45 participants with mild cognitive impairments were followed over a 12-month period. Treatment with lithium was associated with a significant reduction in intrathecal concentrations of phosphorylated tau peptide as well as a notable improvement in cognitive performance. Furthermore, another study suggested that daily microdoses of lithium might be beneficial for patients suffering from Alzheimer's disease. Indeed, an improvement in Mini-Mental State Examination (MMS) scores was observed after just three months of treatment, with patients receiving 300 mg of lithium per day showing significant progress compared to a placebo group over a 15-month period.
Posologie
Orally
500 mg
Herpes ✪✪✪✪✪
Lithium has demonstrated antiviral effects by suppressing the replication of DNA viruses through competitive inhibition of magnesium as a cofactor of DNA-synthesizing enzymes. Apart from these antiviral effects, lithium's general immunomodulatory capabilities and its indirect mood-stabilizing effect (followed by stress reduction) seem promising. Clinical observations suggest a reduction in the frequency of recurrent herpes labial reactivations with lithium.
Posologie
Orally
500 mg
Leukopenia ✪✪✪✪✪
Administration of lithium is associated with increased neutrophil activity in fighting infections. Lithium indeed increases the number of phagocytes and their formation.
Posologie
Orally
500 mg
Sleep disorders ✪✪✪✪✪
Lithium is used as a trace element in mild sleep disturbances and irritability in adults and children over 6 years.
Posologie
Orally
1 - 4 mg
Properties
Neurological
Epidemiological studies show that regions with lower lithium content in tap water have higher rates of psychiatric hospitalizations, suicides, homicides, and other crimes, suggesting that lithium consumption could affect behavior. The exact mechanism of action of lithium in psychological and behavioral disorders is unknown. It seems to affect the activity of dopamine and serotonin. Indeed, lithium increases serotonergic neurotransmission through multiple mechanisms, including increased serotonin synthesis, tryptophan absorption, and serotonin release. The serotonergic effects of lithium have been suggested as responsible for its anti-suicidal and anti-aggressive actions. Lithium could also increase monoamine oxidase (MAO) activity and improve the transport of folate and vitamin B12 into brain cells, which may affect mood.
Usages associés
Dermatological effect
The use of lithium in seborrheic dermatitis has shown beneficial effects. The mechanism by which lithium exerts this therapeutic effect is not well understood. Experimental data suggest a dose-dependent immunomodulatory effect, leading to improved anti-inflammatory immune responses.
Usages associés
Immuno-modulator
Lithium stimulates the production of colony-stimulating factor by monocytes. It produces neutrophils and can also increase the number of erythrocytes and platelets and decrease the number of lymphocytes.
Usages associés
Safety dosage
Adult: 2 mg - 4 mg
The dose should be stabilized at the lowest effective rate. The recommended effective minimum lithiaemia is 0.5 to 0.8 mEq/l. Lithium carbonate and lithium citrate are available in prescription drugs for the treatment of bipolar disorder. The initial dose is 500 mg. Lithium as a trace element has no place in the treatment of these disorders. In oligotherapy, the lithium dosage in the form of lithium citrate is 2 to 4 mg (2 to 4 ampoules) in adults and 1 to 2 mg in children over 6 years (1 to 2 ampoules).
Child from 6 year(s): 1 mg - 2 mg
In oligotherapy, the lithium dosage in the form of lithium citrate is 1 to 2 mg in children over 6 years (1 to 2 ampoules).
Interactions
Médicaments
Antihypertensive: moderate interaction
The use of lithium with angiotensin-converting enzyme inhibitors could increase lithium concentration.
Anticonvulsants: moderate interaction
Carbamazepine and phenytoin could increase the risk of neurotoxicity.
Calcium channel blocker: moderate interaction
Calcium channel blockers enhance gastrointestinal and neurological side effects and may reduce lithium concentrations.
Monoamine oxidase inhibitor (MAOI): strong interaction
The combination of serotonergic drugs and lithium enhances side effects.
Loop diuretic: strong interaction
Theoretically, taking lithium supplements with loop diuretics could increase lithium levels and adverse effects.
Serotonin Reuptake Inhibitors: strong interaction
The combination of serotonergic medications with lithium could increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstriction disorders. It is unclear if this interaction would occur with the lower doses found in lithium supplements.
Contraindications
Pregnant woman: prohibited
The safety of lithium supplements during pregnancy is unknown. Prescription lithium may be used under close supervision by a healthcare professional when the potential benefits for the mother outweigh the possible risk to the fetus.
Breastfeeding woman: prohibited
Lithium is secreted in breast milk and may cause adverse effects in the infant. Its use during breastfeeding is contraindicated.
