Nirvana made “lithium” a commonplace term in the early ‘90s with the release of their hit song under the same moniker. Since then, several other references to lithium in song lyrics and art pieces have coined the drug as a pop culture icon and
Since then, several other references to lithium in song lyrics and art pieces have coined the drug as a pop culture icon and conversational piece about the mind-altering effects of mood-stabilizing drugs and the pharmacological treatment of mental illnesses.
But what exactly is lithium, and what does it have to do with treatment of mental illnesses?
Prescribed generally by a psychiatrist as lithium carbonate or lithium citrate, lithium is a chemical compound used as a psychiatric medication. Lithium salts are used as a mood-stabilizing drug most often to treat bipolar disorder, but sometimes also to treat other severe mental illnesses such as major depression and schizophrenia. Though usually more effective in preventing manic episodes than depressive episodes, lithium can also reduce the risk of suicide. In depression, lithium can be used to augment other antidepressants. Lithium is also shown to be effective in treating early-onset bipolar disorder in children, and may encourage the growth of gray matter in the cerebral cortex. Studies currently are being tested whether lithium might prevent or slow the progression of Alzheimer’s disease, senile, dementia, and Parkinson’s disease.
One of the main benefits of lithium that has not been seen with other medications is its ability to decrease the risk of suicide in people with mood disorders. Areas where there are high levels of naturally occurring lithium in drinking water also have been associated with lower suicide rates. In the 1970s, researchers heralded the drug as a wonder drug in treating those with mood disorders, praising lithium as “the first specific chemical treatment for a mental illness” and its “lack” of undesirable side effects that other neuroleptics caused. Groups sought to promote lithium as the magical drug that removed all symptoms of disorder while leaving the rest of a person’s personality intact. During that timeframe, lithium became so popular, some even advocated putting it in the drinking water, placing everyone in the United States under a medicated state of bliss.
Obviously, this initial aggrandizement of the drug did not realistically represent the risks and side effects of lithium use. Since its introduction, the prescription of lithium has grown increasingly controversial due to reports of poisoning, memory loss, and the drug having a “lobotomizing effect” on patients. The “calming” and tranquil” effects that supporters lauded have been referred to by critics as psychiatric sedation. When testing the effects of lithium on guinea pigs, the animals became sluggish and unresponsive to stimuli, even seeming flaccid. In a state hospital, hospital inmates could be easily subdued with lithium, becoming docile under the drug’s effect. Furthermore, in a study done by Schou, all three patients that were given dosages of lithium all appeared emotionally flattened to their families, as if the drug had had a “blunting effect” on their personalities. This sluggishness induced by lithium also seems to affect mental concentration and memory, as a study in 1989 showed that 43% percent of patients stop taking their lithium prescription due to symptoms like “mental confusion” and “memory problems.” The growing list of symptoms and neurological effects caused by lithium has caused the drug to be increasing used less in the treatment of mood disorders.
So, is the risks of lithium worth its value in treating bipolar disorder?
Overall, it’s hard to speak definitively about the drug’s efficacy in treating those who suffer from bipolar disorder as a whole. To some, the fear of being “medically lobotomized” by lithium and the possibility of poisoning makes the drug too great a risk to even consider for treatment. For others, the numbing effects of lithium may be minimal, and, in comparison to the extreme manic and depressive symptoms of bipolar disorder, be preferred. In consideration to the debate regarding the use of lithium, the controversy only further conveys how complex treatment for mood disorders can truly be, and how there may never be a wonder drug that can eradicate all of the symptoms without any side effects. It is only our hope that as medical technologies and methods evolve, treatment for mood disorders and the knowledge and medical advancements made available to psychiatrists also continues to improve and better the lives of our patients.
To read more about the history and risks of lithium treatment, you can check out this article: http://www.sntp.net/drugs/lithium_breggin.htm