View Full Version : Low-Dose ("Nutritional") Lithium


alan1
05-18-17, 03:02 PM
Lithium is used in high doses (600mg 3x/day = 1800mg) to treat bipolar disrder. We consume very small amounts (1 - 2mg) in our daily diet every day. In his new book, Finally Focused, Dr. James Greenblatt suggests that taking 2 - 5 mg/day of Lithium Citrate is often helpful for people with ADHD, especially those prone to irritability, aggression, impulsivity, hyperactivity and anger. It does not seem to help inattention. He has found that Lithium in this form and at extremely low doses has had beneficial effects without the undesirable adverse affects associated with the higher dose and form used to treat bipolar disorder.

I'm wondering if anyone on this forum has used Lithium this way.
Did you find any benefit?
How long until you found any benefit?
Are you still on it? If not, why not?
Did you suffere from any adverse effects?
Was any testing done e.g. hair samples to see what your baseline was?
Thanks

namazu
05-18-17, 10:14 PM
As you note, we do consume trace amounts of lithium (a naturally-occurring element) via our diets/water.

However, as far as I can tell, lithium citrate is a drug sold by prescription only in the US -- it's not available (legally) as a dietary supplement. Other forms of lithium (e.g. orotate) may [?] be sold as dietary supplements, but the legal status is unclear (to me, anyway).

The distinction between "nutritional lithium" and "pharmaceutical lithium" is artificial, unless we're just talking about what we naturally consume through the food we eat and the water we drink Otherwise, some company mass-produced the compound -- whether carbonate, citrate, or orotate -- in a lab and put it into a pill or a liquid (with varying amounts of oversight).

The more relevant distinction seems to be dose -- a few mg vs. hundreds of mg/day -- and that's a big difference.

That said, Dr. Greeblatt himself has not published any research in scientific journals about low-dose lithium for the treatment of psychiatric disorders (that I could find, anyway).

...And the studies he cites in his book include:
- a case study of 1 child with multiple diagnoses given high-dose lithium (600mg/day), plus other meds (https://www.ncbi.nlm.nih.gov/pubmed/?term=%22Challenges+in+Psychopharmacological+Manag ement+of+a+Young+Child+with+Multiple+Comorbid+Diso rders%2C+History+of+Trauma%2C+and+Early-Onset+Mood+Disorder%3A+The+Role+of+Lithium+%22),
- a trial focused on high-dose (300-2100mg/day) lithium in kids with conduct disorders who had been hospitalized (http://jamanetwork.com/journals/jamapsychiatry/fullarticle/481628), and
- a different trial focused on high-dose lithium (average: 1248mg/day) in kids with conduct disorders who had been hospitalized (https://www.ncbi.nlm.nih.gov/pubmed/7751258).

I don't think it's sensible to generalize these particular results to people with ADHD (without severe aggression / conduct disorder). I also don't think it is legitimate to claim or even to imply that these studies provide evidence for the use of low-dose lithium in treating aggression (or anything else), since all of these studies used higher-dose lithium. At those higher doses, which were sufficient to produce effects in these studies, there were also plenty of side effects and the potential for toxicity.

That's not to say there couldn't be anything to the use low-dose lithium, and I don't have grounds to dismiss Dr. Greenblatt's claims about his personal clinical experience. There's just not (yet) a lot of research to support its efficacy in managing any ADHD symptoms or irritability, and even the "best" studies he cites are of minimal relevance to the use of low-dose lithium.

If you think you want to try low-dose lithium, I would suggest speaking with your doctor about it.

sarahsweets
05-19-17, 03:34 AM
Definitely get medical advice and treatment with a doctor. Lithium, at least the prescription kind can be touchy and very hard on your liver if its not managed with safe oversight.

alan1
05-20-17, 10:01 AM
- Lithium Citrate in VERY LOW DOSE FORM is available in the US over--the-counter. You can buy it on Amazon.

- I appreciate the concerns expressed about the use of Lithium. But again, I would point out that the daily dose that was recommended in the book is about 1/900 the dose used to treat bipolar disorder. It is hard to imagine that the adverse reaction profile would be remotely the same. That is not to say it is impossible. Just unlikely in the extreme. Any drug that toxic in such low dose would likely be fatal at the vastly higher medically therapeutic dose used for bipolar disorder. I am questioning if at that low dose it is even useful.

- I did ask my doctor and he did not see a problem with its use at that low dose. But neither was he familiar with anyone using it for ADHD. My question was if anyone on this forum has actually used it at this dose. Thanks.

namazu
05-20-17, 04:05 PM
- Lithium Citrate in VERY LOW DOSE FORM is available in the US over--the-counter. You can buy it on Amazon.
A lot of things are sold on Amazon as "research chemicals" that are illegal to market as "dietary supplements" in the United States, but that doesn't stop people from self-experimenting. (Neither I nor ADDF endorses this practice.)

You may be correct and I may be mistaken about lithium citrate. If you can get it over the counter at a legitimate pharmacy in the US, then that suggests I may be wrong about how it is regulated in the US. Being able to order it on Amazon doesn't say much, though.

I appreciate the concerns expressed about the use of Lithium. But again, I would point out that the daily dose that was recommended in the book is about 1/900 the dose used to treat bipolar disorder. It is hard to imagine that the adverse reaction profile would be remotely the same. That is not to say it is impossible. Just unlikely in the extreme. Any drug that toxic in such low dose would likely be fatal at the vastly higher medically therapeutic dose used for bipolar disorder. I am questioning if at that low dose it is even useful.
That's an excellent question, and one that I don't think has a solid answer yet.

What I was trying to point out earlier is that the research mentioned in the book does not apply to low-dose use, so I'm not really sure why it was even included. If the doctor is recommending such low doses, why doesn't he cite studies supporting the efficacy of these low doses in relevant populations?

The research presented does not support the efficacy of low-dose use for ADHD or related symptoms.

Again, I can't prove it doesn't work, and perhaps it could work, but I would suggest that you proceed with caution.