Lithium: benefits, dosage, contraindications
Other name(s)
Li
Scientific name(s)
Li
Family or group:
Minerals and trace elements
Indications
Scoring methodology
EFSA approval.
Bipolar disorder ✪✪✪✪✪
Lithium, the first psychotropic agent, is also the first mood stabilizer. In the international recommendations of the Canadian Network for Mood and Anxiety Treatments-International Society of Bipolar Disorders (CANMAT-ISBD), lithium as monotherapy or combined with an atypical antipsychotic depending on severity is recommended as first-line treatment for manic episodes. nnFor prophylactic purposes, it is prescribed in the maintenance treatment of bipolar disorder and in the prevention of suicide risk.nn
Posologie
Oral
500 mg
Emotional balance ✪✪✪✪✪
Although lithium has shown consistent efficacy in the treatment of acute mania, its efficacy in treating acute depression has been controversial since the earliest 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 combination with magnesium to enhance its effectiveness.nn
Posologie
Oral
500 mg
Synergies
Seborrheic dermatitis ✪✪✪✪✪
Topical use of lithium in seborrheic dermatitis is associated with beneficial effects such as a reduction in burning sensation and dryness, and can 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
Topical application
lotion
Alzheimer's disease ✪✪✪✪✪
Researchers have explored lithium's preventive potential against Alzheimer's disease. In a randomized, double-blind clinical trial, 45 participants with mild cognitive impairment were followed for 12 months. Lithium treatment 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 with Alzheimer's disease. Indeed, an improvement in Mini-Mental State Examination (MMSE) scores was observed as early as three months of treatment, with patients receiving 300 mg of lithium per day showing significant gains compared with a placebo group over a 15-month period.
Posologie
Oral administration
500 mg
Herpes ✪✪✪✪✪
Lithium has demonstrated antiviral effects by suppressing replication of DNA viruses through competitive inhibition of magnesium as a cofactor of DNA-synthesizing enzymes. Besides these antiviral effects, lithium's general immunomodulatory capabilities and its indirect effect through mood stabilization (followed by reduced stress) appear promising. Clinical observations suggest a reduction in the frequency of recurrent labial herpes reactivations thanks to lithium.
Posologie
Oral
500 mg
Leukopenia ✪✪✪✪✪
Lithium administration is associated with increased neutrophil activity in fighting infections. Lithium effectively increases the number of phagocytes and their production.
Posologie
Oral
500 mg
Sleep disorders ✪✪✪✪✪
Lithium is used as a trace element for mild sleep disorders and irritability in adults and children over 6 years old.
Posologie
Oral
1 - 4 mg
Properties
Neurological
Epidemiological studies show that regions where the lithium content of tap water is lower 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 appears to affect dopamine and serotonin activity. Indeed, lithium increases serotonergic neurotransmission by multiple mechanisms, notably by increasing serotonin synthesis, tryptophan uptake, and serotonin release. The serotonergic effects of lithium have been suggested to be responsible for its anti-suicidal and anti-aggressive actions.nnLithium may also increase monoamine oxidase (MAO) activity and improve the transport of folate and vitamin B12 into brain cells, which can affect mood.nn
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 an improvement in anti-inflammatory immune responses.nn
Usages associés
Immunomodulatory
Lithium stimulates the production of colony-stimulating factor by monocytes. It stimulates neutrophil production and may also increase the number of erythrocytes and platelets and decrease the number of lymphocytes.nn
Usages associés
Safe dosage
Adult: 2 mg - 4 mg
Dosage should be stabilized at the lowest effective level. The recommended minimum effective blood lithium level is 0.5 to 0.8 mEq/L. Lithium carbonate and lithium citrate are available as prescription medications for the treatment of bipolar disorder. The initial dose is 500 mg. Lithium as a trace element has no role 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 old (1 to 2 ampoules).
Child from 6 years: 1 mg - 2 mg
In oligotherapy, the lithium dosage as lithium citrate is 1 to 2 mg in children over 6 years old (1 to 2 ampoules).
Interactions
Médicaments
Antihypertensive: moderate interaction
Using lithium with angiotensin-converting enzyme (ACE) inhibitors could increase lithium concentrations.
Anticonvulsants: moderate interaction
Carbamazepine and phenytoin may increase the risk of neurotoxicity.
Calcium channel blocker: moderate interaction
Calcium channel blockers increase gastrointestinal and neurological side effects and may reduce lithium concentrations.
Monoamine oxidase inhibitor (MAOI): strong interaction
The combination of serotonergic drugs and lithium increases 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 vasoconstrictive disorders. It is unknown whether 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 to the mother outweigh the possible risk to the fetus.
Breastfeeding: prohibited
Lithium is excreted in breast milk and may cause adverse effects in the infant. Its use during breastfeeding is contraindicated.
