Identifying the neuropsychiatric health effects of low-dose lithium interventions: A systematic review

Reevaluating the Association Between Autism and Lithium Exposure During Pregnancy

“…A justification for the article appears to be concerns with lithium during pregnancy, but the evidence or concerns referenced pertain to prescribed lithium (>100 mg ionic lithium), whereas environmental lithium intake is orders of magnitude lower (here, 0.6-30.7 μg/L or <1 mg daily). Our review found safety with levels of 112.5 mg or less.…”

Lithium: how low can you go?

“…In terms of suicidality, one study reported no effect and another identified some benefits to suicidality (unipolar depression). Of the 16 included studies, reports were unanimous safety of lowdose lithium across all studied populations (Strawbridge et al 2023b). Other studies have reported fewer side effects with doses in this range compared to higher doses, and although it has been suggested that this may not lead to fewer treatment discontinuations (Nolen et al 2019), it may be that adherence is improved in the absence or reduction of side effects (Barroilhet and Ghaemi 2020).…”

“…5-20 mg lithium (equivalent to 27-107 mg lithium carbonate) can be purchased over the counter as a nutritional supplement, most commonly in the form of lithium orotate (Strawbridge and Young 2022). No studies of these lithium supplements have formally assessed neuropsychiatric outcomes (Strawbridge et al 2023b) although two small human studies, conducted decades ago, reported extremely positive findings of lithium orotate (for various diagnoses) notwithstanding notable methodological limitations (Nieper 1973;Sartori 1986). The putative utility, however, of microdose lithium include: (1) safety, given its use in the community for decades without safety concerns (Strawbridge and Young 2022), (2) bioavailability, with some animal studies even suggesting an orotate anion may be able to facilitate relatively higher serum levels than other formulations (Pacholko and Bekar 2023) and preliminary evidence of clinical effects of lithium at similar doses: two of the sixteen studies included in our low-dose lithium systematic review used doses of 300ug (dementia) and 400ug (mood), both reporting effects similar to other studies of somewhat higher doses (Strawbridge et al 2023b).…”

Lithium: balancing mental and renal health

“…A 'microdose' of lithium orotate can be purchased without prescription as a nutritional supplement. Despite a distinct lack of human scientific studies, recent commentaries have extolled lithium orotate's potential: 9 Advocates highlight its use over several decades in the community without safety concerns, and safety is also supported by evidence from studies of low-dose lithium (other formulations), 10 and established knowledge of this mineral's pharmacodynamics. It has also been claimed that lithium orotate formulations impart benefits at lower doses than carbonate forms, and that the orotate anion itself could have biosynthetic advantages.…”