Fluoride and... Lithium?

[MDhasbeen]

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A Japanese study has shown that even low levels of lithium in drinking water can curb suicide. Think we should start lithium-ating our water?

 

[Indryd]

A Japanese study has shown that even low levels of lithium in drinking water can curb suicide. Think we should start lithium-ating our water?

Lithium is no fun. It should be used only in people who need it, not on a preventative basis.

Here are some other things you could put in drinking water to curb suicide:

Haldol
Arsenic
Strippers

This is scientific fact.

 

[Solideliquid]

Lithium is no fun. It should be used only in people who need it, not on a preventative basis.

Here are some other things you could put in drinking water to curb suicide:

Haldol
Arsenic
Strippers

This is scientific fact.

After giving the scientific data a very close look, I would choose option C.

 

[MDhasbeen]

Lithium is no fun. It should be used only in people who need it, not on a preventative basis.

Here are some other things you could put in drinking water to curb suicide:

Haldol
Arsenic
Strippers

This is scientific fact.

Sources?

And lithium toxicity is no fun. The concentrations the study mentions seem to be miniscule, homeopathic even. People were drinking far higher concentrations in 7 Up back in the day. (BTW, just playing devil's advocate here.)

 

[surftheiop]

Lithium is no fun. It should be used only in people who need it, not on a preventative basis.

Here are some other things you could put in drinking water to curb suicide:

Haldol
Arsenic
Strippers

This is scientific fact.

wasnt the idea that the lithium in the certain area was/has been in the water in higher concentrations naturally?

so it seems if it had been causing health issues data could easily be taken from these populations that have been drinking the increased levels for their whole lives.

 

[Indryd]

Sources?

And lithium toxicity is no fun. The concentrations the study mentions seem to be miniscule, homeopathic even. People were drinking far higher concentrations in 7 Up back in the day. (BTW, just playing devil's advocate here.)

What if we served every glass of water with a quick dollop of elemental lithium right there at the table. Or include a little baggy with every bottle of Fuji. Now THAT is gonna keep the people happy.

And while I can't speak to homeopathic levels, I can assure you that even therapeutic levels (non-toxic) have plenty of ill-effects that would deter most people from taking it if they didn't need it. Hell, these ill effects have deterred me from taking it a number of times even though I damn well KNEW I needed it.

😱😕 Decompensation anyone? 😕😱

BTW your second post is gonna force me to actually LOOK at the article. Thanks a lot for that. If there's one thing I don't wanna look at, it's science. I'll come back once I've had a look.

 

[billypilgrim37]

Lithium is no fun. It should be used only in people who need it, not on a preventative basis.

Eh, 300mg QHS is a nice night cap. Your kidneys don't even notice it!

 

[surftheiop]

why are people instantly dismissing this so fast?

Im not saying its a good idea but it seems kind of silly to dismiss it just because of the effects of lithium in higher doses

Im not a doctor (nor have I researched it) , but from wikipedia it says 1g-10 g of a fluoride salt will kill a person.
While on the other hand it looks like ~1g a day of lithium per day would be a reasonable prescription.

So it looks like lithium would be at most 2-5x more dangerous per mass than fluoride. And water supplies have been flouridated without much trouble, so I dont see why the same couldnt feasibly be done with lithium seeing as flouride salts and lithium fatal doses are on the same orders of magnitude.

Is there something im completly missing here? (Like that lithium builds up in body overtime but flouride doesnt, or something of that nature)

 

[mrboh]

A typical therapeutic dose of lithium might be 1000 mg of lithium carbonate, which would be equivalent to 188 mg of the lithium ions that the article is presumably talking about. The maximum level of lithium quoted in the article is 59 μg/L, which would equate to 64.6 mg per year based on 3 L of tap water consumption per day. So it would take three years to consume the equivalent daily therapeutic dose. Of course this is all without reading the actual paper, so there may be more going on, but it sounds a little implausible based on what the news article states.

 

[Hurricane]

A typical therapeutic dose of lithium might be 1000 mg of lithium carbonate, which would be equivalent to 188 mg of the lithium ions that the article is presumably talking about. The maximum level of lithium quoted in the article is 59 μg/L, which would equate to 64.6 mg per year based on 3 L of tap water consumption per day. So it would take three years to consume the equivalent daily therapeutic dose. Of course this is all without reading the actual paper, so there may be more going on, but it sounds a little implausible based on what the news article states.

The goal wouldn't be to reach the therapeutic dose for bipolar I. That's comparing apples and oranges. Lithium is used at doses well below the bipolar therapeutic dose for augmentation in unipolar depression. And what they're talking about here is even smaller doses for suicide prophylaxis in a heterogenous mostly "normal" population.

 

[masterofmonkeys]

while we're at it, let's throw in a little zoloft (short half life, good side effect profile), a little modafinil (helping all of us sleep-starved people, not to mention better cognitive performance), a touch of orlistat, a little lipitor, and some metformin for all the fatties, and lets not forget abilify and seroquel, which are both on the verge of getting approval for every condition in the DSM-V.

WOOHOO!!! better living through chemistry!

 

[surftheiop]

while we're at it, let's throw in a little zoloft (short half life, good side effect profile), a little modafinil (helping all of us sleep-starved people, not to mention better cognitive performance), a touch of orlistat, a little lipitor, and some metformin for all the fatties, and lets not forget abilify and seroquel, which are both on the verge of getting approval for every condition in the DSM-V.

WOOHOO!!! better living through chemistry!

I really dont understand why you all are mocking this w/o actually presenting evidence about what trace levels would do.

Obviously this might be more "extreme" than some other fortifications, but we are no strangers to adding potentially deadly things to food/water supply.

We have vitamin D fortified milk.

We have iodized salt.

Vitamin A fortified sugar.

Folic Acid in Flour

Niacin in Bread.

Fluoridation of water.

 

[kugel]

I really dont understand why you all are mocking this w/o actually presenting evidence about what trace levels would do.

Personally, I'd vote in favor of lithium fortified water, but I suspect I'm in the vast minority of general voters.

I think perhaps the difference between the flouridation and chlorination of water and the "lithification" (I kinda' like that neologism) is that almost everyone benefits from the first two, only a minority would benefit (as far as we now know) from lithification, but everyone would have to endure the risks.

However, I'd be willing to donate a few dollars to help get it studied.

 

[billypilgrim37]

I really dont understand why you all are mocking this w/o actually presenting evidence about what trace levels would do.

What evidence in this case could POSSIBLY matter? Do you realize the political implications of putting forth policy to put a trace element specifically used as a psychiatric pharmaceutical to prevent suicide? It doesn't matter how brilliant an idea this would be, how safe it would be, how effective. It just wouldn't matter.

I'd vote for it. On secret ballot. I'd also buy stock in tin foil hats. And vodka.

The only way this would get passed would be if it also extended male genitals by a few inches and/or increased female bust size by two cup sizes in just ten days.

 

[Thorazine]

every few years there is an article in the news about how they find trace amounts of various prescription drugs in the drinking water supply. we already are drinking lithium, and prozac, and lipitor, and augmentin and viagra.

http://www.usatoday.com/news/nation/2008-03-10-drugs-tap-water_N.htm

weeeee!

i wonder if my brita filters this stuff out?

 

[kugel]

http://www.usatoday.com/news/nation/2008-03-10-drugs-tap-water_N.htm

the EPA official interviewed is named Grumbles.
I want to be a bureaucrat named Grumbles.

 

[BobA]

I really dont understand why you all are mocking this w/o actually presenting evidence about what trace levels would do.

Obviously this might be more "extreme" than some other fortifications, but we are no strangers to adding potentially deadly things to food/water supply.

We have vitamin D fortified milk.

We have iodized salt.

Vitamin A fortified sugar.

Folic Acid in Flour

Niacin in Bread.

Fluoridation of water.

Epidemiolgoic studies like the one described in the article are not very good at establishing causation. For example, the incidence of stroke is higher in the Southeast. Does that mean living in the Southeast causes strokes? Of course not. Obesity, hypertension, smoking, diabetes, and sedentary lifestyle (all causes of stroke) just happen to be more common in the Southeast. In this instance, living in the Southeast would be considered a "confounder" since it can be associated with stroke but doesn't cause stroke.

Stronger studies that look more directly at the relationships between, in this case, very low lithium levels in the water and decreased suicide would be required in order to establish that low lithium levels in the water actually reduces suicide.

 

[surftheiop]

Epidemiolgoic studies like the one described in the article are not very good at establishing causation. For example, the incidence of stroke is higher in the Southeast. Does that mean living in the Southeast causes strokes? Of course not. Obesity, hypertension, smoking, diabetes, and sedentary lifestyle (all causes of stroke) just happen to be more common in the Southeast. In this instance, living in the Southeast would be considered a "confounder" since it can be associated with stroke but doesn't cause stroke.

Stronger studies that look more directly at the relationships between, in this case, very low lithium levels in the water and decreased suicide would be required in order to establish that low lithium levels in the water actually reduces suicide.

agreed, I was just saying that it seems like it could be worth studying some more

 

[Hurricane]

the EPA official interviewed is named Grumbles.
I want to be a bureaucrat named Grumbles.

Anyway, I think they should put the lithium back in 7-Up and the cocaine back in Coca Cola.

 

[Regnvejr]

When I think of all the gray hair I get from monitoring side effects and drug interactions in my more challenging, poor-compliance, polypharmacy patients, then the last I want to worry about is a baseline polypharmacy problem from the water. Psychiatric medications are messy and side effects can make patients feel rotten. For the ones you make better, there are also the ones that you give bad side-effects and who are to polite to tell you until you get them back after a month and find out they have been miserable or to sedated for work and got fired and all sorts of social disasters. I definitely prefer to know that no other medication interactions have occurred to further complicate the picture.

And lithium by itself is a terrible medication. Loss of thyroid function, lethargy, weight gain, near-complete suppression of any mood of any kind and whatnot. Better have a REALLY good reason for putting lithium into people.

The patients that psychiatrists end up seeing would not derive sufficient benefit from homeopathic lithium, they are already to severely affected by mental illness. I prefer a clean slate and not have to worry about the water

 

[billypilgrim37]

Better have a REALLY good reason for putting lithium into people.

Yes, like not having to be on depakote 😉

 

[OldPsychDoc]

Anyway, I think they should put the lithium back in 7-Up and the cocaine back in Coca Cola.

Given the comorbidities of alcohol dependence and bipolar disorder, perhaps this would be in order as well.

 

[Indryd]

And lithium by itself is a terrible medication. Loss of thyroid function, lethargy, weight gain, near-complete suppression of any mood of any kind and whatnot. Better have a REALLY good reason for putting lithium into people.

This.

 

[billypilgrim37]

This.

For younger members of this thread, I think this would be a good time to bring up that in psychiatry, there are generally two political parties of pharmacology: the lithium people, and the depakote people. Like real political parties, not every one cares, and not everyone is a member, but you will find plenty of people who defend one or the other to their dying day.

So, MS3s, don't show up to your psych rotation decrying lithium, one of the most important, life-saving drugs in our pharmacopoeia, until your attending does. And same goes for depakote.

It sucks to fry your kidneys and your thyroid, and it sucks to have your cognition beat down with a crowbar and gain a lot of weight. Both meds have serious problems.

Only one of them is awesome. 😉

 

[BobA]

...

 

[Regnvejr]

...Only one of them is awesome.

Both of them are awful. No treatment is even more awful. Just about anything you can do for treating bipolar disorder is awful, only overshadowed by not treating.

 

[chameleonknight]

Never mind the psych implications of lithium in the water:

Bioaccumulation is a great reason to NOT add pharmaceuticals to the water supply!

 

[Indryd]

So, MS3s, don't show up to your psych rotation decrying lithium, one of the most important, life-saving drugs in our pharmacopoeia, until your attending does. And same goes for depakote.

This is good advice.

MSIII though I am (not young though 🙁 ), I very much understand the benefits and literally life-saving power of lithium.

However, it's no fun to take a drug that changes your interface with the world, feels like it changes who you are, will likely cause you permanent damage.

You also eventually come to understand you might actually die (you learn one way or another, right?), kill, or--best case--end up with a nice stay stay on the psych ward, if you decide to stop taking it.

So, my glib "this" was not a condemnation of lithium, just an assertion that it is, indeed, a terrible drug. But now that I think of it, I would call it "terrible" in a sort of biblical sense:

For the LORD your God is God of gods, and Lord of lords, a great God, a mighty, and a terrible God, which regardeth not persons, nor taketh reward:
He is thy praise, and he is thy God, that hath done for thee these great and terrible things, which thine eyes have seen.

and lithium is thy medication, that hath done for thee these great and terrible things, which thine eyes have seen.

This.