Lithium In Water "Curbs Suicide"

SpuriousLogic writes "Drinking water which contains lithium may reduce the risk of suicide, a Japanese study suggests. Researchers compared levels of lithium in drinking water to suicide rates in the prefecture of Oita, which has a population of more than one million. The suicide rate was significantly lower in those areas with the highest levels of lithium, they wrote in the British Journal of Psychiatry. And I was only worried about fluoridation affecting my precious bodily fluids before ..."

Comments

Re:Not surprising

[Anonymous Coward]

Manic episodes are definitely not "irrationally and exceptionally happy" and are very often extremely unpleasant.

Lithium acts as a mood stabilizer and works on both depression and mania.

The post you replied to is exactly right. In places with a mood stabilizing chemical in the water, suicide rates are lower. Fairly unsurprising except that the amount of lithium being dealt with is probably well below the known therapeutic threshold.

ebstein's anomaly

[bgeer]

lithium can cause cardiac birth defects when taken in the first trimester, so unless they're going to put pregnant women on a separate water system this is probably a bad idea. http://emedicine.medscape.com/article/154447-overview

Re:Not surprising

[ColdWetDog]

Lithium is basically a "mood stabilizer" and is increasingly used in recalcitrant depression (plenty of stuff on the web), albeit at much higher doses than what is found in drinking water.

Just glancing at the study, it's an interesting correlation, but it's going to be hard to do much with this. Just imagine the anti-floridation crowd going ballistic if anyone suggested adding Lithium to municipal water supplies.

Re:Anyone else massively creeped out by this?

[altek]

I don't think anyone's saying anything about scientists PUTTING lithium into the water. They went around and measured levels of lithium already in the water and found that the areas with higher levels had less suicides. Seems like other factors could be at play here too, considering that geographic areas are often different from one another in many societal aspects.

Side Effects

[mr100percent]

According to Epocrates, Lithium has side effects

Common Reactions:
tremor
polyuria
diarrhea
vomiting
drowsiness
muscle weakness
arrhythmias
anorexia
nausea
blurred vision
dry mouth
fatigue

Serious Reactions:
coma
seizures
ventricular arrhythmias
bradycardia, severe
syncope
goiter
hypothyroidism
hyperparathyroidism
pseudotumor cerebri
Raynaud's phenomenon
diabetes insipidus

Re: Lithium is used to fight bipolar disorder

[jd]

It can also cause thyroid problems and kidney failure. Patients must undergo very stringent tests to see if their body can cope with lithium, before it is given to them.

The problem is, lithium is highly toxic only very slightly above the theraputic threshold, making it extremely dangerous. Failure to drink, or sweating too much, will cause the lithium concentration to become dangerous or possibly deadly.

Well, that's -a- problem. Another is that it massively reduces the seizure threshold, so anyone potentially subject to seizures must also be put on anti-seizure medication to cancel the side-effect or risk having their brain turn into swiss cheese. However, each time you add medicines, you add risk of an abreaction to the new medication and also risk of the medications interacting in harmful ways.

(Many who die of medications they were prescribed die because the medications interacted.)

Despite Lithium being one of the longest-used medications for mental healthcare, it is still not very well understood. Patients are tried on it to see if it'll work for them, because it works much of the time. If it doesn't work, the doctor will try something else at random, and keep on going until something does work.

Why there haven't been studies using Lithium isotopes to trace the effects and identify the specific class(es) of condition(s) Lithium can deal with and which it can't, I don't know. It would seem easy enough and it would reduce the randomness in the mental healthcare industry.

Re:Great for mind, not to great for the Kidney's

[compro01]

FYI, lithium is not a heavy metal. It's the lightest metal, and 3rd lightest element, just behind hydrogen and helium.

That said, yes, it is quite toxic at the higher end of the therapeutic range, but the bottom end of the dosing range is about 5 orders of magnitude above the highest levels found in this (assuming an consumption of average of 3 litres per day), so I would think the toxic results from the naturally occurring lithium would be negligible.

That's not how it works

[Nicolas MONNET]

In fact, it's the complete opposite: depressed people are much more complacent than not. Depression is not "being sad."

If you'd ever met a bipolar person you'd know what I mean. In their manic phases they'd go fight an army by themselves, they don't care about rules and retribution. In their depressed phase they can't get out of bed, let alone rebel against the established social order.

Re:That's not how it works

[aurispector]

One of the biggest challenges in diagnosis and treatment of these diseases is defining the terms accurately in a clinically relevant manner. You got the depression part sort of correct, but bipolar disorders encompass a wide variety of symptom presentations. The "classic" manic depressive who might behave as you describe is called "type 1 bipolar disorder", but with type 2 bipolar disorder people are generally depressed with moods cycling downward toward more severe depression, although moods may swing upward toward hypomania. There's also a wide variety in the duration of the cycling, to the point where it may not be apparently different from normal mood changes.

Ultimately what we are talking about is the behavioral presentation of differences in brain structure and chemistry. On the surface what clinicians try to do is balance neurotransmitters using medications, but in practice what often happens is they merely try a series of medications until they hit on something that works. The effects of lithium are specific enough that it can almost be used diagnostically.

The interesting question raised here is when a naturally occurring substance becomes a drug. This question has been raging for years around fluoride. As a public health measure fluoridation is measurably effective but people question whether dental health is a sufficiently important reason to add a substance to drinking water. Iodized salt prevents an actual medical problem and goiter is now virtually unknown. Is the iodine a nutrient or a drug? What about fluoride? It seems to me that addition of lithium to the water supply would clearly fall under the definition of a drug. Even if it reduces the rate of suicide and mental illness the precedent set for "drugging the public" is far too serious and impinges on the rights of people who do not have a mental illness or chemical imbalances.

Treatment of mental illness must remain between a doctor and patient. The main benefit of this study is to increase public awareness of mental health issues, especially in a culture where mental illness is stigmatized.

Re:me too

[Sometimes_Rational]

Lithium is the third element in the periodic table, and the first metal. In other words, it is as far from being a heavy metal as it is possible to get.

Re:Anyone ever read that Stephen King story?

[hackstraw]

For those that do not know, lithium is a commonly prescribed medication for people with bipolar/manic depression disorder. Suicide is the only top 10-20 killer among all age groups in the US. The people most likely to commit suicide are bipolar people as opposed to people who are "normal" or those with other psychiatric disorders (major/minor depression, schizophrenia, etc). Similar studies to the one in this story have been done in Texas where lithium levels in the water supply are significantly above average compared to other states and the hospitalizations and suicide rate of bipolar people are less in Texas than other states. Yes, these studies are correlational, but anyone with a basic knowledge of statistics knows that correlation is well beyond the mantra shouted here that "correlation != causation".

Case in point with Nirvana's Lithium lyrics, the author of the song, Kurt Cobain, was bipolar, and he is now dead from suicide. The reason suicide is so common with bipolar people is because it is so difficult for them to handle the swings from the feelings of mania and euphoria down to the feelings of worthlessness and despair. Also, heavy substance abuse, particularly with central nervous system depressants like alcohol and heroin are common among bipolar people because they temporarily relieve stress (a trigger for instability) and well alcohol and heroin are quite pleasant drugs to do in the first place. Its not uncommon for them to semi-regularly do drugs like cocaine, MDMA, or LSD to bring back the familiar feelings of mania and euphoria.

Its common for the drug use or other unconventional social behaviors to be incorrectly deemed as causal towards the feelings and behaviors of people with bipolar disorder. I know someone very well who has bipolar disorder who has gone back and forth between a highly functional, well educated, intelligent, middle-class professional to chronic alcoholism, homelessness, in and out of jail and unemployment, to back again to the functional part. In our society, its not very permitted for people to take weeks, months or years away from activities like work or school which is what most people do from 5-65 years of age, and any and all deviations from consistency are heavily punished due to lower pay, lack of promotions, loss of jobs, jail, hospitalization, etc, which is enough to make any "normal" person depressed.