Can Lithium Be Used For Alcohol Withdrawal
You have heard of lithium before. But can it be used for alcohol withdrawal? What is it usually used for?
Reviewed by Dr. Jeffrey Berman, MD
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Several medications may be used for people recovering from alcohol addiction. Lithium is a drug that has gotten attention. A study was conducted with 18 men with alcohol use disorder who were in withdrawal.
It was found that in mild alcohol withdrawal, lithium reduces the visible symptoms of withdrawal and normalizes performance on a motor skills task. Individuals who start taking lithium while still drinking show improvement because it takes longer than 3 days for lithium concentrations in the blood to level off.
How Is Lithium Dosed
There are both immediate- and extended-release forms of lithium. The immediate-release form is available as a capsule, tablet, and oral liquid. This version is often taken three times per day when you first start lithium. is only available as a tablet.
While taking lithium, your provider will routinely check blood lithium levels. This to make sure that you are taking a dose that relieves bipolar disorder symptoms while also minimizing side effects.
Lithium works differently for everyone. Your provider will monitor various blood tests and your response to the medication to find the right dose for you.
Lithium Orotate Vs Aspartate
Those wishing to take a dietary supplement of this trace mineral do have another option the apartate version.
What is the difference between lithium orotate and lithium aspartate?
The former is made with orotic acid, while the latter uses aspartic acid, which is an amino acid . Its name comes from the 1827 discovery of it in asparagus juice. The aspartate acts as an ion carrier for the lithium.
This is the supplement facts label for Doctors Best brand, showing how the elemental mineral represents 4%. They have discontinued this product due to lack of demand. Very few brands today sell it because orotate is believed to be best, even though it has no proven advantages.
Both of these forms are sold over the counter without a prescription because they are only for use as dietary supplements. Both contain approximately 4% of the mineral, with the rest being the ion carrier.
While there are no special health benefits of lithium aspartate, the same holds true with side effects there is no evidence of it being mutagenic like orotic acid is.
At least when its separate from lithium, the safety of aspartic acid is believed to be neutral, since it is a non-essential amino acid. In addition to food sources, our bodies create aspartate for use in various biological processes, such as for the ATP synthase enzyme .
For this reason, aspartate appears to be the best supplement type, or at least its better than orotate.
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Information About Your Lithium Treatment
When you start taking lithium, you will get a lithium treatment pack with a record booklet. You need to show your record booklet every time you see your doctor, go to hospital, or collect your prescription.
When you go to the doctor for blood tests, you or your doctor will write in the record booklet:
- your dose of lithium
- problems with your eyesight
- increased need to pee, lack of control over pee or poo
- feeling faint, lightheaded or sleepy
- confusion and blackouts
- shaking or muscle weakness, muscle twitches, jerks or spasms affecting the face, tongue, eyes or neck
If you need to go to A& E, take the lithium packet or the leaflet inside it, plus any remaining medicine, with you.
Can We Compare Np03 To Low Dose Lithium Orotate
What is really interesting is that low dose lithium in the form of lithium orotate is commonly recommended by integrative practitioners for anxiety, mild mood swings, brain fog, ADHD and insomnia. I have found it to be extremely beneficial for many of my clients and have used it personally with success .
Just how much lithium orotate is low dose? Typical doses are 5-10 mg per day, increasing to 20mg per day.
Can we compare NP03 to low dose lithium orotate? Its too early to know for sure but we I believe we can start to make extrapolations, especially given that both are very low doses.
Integrative psychiatrist, Dr. James Greenblatt, MD has written extensively about low dose lithium orotate for the above purposes and for Alzheimers too. In this article, Lithium: The Cinderella Story About a Mineral That May Prevent Alzheimers Disease, he shares that
Scientists first became interested in the use of lithium for treating neurodegenerative disorders when they observed that bipolar patients using lithium therapy seemed to have lower rates of cognitive decline than peers on other medications.
He writes how an enzyme called Glycogen Synthase Kinase-3 a serine/threonine protein kinase normally plays a major role in neural growth and development and how lithium
works as a direct GSK-3 inhibitor halting inappropriate amyloid production and the hyper-phosphoryation of tau proteins before they become problematic.
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What To Expect When You Start Taking Lithium
Although lithium is effective for treating bipolar disorder, it also has various side effects and risks. Lithium is a mood stabilizer that has a narrow therapeutic index. This means that small differences in the dose and the amount of lithium in your body can greatly impact its effectiveness and potential for side effects.
Some side effects are common when people first start lithium, such as:
Tremors , especially in the hands
Nausea often the first side effect experienced
Thankfully, most of these side effects improve as your body adjusts to the medication.
Since nausea may be related to how quickly your body is absorbing lithium, taking it with food or switching to the extended-release form can help slow lithiums absorption and relieve this side effect.
Lithium affects how kidneys filter urine and can cause your body to produce more urine. Although this side effect tends to improve over time, your provider will monitor your kidney function with blood tests to lower your risk of long-term kidney damage.
How Does It Work
We don’t know, exactly4.
It seems to increase the levels of serotonin by triggering greater production. In this sense, it works along the same lines as SSRI antidepressants in increasing the amount of serotonin in the brain.
It also affects your levels of norepinephrine, similar to the way SSNI antidepressants do.
Given that both of these are commonly believed to have an affect on our mood, hence the regulating of them by antidepressant drugs, it seems plausible that lithium works similarly. However, there are several competing theories about how it exactly works.
It may also be that it helps to reduce mood by helping the body control its levels of dopamine and glutamate. If so, this should suggest that at least some of the benefit is limited to bipolar disorder, and not depression or anxiety.
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Limitations Associated With Research Of Lamictal For Anxiety
There are a host of limitations associated with the currently-available research of lamotrigine for the treatment of anxiety. Perhaps the biggest limitation is that lamotrigine hasnt been evaluated as an anxiolytic monotherapy among patients with anxiety disorders. Other limitations include: sample sizes, study designs, and the overall lack of research testing lamotrigines anxiolytic effect in humans. As a result of these limitations, theres currently inadequate quality evidence to determine if lamotrigine is an effective off-label anxiolytic among patients with anxiety disorders.
Verdict: Lamictal Possibly Effective For A Subset Of Persons With Anxiety Disorders
Since lamotrigine hasnt undergone extensive testing via large-scale randomized controlled trials to determine its anxiolytic efficacy, no strong conclusions can be made regarding its therapeutic value in the treatment of anxiety disorders. Nonetheless, nearly every study in which the anxiolytic efficacy of lamotrigine was evaluated provides preliminary evidence to support the hypothesis that it is capable of attenuating anxious symptoms. In other words, virtually all preliminary data is unanimous in suggesting that lamotrigine administration may be therapeutically effective for the treatment of anxiety.
Whats more, there dont appear to be any convincing data from studies indicating that lamotrigine may be ineffective or useless for the treatment of anxiety disorders. Although there isnt much animal model data, the available data from work by Mirza, Bright, Stanhope, et al. suggests that lamotrigine induces an anxiolytic-like effect. The anxiolytic-like effect was observed in the rat conditioned emotional response test of anxiety, likely through blockade of voltage-gated sodium channels, and the significance of this effect was comparable to that observed after the administration of benzodiazepines.
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What Is The Safest Mood Stabilizer For Children
Children and teenagers with bipolar disorder can be treated with carbamazepine to stabilize their mood. In addition to being used as an anticonvulsant, it is also used as a sedative. There have been limited studies that demonstrate sodium valproate can reduce mania symptoms in children with bipolar disorder.
Complications Of Alcohol Use Disorder And Bipolar Disorder
AUD can impair your judgment, make you more impulsive, and also increase your risk of suicide, injury, and sexually transmitted infections like HIV. Research from the Medical University of South Carolina found that suicide is nearly twice as high in people with bipolar disorder and AUD as it is in people with Bipolar alone.
In addition, the effect alcohol has on a persons moods and judgment can make sticking to drug therapy more difficult, wrecking the very goals of treatment.
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What Is Lithium Used For
was approved over 50 years ago to treat bipolar disorder and is still commonly used for this condition. According to the American Psychiatric Association, lithium remains a first-choice medication to treat and prevent manic and depressive episodes in people with bipolar disorder.
Bipolar disorder is a mental health condition where people experience extreme mood swings from periods of low moods to episodes of high moods . People with bipolar disorder experience more drastic mood changes than the ups and downs most people have.
If untreated, bipolar disorder can worsen over time. Mood swings can be overwhelming and negatively impact peoples lives, including work, social life, and relationships with family and friends. Lithium can lower the frequency and severity of manic episodes and help prevent depressive episodes.
How To Cope With Side Effects
What to do about:
- feeling or being sick take lithium with or after a meal or snack. It may also help if you do not eat rich or spicy food. If you are being sick, take sips of water to avoid dehydration.
- diarrhoea drink plenty of fluids to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
- a dry mouth and/or a metallic taste in the mouth try sugar-free gum or sweets, or sipping cold drinks. If this does not help, talk to your pharmacist or doctor. Try not to have drinks with a lot of calories in as this might also mean you put on weight.
- slight shaking of the hands talk to your doctor if this is bothering you or does not go away after a few days. These symptoms can be a sign that the dose is too high for you. Your doctor may change your dose or recommend taking your medicine at a different time of day.
- feeling tired or sleepy as your body gets used to lithium, these side effects should wear off. If these symptoms do not get better within a week or two, your doctor may either reduce your dose or increase it more slowly. If that does not work you may need to switch to a different medicine.
- weight gain try to eat well without increasing your portion sizes so you do not gain too much weight. Regular exercise will help to keep your weight stable and help you feel better.
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Lithium Use In Alcohol Addiction Treatment
Lithium is one of the oldest psychotropic drugs on the market. Its primarily used to help stabilize moods in those who have bipolar disorder, which includes experiences of both depression and mania. However, it has also been used to help with alcohol addiction treatment.
When someone is healing from an addiction to alcohol, especially if that addiction was long and intense, then he or she is likely going to experience psychological, physical, and emotional symptoms while the body and brain learn to live without alcohol and stabilize. The psychological experiences that a recovering addict has can be the most troubling.
To minimize the challenges of anxiety, depression, and mania that a person might have while withdrawing from alcohol, doctors frequently prescribe medication. One of these is lithium, which has worked specifically to address the depression and mania.
However, experts disagree on what specifically lithium can treat in a recovering addict. There is a debate concerning whether lithium is really only good for those recovering addicts who also suffer from bipolar disorder. Recent research suggests that this likely the case.
Some Of The Assets Of Lithium
Lithium prevents depressions as well as manias
It is important to note that British naysayers and critics said that lithiums use was based on a shaky foundation. Not only did Schou perform the critical studies to validate the efficacy of lithium in bipolar disorder, lithium continues to have the best record in long-term prophylaxis among a variety of agents . Its acute and prophylactic antimanic effects are amply demonstrated, and recent meta-analyses document its prophylactic antidepressant effects as well .
Acute and prophylactic effects in unipolar depression
Lithium has antisuicide effects, even in minute levels in the drinking water
Lithium has the best data to support its antisuicidal effects when used in therapeutic doses . However, miniscule but higher concentrations of lithium in the drinking water are associated with lower rates of suicide in the general population compared with locales with lesser amount of lithium. These findings have now been documented in more than a half dozen studies . One study reported a lower incidence of crimes, suicides, and arrests for drug use in adolescents . Now a new study from Japan indicates higher levels in the water supply are associated with lower rates of depression and interpersonal violence in adolescents in the general population .
Lithium may reduce risk of dementia
Lithium has neurotropic and neuroprotective effects
Lithium increases telomere length
Lithium decreases incidence of some medical illnesses
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