By
Jason E. Barker, ND
Depression and other mood disorders are some of the most common and debilitating conditions experienced by patients. In the U.S. alone, an estimated 26.2 percent of Americans suffer from mental disorders—including depression and bipolar disorder.1 Applied to the 2004 United States Census, this equates to roughly 57.7 million people.2 In other words, 1 in 4 people we encounter during the day (friends, family members, co-workers) have some form of depression. Furthermore, nearly half of those with mental disorders suffer from more than just one condition at any given time.1
Some of the more prevalent mental disorders include conditions that are classified as mood disorders, such as major depressive disorder (depression) and bipolar disorder. Depression is considered the leading cause of disability in the U.S. for people aged 14 to 44,3 affecting a total of 14.8 million adults, or 6.7 percent of the adult (age 18 and above) population in the U.S.1 The median age of onset for depression is 32,4 and is more common in women than men–however, it can develop at any time and can occur in men as well.5
| Table 1. Diagnostic Criteria for Major Depressive Disorder |
| Depression is characterized by the presence of altered mood nearly every day, markedly diminished interest or pleasure in most or all activities and three or more of the following: - Poor appetite or significant weight loss or increased weight gain
- Insomnia or excessive sleep
- Psychomotor agitation or retardation (i.e. either agitated or lethargic behavior)
- Feelings of hopelessness
- Loss of energy or fatigue
- Feelings of worthlessness, self reproach, or excessive or inappropriate guilt
- Complaints or evidence of a diminished ability to think or concentrate
- Recurrent thoughts of death, suicidal thoughts or attempted suicide
- Reduced sex drive
|
Depression
Depression is a mental illness that affects both the mind and the body, influencing the way a person eats, sleeps and how he or she views the world and themselves. It is not simply an extended “bad” mood or a lack of personal or mental strength; nor is it laziness. Left untreated, depression exerts a profound crippling effect and symptoms can last a lifetime. Depression and other mental conditions are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).6
Bipolar disorder
Bipolar disorder, also known as manic depression, is a condition that is punctuated by wide changes in mood, thought, energy levels, and behavior. Although different from clinical depression, the depressive episodes in bipolar disorder are similar. Bipolar disorder affects roughly 5.7 million American adults, or about 2.6 percent of the adult population1; the median age of onset is 25 years for this condition.4
People with bipolar disorder experience moods that can alternate between excessive highs (mania) and excessive lows (depression). Changes can be apparent for as little as a few hours to days, weeks, and even months. The cyclical or episodic occurrences of depression and mania can be solitary in nature, and episodes of mixed mania and depression can appear as well, becoming increasingly frequent leading to disruptions in all aspects of the person’s life.
Seasonal Affective Disorder
Another related condition to depression and bipolar disorder is Seasonal Affective Disorder (SAD), which is generally caused by bodily rhythms that are out of synch with the sun due to the late dawn and early dusk of wintertime. Symptoms of SAD are similar to those of clinical depression, including lack of energy.7 In the U.S., it is thought that SAD affects roughly 9 percent of the population in the Northern U.S. and about 1.5 percent of the population in Florida.8 Additionally, a milder form of SAD known as Subsyndromal SAD is thought to affect 14.3 percent (northern) to 6.4 percent (Southern) of the population in the U.S.9 The majority of people with SAD will also experience depression, and up to 20 percent of people with SAD may also suffer from bipolar disorder.9 Such people will be depressed in the winter and manic in the summer.
Clinically, many patients present with these conditions that are often not extreme nor frequent enough for them to have been “officially” diagnosed according to DSM-IV standards. This population is perhaps at greater risk of not obtaining proper treatment, as they may fall through the proverbial diagnostic criteria gap, resulting in their symptoms either being downplayed or completely unaddressed as a result. In my practice based in the Pacific Northwest, where sunlight is often scarce, I tend to see many patients who did not receive proper treatment and happen to mention mood symptoms. Other patients wait until they can no longer stand the emotional pain to finally speak out about their condition. In these cases, if the patients’ symptoms are worse in winter, I suspect SAD as a possible cause.
Lithium’s Mood-Elevating Properties
The mineral lithium orotate is used by doctors to help stabilize and equilibrate mood swings and is therefore of particular interest to people with mood disorders. It is helpful in making the highs and lows of bipolar less dramatic, and for lifting depressive symptoms. It also works to stop mood swings and depressive lows, as long as it is taken regularly. The exact mechanism of action of lithium is not well understood; it is thought to regulate how the brain communicates messages within itself.
Lithium is available in several forms; most often it is prescribed in a form known as lithium carbonate or lithium citrate. Both of these types of lithium have a very narrow therapeutic range, meaning that the most effective dose is very close to a toxic dose as well. However, because of the side effects that are often encountered due to the large amounts typically prescribed, people taking lithium often suffer from several medication side effects.
Prescription strength lithium must be used in high amounts to achieve therapeutic efficacy, because the cells of the body generally poorly absorb it. Lithium and many other drugs must be absorbed into the cells where they affect the internal cellular chemistry to cause physiologic changes. Because lithium does not readily enter the cells, patients must take very high doses to “force” lithium into the cells. At the same time, these high doses are extremely close to toxic levels; prescription strength lithium must be used with extreme caution, as the difference between therapeutic and toxic levels are extremely small. Because of this, people taking lithium must maintain strict dosing schedules and be diligent about obtaining blood tests every 3 months to ensure they stay within optimal, non-toxic dose ranges. Symptoms of lithium overdose include tremors, diarrhea, thirst and frequent urination, nausea and a feeling of detachedness.
Lithium in any of its forms is not a pharmaceutical drug in the strictest sense; rather the different forms are simply minerals (very similar to salt) with significant effects on conditions of the mind. Lithium occurs naturally in the environment and it is found in very small amounts in the food and water supply.
Lithium Orotate – The Safe Lithium
Another form of lithium, known as lithium orotate, is much safer than its prescription strength counterparts yet at the same time it maintains a similar degree of efficacy. Because of this, much lower doses can be used, and toxic side effects are avoided, but clinical improvements are similar.
Lithium orotate differs chiefly from prescription strength lithium based on the ion it is bound to. This seemingly insignificant change makes all the difference in the world in the realm of safety. The original scientific study looking at lithium orotate theorized that this form of lithium was specifically released within cells at the critical sites where cellular transmission occurs, and that this form of lithium is able to cross the blood brain barrier with greater efficacy than standard lithium.10
It is theorized that the cells can absorb lithium orotate more effectively than the prescription form.11 This study looked at lithium orotate absorption in animals and showed that the brain and blood serum concentrations of lithium orotate remained stable in the serum up to 24 hours post-administration, and brain concentrations were 3 times higher than that found with prescription lithium carbonate – leading to greater therapeutic efficacy.
Other Uses of Lithium
People with mood disorders (especially depression) are at a much higher risk of suicide than the general population.12 Lithium has been shown to lessen the incidence of suicide in patients with depression who are taking it compared to those who do not. And, suicide is also lower among those taking lithium compared to other types of antidepressant medications.13-14 Lithium has been used with success in a variety of conditions other than mood disorders, including alcoholism, anemia, migraine and cluster headache15, as well as nearsightedness and glaucoma.10
Conclusion
Lithium orotate is a simple mineral available as a safe nutritional preparation that has significant effects on conditions such as depression, bipolar disorder, and Seasonal Affective Disorder. Lithium orotate is available as a safer alternative to prescription strength lithium, which has a high risk of several dangerous side effects. Lithium orotate is uniquely designed to provide the same positive effects on mood as prescription lithium, but at a much lower and thus safer dose. Lithium can be used in clinically diagnosed mood disorders as well as for subclinical mood conditions that are not always readily diagnosed by clinicians. Lithium orotate should always be used under the discretion of a physician.
References
1. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):617-27.
2. U.S. Census Bureau Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005. http://www.census.gov/popest/national/asrh/
3. The World Health Organization. The World Health Report 2004: Changing History, Annex Table 3: Burden of disease in DALYs by cause, sex, and mortality stratum in WHO regions, estimates for 2002. Geneva: WHO, 2004.
4. Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):593-602.
5. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association. 2003; Jun 18;289(23):3095-105.
6. American Psychiatric Association. Diagnostic and Statistical Manual on Mental Disorders, fourth edition (DSM-IV). Washington, DC: American Psychiatric Press, 1994.
7. Lam RW, Levitt AJ, Levitan RD, Enns MW, Morehouse R, Michalak EE, Tam EM. “The Can-SAD Study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder.” American Journal of Psychiatry. 2006;163(5):805-12.
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9. Avery DH, Kizer D, Bolte MA, Hellekson C. Bright light therapy of subsyndromal seasonal affective disorder in the workplace: morning vs. afternoon exposure. Acta Psychiatrica Scandinavica. 2001;103 (4): 267-274.
10. Nieper HA. The clinical applications of lithium orotate. A two years study. Agressologie. 1973;14(6):407-11.
11. Kling MA, Manowitz P, Pollack IW. Rat brain and serum lithium concentrations after acute injections of lithium carbonate and orotate. J Pharm Pharmacol. 1978 Jun;30(6):368-70.
12. Moscicki EK. Epidemiology of completed and attempted suicide: toward a framework for prevention. Clinical Neuroscience Research. 2001; 1: 310-23.
13. McElroy SL, Kotwal R, Kaneria R, Keck PE Jr. Antidepressants and suicidal behavior in bipolar disorder. Bipolar Disord. 2006 Oct;8(5 Pt 2):596-617.
14. Howland RH. Lithium: underappreciated and underused?
J Psychosoc Nurs Ment Health Serv. 2007 Aug;45(8):13-7.
15. Sartori HE. Lithium orotate in the treatment of alcoholism and related conditions. Alcohol. 1986 Mar; 3 (2): 97-100.