Ryan Sheridan, NP
How Low-Dose Lithium Can Improve Mood and Mental Health
Updated: Dec 7, 2022
Is supplemental lithium orotate right for me?
Most people think of lithium as a scary, old medication with lots of side effects. In low doses lithium has few, if any, side effects. A lot of my patients feel a noticeable, positive shift as quickly as a few days after beginning lithium supplementation.
Lithium definitely gets a bad rap, but in low doses can be quite effective. Let’s go over some of the key points about lithium and how it might be able to help you.
Prescription lithium vs. supplemental lithium:
I can’t stress enough: prescription-strength lithium is not the same as supplemental lithium (lithium orotate). The type of lithium I am suggesting you consider here is a low-dose over the counter supplemental lithium, lithium orotate.
Prescription-strength lithium is a much, much higher dose of lithium that carries a range of potentially dangerous side effects and should only be taken under close supervisor of a provider with experience prescribing lithium. Supplemental lithium is used to supplement what we aren’t getting from our diet. Wait – what? Yes! Lithium is a naturally occurring element and has been almost entirely eliminated from our highly processed, shelf-to-mouth diets and because our water is so heavily filtered.
Dosages of prescription-strength lithium are at least 23 times higher than supplemental lithium. As you can see in the chart below, a single dose prescription-strength lithium is significantly larger than a single dose of lithium orotate.
What can supplemental lithium do for me?
The reality is lithium isn’t exclusively a medication per se – it’s a naturally occurring element! A metal, in fact. You might remember Lithium from chemistry as Li or hear about as the naturally occurring metal used in modern batteries that power just about everything.
Ok enough of the jargon! Interestingly enough lithium is still poorly understood, even today. So we don’t exactly know how it works. What we do know is that lithium has mood stabilization effects – it helps soften the lows and temper the highs. In my experience, patients given lithium orotate report feeling more at ease, less reactive, and in some cases a significant reduction in depressive symptoms.
Another known benefit of lithium are its neuroprotective qualities. There is a growing consensus that lithium positively impacts the brain in anti-aging ways. In a sense, lithium is thought to do this by balancing certain naturally occurring chemicals in our brain – GABA and glutamate – and in doing so slows cell death. In subjects given lithium orotate, glutamate was reduced while GABA was increased. This contributes to that mood stabilization we talked about earlier. Lithium was also shown to stimulate production of essential proteins in the brain like BDNF (a key neurotransmitter for memory and learning)!
Cool, right? There’s more though! Lithium has been shown to increase grey matter in the brain. What’s grey matter? Grey matter is where the highest concentration of cell bodies are in the brain – it’s where most of the computing is done in our brains.
This isn’t a complete list of what lithium does in the brain. There is likely more we don’t even know. What we do know is that lithium can do a whole bunch of things for mental health, including improving your mood and providing some anti-aging effects for your brain!
Success! One patient’s story with lithium orotate
In my integrative psychiatry practice, patients given lithium orotate often see improvements that make this treatment option worthwhile. In full transparency, some patients see no benefit, so we discontinue the treatment (FYI: there is no such thing as a one-size-fits-all miracle drug). Many patients see a modest improvement and are happy with their results. In some cases, patients see a significant improvement in their overall reported mood.
Here's an example! In one patient with mild depression, lithium orotate provided the oomph she needed to break out of her depressive episode. She’d tried antidepressants, including a selective serotonin reuptake inhibitors (SSRIs), on and off for some time. But didn’t quite get where she wanted to be – and rightfully so. We started her on 5mg of lithium orotate, after a week we bumped that to 10mg of lithium orotate every night before bed. After another two weeks, and given she had no side effects, we ended up at 20mg of lithium orotate. She reported improvement! In fact, she reported almost no symptoms of depression after nine weeks. We stayed here for a while. Eventually we slowly discontinued her SSRI and maintained her lithium orotate. An all-around success story. A few notes here… this patient was not severely depressed nor was she actively suicidal. She also had lots of support. Putting depression into remission is not done at the snap of a finger – it takes work! In this case, lithium orotate may have provided the extra layer of support she needed. It also might have provided a safety net for her by smoothing out her mood – in some ways protecting against future depressive episodes. Lithium orotate was used as a complementary therapy under the guidance of a trained provider. All this is to say lithium orotate can work – but our expectations should be realistic.
I want to try lithium orotate – how should I start?
A word of caution: supplements can still be dangerous and are not for everyone. While lithium orotate is completely safe for most people when taken properly, it is still a good idea to discuss all of your over the counter medications and supplements with your provider. The below details are for informational purposes only and not intended to be prescriptive. This should give you a framework to chat with your provider, if you’re interested in giving lithium orotate a try.
I like to start patients at 5mg of lithium orotate taken at night before bed. If no side effects are noted, move up to 10mg lithium orotate taken at night before bed. Still no side effects after a week? We can slide up to 15mg of lithium orotate taken at night before bed. The maximum dose I recommend is 20mg of lithium orotate. It is important to give lithium time to work – so 4 to 6 weeks is a good length for a trial.
Dosing schedule: Week 1. 5mg/lithium orotate 30 minutes before bed, if no side effects then 2. 10mg/lithium orotate 30 minutes before bed, if no side effects then 3. 15mg/lithium orotate 30 minutes before bed, if no side effects then 4. 20mg/lithium orotate 30 minutes before bed, if no side effects then continue
We are still a far cry from the prescription-strength lithium. If we don’t notice the benefits at 20mg or below going up probably won’t make a difference in the way we are hoping. You can likely find lithium orotate at most vitamin shops or online. It is relatively inexpensive – you should be able to find a bottle of 5mg capsules of lithium orotate for less than $20. Here is the one I typically recommend on Amazon. That being said, please first have a chat with your provider. It is important to get things right and the best way to do that is with a professional.
Lithium is exciting at low doses. This is a powerful tool that might help you. The low risk, high potential reward makes low dose lithium an option for a wide range of scenarios.
If you’re looking for a new provider who can be a partner in your health, feel free to reach out to me. I’d be glad to see if we can work together. Feel free to repost this blog, just give me a link back!