Lithium In Water "Curbs Suicide" 458
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 ..."
Re:Not surprising (Score:3, Informative)
Re:HS chem may be a fading memory but... (Score:4, Informative)
Evidently it is fading for you ;-)
They are talking about lithium ions in water (from salts like lithium chloride), not dumping metallic lithium in the reservoires ;-)
Re:Not surprising (Score:5, Informative)
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.
Re:HS chem may be a fading memory but... (Score:3, Informative)
Yes, in certain amounts, lithium helps, but in larger amounts, it is toxic to the human body. If we put it in something like water, how are we going to explain to people that drinking too much water might cause bone loss, kidney damage and seizures? This is not to mention the problems lithium can cause on the unborn during pregnancy. What, are we going to add tap water to things women shouldn't ingest when pregnant?
ebstein's anomaly (Score:5, Informative)
Re:Not surprising (Score:5, Informative)
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:me two. (Score:4, Informative)
Hi! I also base all my scientific, medical, and public policy opinions on movies and other fiction.
FYI, lithium has been widely proscribed for depression for 25+ years. It's hardly surprising that a population that consumes more of it than normal would have a lower rate of suicide.
But you were saying about movies and other fiction? One can't make a humorous Strangelove reference in the same paragraph as reporting news?
Re: Lithium is used to fight bipolar disorder (Score:3, Informative)
We already do.... (Score:1, Informative)
Why not just flood all water supplies with every drug we can think of? Hey, thorazine seems to work! Is it really the governments job to inject vitamins/minerals/animals into our water supply? Sure, flouride seems to work, and I can see this study leading to lithium being added. I wonder if I could make Riddalin(sp?][TM] bottled water? Justs seems to be getting a bit nuts to me that we have to add something to everything.
We already have an abundance of prescription drugs in our water supply, through excretion as well as through the practice of "flushing" unused meds to keep them from the children.
It'll take 3 seconds on the NY Times, Google, or Wikipedia to uncover numerous reputable articles on this.
Re:Anyone else massively creeped out by this? (Score:5, Informative)
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.
Re:Anyone else massively creeped out by this? (Score:3, Informative)
Lithium is found naturally in some spring water. Being that it's an an ionic element, as the water filters through certain rocks it can pick up natural lithium salts.
Some bottled spring water even has trace amounts. Not the "spring water" that is actually from a tap in New Jersey, but real natural springs. Lithium Springs were once all the rage.
Side Effects (Score:5, Informative)
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 (Score:5, Informative)
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:HS chem may be a fading memory but... (Score:2, Informative)
Re:Great for mind, not to great for the Kidney's (Score:5, Informative)
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.
Re:HS chem may be a fading memory but... (Score:3, Informative)
The highest concentration found in the water (59 micrograms per litre, so 180micrograms per day assuming 3 litres per day) is about 3 orders of magnitude below the therapeutic range (15-20mg per day).
Re:Great for mind, not to great for the Kidney's (Score:3, Informative)
Correction : that should be 3 orders of magnitude, not 5.
Re:Anyone ever read that Stephen King story? (Score:3, Informative)
Or perhaps the Firefly series and the creation of the Reavers.
Re:Anyone else massively creeped out by this? (Score:1, Informative)
I have a mild form of bipolar disorder called cyclothymia. I have hypomanic episodes and minor depressive episodes.
There are definitely benefits to the hypomanic phase. You have more ideas and you have the energy to do the work it takes to accomplish them.
However, I also have to watch out or I can get myself into trouble. When you're leaping from idea to idea it can be easy to jump to conclusions and act foolishly.
The depressive phase hurts. The world feels dimmer and I feel like I'm just an asshole.
So I make the best of it. I use the hypomanic phase to accomplish things while constantly reminding myself that I'm human. I use the depressive phase to reflect on the world and myself and constantly remind myself that there are both good and bad in both and I focus on the idea that I can improve them both.
That's not how it works (Score:5, Informative)
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:HS chem may be a fading memory but... (Score:4, Informative)
Oxygen atoms have a larger nucleus than hydrogen atoms, so in water, the shared electrons spend more time on average near the oxygen end of the molecule than the hydrogen ends. Because of this, the oxygen end has a negative and the hydrogen ends have a positive electric charge. Consequently, nearby water molecules will form networks, with one of the hydrogen atoms in one molecule being attracted to the oxygen atoms in another. This attractive force keeps the molecules partially bonded to each other, the state we call "liquid", in surprisingly high temperatures relative to water's molecular weight.
Re:me too (Score:3, Informative)
while lithium bicarbonate [google.com] worked well for me for several years, the side effects got worse and the drug became ineffective.
the toxic levels for lithium are close to the therapeutic levels.
Re:me two. (Score:3, Informative)
It's still very widely prescribed for bipolar disorder. In mild cases, such as cyclothemia, the therapeutic doses are way below the toxicity level, unlike full-blown cases. There has been great success in recent years with low doses (200-600mg per day) in sub-clinic bipolar cases. I know several people who were either prescribed it immediately, or switched to it from more modern drugs.
Re: Lithium is used to fight bipolar disorder (Score:3, Informative)
What you say used to be true a couple of decades ago when lithium was mainly used in the treatment of "full-blown" type I bipolar disorder. This is what used to be called manic depression before the bipolar disorders were re-classified. In that case a therapeutic does is 1-1.5g lithium per day and toxicity is a major concern, especially over the decades that the drug may be administered for.
Medicine has come up with lots of different replacements drugs that work well in those chronic cases and so the prescription rates for lithium have fallen. But it has found a new niche in the milder forms of bipolar disorder, such as cyclothemia where the therapeutic dose is much smaller, perhaps as low as 200mg per day. In these cases there is a large effect on symptoms at a level far below that which would be toxic.
Long-term build-up is still an issue, and rapid changes in lifestyle (taking up a new sport, flying to a different climate) can alter the re-uptake levels and cause problems.
Re:me two. (Score:3, Informative)
Lithium is better at treating the "manic" side of bipolar disorder (manic depression) as it is a mood stabilizer.
When treating depression (unipolar disorder) Lithium is also prescribed to enhance other antidepressants, so he is more than half right.
Re:me two. (Score:2, Informative)
Re:That's not how it works (Score:5, Informative)
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 two. (Score:3, Informative)
I think your point still stands, as lithium carbonate is a pretty simple probably naturally occurring molecule and this should affect whether is patent is granted. However, some of the other lithium salts used as anti-depressants are more complex, probably harder to derive and are arguably more worthy of being patentable.
My apologies for two instances of "probably" - IANAChemist
Re: Lithium is used to fight bipolar disorder (Score:2, Informative)
At my local airport there's a sign saying "you should drink 1 litre of water for every flight hour"
I regularly fly trans-atlantic to the US west coast. A 9.5 hour flight.
Fail.
Yeah, you really have to wonder from whose ass those kinds of numbers are pulled.
The company that sells the bottled water on flights and in the airport, of course.
Re:me too (Score:5, Informative)
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? (Score:5, Informative)
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 [wikipedia.org], 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.