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| {{SummarySheet}} | | {{SummarySheet}} |
| {{SubstanceBox/Lithium}} | | {{SubstanceBox/Lithium}} |
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| [[File:Lithium carbonate.svg|350px|thumbnail|right|The structure of the carbonate of lithium, lithium carbonate.]] | | [[File:Lithium carbonate.svg|350px|thumbnail|right|The structure of the carbonate of lithium, lithium carbonate.]] |
| '''Lithium carbonate''', '''Lithium salts''', or '''lithium''' (sold as many salts of the lithium ion and under many trade names, such as Eskalith) is a widely-prescribed mood-stabilizing pharmaceutical of the lithium salt chemical class. Lithium carbonate is an inorganic compound, the lithium salt of carbonate with the formula LiC<sub>2</sub>O<sub>3</sub>. Lithium carbonate produces mood-stabilizing, calming, and dulling effects when administered. Lithium is used clinically for bipolar disorder. Lithium has been reported anecdotally on Erowid to potentially trigger psychosis and severe seizures when combined with psychedelics, notably [[LSD]].
| | Lithium salts, or lithium (sold as many salts of the lithium ion and under many trade names, such as Eskalith, Lithobid, and Carbolith) is a widely-prescribed mood-stabilizing pharmaceutical that produces mood-stabilizing, emotional dampening, and anti-manic effects when administered. It is primarily used in the treatment of bipolar disorder and severe depression. Lithium has been reported to potentially trigger dangerous interactions when combined with psychedelics, particularly [[LSD]]. |
| //C'mon people. Isolated reports on Erowid don't constitute reliable information. Especially in recent years when other tryptamines have been sold as LSD. The one scientific study cited on that Erowid page about subjects taking LSD and Lithium together, "Alterations in responses to LSD in humans associated with chronic administration of tricyclic antidepressants, monoamine oxidase inhibitors or lithium." Behav Brain Res 1996;73(1-2):229-33, Bonson KR; Murphy DL has NO reports of seizures with people taking LSD and lithium. Contrast this with one of the Erowid reports where the reporter said she no longer took lithium or suffered from bipolar after her LSD incident. I haven't heard of someone suddenly recovering from bipolar, and if she does it's a miraculous recovery that maybe should be credited to LSD!//
| | History and culture |
| | | Lithium's mood-stabilizing properties were first discovered in 1949 by John Cade, an Australian psychiatrist. It became the first medication specifically approved for the treatment of mania in 1970 by the FDA. Despite being one of the oldest psychiatric medications still in widespread use, its precise mechanism of action remains incompletely understood. |
| Note there are also forms of lithium sold as nutritional supplements: '''Lithium orotate''', is a [[salt (chemistry)|salt]] of [[orotic acid]] and [[lithium]]. It is available as LiC<sub>5</sub>H<sub>3</sub>N<sub>2</sub>O<sub>4</sub>·H<sub>2</sub>O. Lithium aspartate is also sold as a supplement. It is a salt of aspartic acid and lithium.
| | Chemistry |
| //PS I've taken 1P-LSD with Lithium Orotate with no bad side effects, actually a bit of heightened euphoria. Let's not give into anti-drug rumors, we're supposed to be combatting that!//
| | Lithium is typically administered as a salt, most commonly lithium carbonate (Li₂CO₃) or lithium citrate. The therapeutic effects come from the lithium ion (Li⁺). Unlike most psychiatric medications, lithium is an element rather than a complex organic molecule. |
| ==History and culture==
| | The therapeutic window of lithium is narrow, requiring regular blood monitoring to maintain safe and effective levels, typically between 0.6 and 1.2 mEq/L. |
| {{historyStub}}
| | Pharmacology |
| | | Lithium's mechanism of action is complex and multifaceted, including: |
| ==Chemistry==
| | • Inhibition of inositol monophosphatase and inositol polyphosphate 1-phosphatase |
| {{chemistry}}
| | • Inhibition of glycogen synthase kinase-3 (GSK-3) |
| Unlike sodium carbonate, which forms at least three hydrates, lithium carbonate exists only in the anhydrous form.[13] Its solubility in water is low relative to other lithium salts. The isolation of lithium from aqueous extracts of lithium ores capitalizes on this poor solubility. Its apparent solubility increases 10-fold under a mild pressure of carbon dioxide; this effect is due to the formation of the metastable bicarbonate, which is more soluble: Li2CO3 + CO2 + H2O ⇌ 2 LiHCO3
| | • Modulation of neurotransmitter systems including serotonin and dopamine |
| The extraction of lithium carbonate at high pressures of CO2 and its precipitation upon depressuring is the basis of the Quebec process. | | • Effects on circadian rhythms |
| | | • Neuroprotective effects through various pathways |
| Lithium carbonate can also be purified by exploiting its diminished solubility in hot water. Thus, heating a saturated aqueous solution causes crystallization of Li2CO3.
| | Subjective effects |
| | | The effects of lithium develop gradually over weeks. Common subjective effects include: |
| Lithium carbonate, and other carbonates of group 1, do not decarboxylate readily. Li2CO3 decomposes at temperatures around 1300 °C.
| | Positive |
| | | • Mood stabilization |
| ==Pharmacology==
| | • Reduction in manic symptoms |
| {{pharmacology}}
| | • Decreased suicidal ideation |
| Lithium carbonate is used to treat mania, the elevated phase of bipolar disorder. Lithium ions interfere with ion transport processes (see “sodium pump”) that relay and amplify messages carried to the cells of the brain. Mania is associated with irregular increases in protein kinase C (PKC) activity within the brain. Lithium carbonate and sodium valproate, another drug traditionally used to treat the disorder, act in the brain by inhibiting PKC's activity and help to produce other compounds that also inhibit the PKC. Lithium carbonate's mood-controlling properties are not fully understood. | | • Emotional regulation |
| | | Neutral |
| Adverse reactions
| | • Emotional dampening |
| Taking lithium salts has risks and side effects. Extended use of lithium to treat various mental disorders has been known to lead to acquired nephrogenic diabetes insipidus. Lithium intoxication can affect the central nervous system and renal system and can be lethal.
| | • Reduced emotional reactivity |
| ==Subjective effects==
| | • Mild cognitive dulling |
| {{EffectStub}}
| | Negative |
| | | • Thirst |
| The subjective effects of lithium are primarily mood stabilisation. The onset of these effects are gradual and take place over weeks or months. Long term users who respond report “normality” and partial or full resolution of symptoms of bipolar disorder or depression. Some users report a reduced emotional range and some reduction in creativity. | | • Frequent urination |
| | | • Mild tremor |
| Lithium has no obvious effects on a single dose within the therapeutic range. Doses above the therapeutic range do not produce positive effects. Effects include nausea, prickling sensation on the skin, headache progressing to confusion, delirium, coma and potentially death.
| | • Reduced creativity (reported by some users) |
| | | • Weight gain |
| ===Experience reports===
| | Toxicity and harm potential |
| There are currently no anecdotal reports which describe the effects of this compound within our [[experience index]]. Additional experience reports can be found here:
| | Risk factors |
| * [https://www.erowid.org/experiences/subs/exp_Pharms_Lithium.shtml Erowid Experience Vaults: Lithium]
| | • Narrow therapeutic window |
| | | • Regular blood monitoring required |
| ==Toxicity and harm potential==
| | • Kidney function must be monitored |
| {{toxicity}}
| | • Dehydration risk |
| It is strongly recommended that one use [[responsible use|harm reduction practices]] when using this substance.
| | • Thyroid function impacts |
| ===Lethal dosage===
| | Lethal dosage |
| ===Tolerance and addiction potential===
| | The lethal dose is approximately 5-10 grams for most lithium salts, though toxicity can occur at lower doses. Symptoms of toxicity include: |
| ===Dangerous interactions===
| | • Severe tremor |
| {{DangerousInteractions}}
| | • Confusion |
| {{DangerousInteractions/Intro}}
| | • Seizures |
| *'''[[Psychedelics]]''' - This combination has been reported by users to cause seizures and psychotic breaks, notably with [[LSD]]. At least one death has been reported to be triggered by the combination of LSD and lithium.<ref>http://www.erowid.org/chemicals/lsd/lsd_health3.shtml</ref>
| | • Kidney failure |
| | | • Coma |
| ==Legal status==
| | • Death |
| {{LegalStub}}
| | Dangerous interactions |
| | | Psychedelics - Particularly dangerous with LSD, with reports of seizures and psychotic episodes. Combination should be avoided. |
| ==See also==
| | SSRIs - May increase risk of serotonin syndrome. |
| *[[Responsible use]]
| | NSAIDs - Can increase lithium levels to toxic range. |
| ==External links==
| | Diuretics - Can dangerously alter lithium levels. |
| *[[wikipedia:Lithium (medication)|Lithium (medication) (Wikipedia)]]
| | Legal status |
| | | Lithium is a prescription-only medication in most countries. It is not scheduled under international drug control conventions. |
| ==Literature==
| | References |
| ==References==
| | [Include standard references] |
| <references />
| | [[Category:Mood stabilizers]] |
| | | [[Category:Prescription drugs]] |
| [[Category:Psychoactive substance]][[Category:Proofread]][[Category:Approval]] | | [[Category:Psychoactive substance]] |
