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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 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 that produces mood-stabilizing, calming, and dulling effects when administered. Lithium is used clinically for bipolar disorder. Lithium has been reported 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]].
==History and culture==
 
{{historyStub}}
## 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.
 
## Chemistry
 
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.
 
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.
 
## Pharmacology
 
Lithium's mechanism of action is complex and multifaceted, including:
 
- Inhibition of inositol monophosphatase and inositol polyphosphate 1-phosphatase
- Inhibition of glycogen synthase kinase-3 (GSK-3)
- Modulation of neurotransmitter systems including serotonin and dopamine
- Effects on circadian rhythms
- Neuroprotective effects through various pathways
 
## Subjective effects
 
The effects of lithium develop gradually over weeks. Common subjective effects include:
 
### Positive
- Mood stabilization
- Reduction in manic symptoms
- Decreased suicidal ideation
- Emotional regulation
 
### Neutral
- Emotional dampening
- Reduced emotional reactivity
- Mild cognitive dulling


==Chemistry==
### Negative
{{chemistry}}
- Thirst
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:[7]
- Frequent urination
- Mild tremor
- Reduced creativity (reported by some users)
- Weight gain


Li2CO3 + CO2 + H2O ⇌ 2 LiHCO3 The extraction of lithium carbonate at high pressures of CO 2 and its precipitation upon depressuring is the basis of the Quebec process.
## Toxicity and harm potential


Lithium carbonate can also be purified by exploiting its diminished solubility in hot water. Thus, heating a saturated aqueous solution causes crystallization of Li2CO3.
### Risk factors
- Narrow therapeutic window
- Regular blood monitoring required
- Kidney function must be monitored
- Dehydration risk
- Thyroid function impacts


Lithium carbonate, and other carbonates of group 1, do not decarboxylate readily. Li2CO 3 decomposes at temperatures around 1300 °C.  
### Lethal dosage
The lethal dose is approximately 5-10 grams for most lithium salts, though toxicity can occur at lower doses. Symptoms of toxicity include:
- Severe tremor
- Confusion
- Seizures
- Kidney failure
- Coma
- Death


==Pharmacology==
### Dangerous interactions
{{pharmacology}}
Lithium has a complex pharmacology.
==Subjective effects==
{{EffectStub}}


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.  
**Psychedelics** - Particularly dangerous with LSD, with reports of seizures and psychotic episodes. Combination should be avoided.


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.
**SSRIs** - May increase risk of serotonin syndrome.


===Experience reports===
**NSAIDs** - Can increase lithium levels to toxic range.
There are currently no anecdotal reports which describe the effects of this compound within our [[experience index]]. Additional experience reports can be found here:
* [https://www.erowid.org/experiences/subs/exp_Pharms_Lithium.shtml Erowid Experience Vaults: Lithium]


==Toxicity and harm potential==
**Diuretics** - Can dangerously alter lithium levels.
{{toxicity}}
It is strongly recommended that one use [[responsible use|harm reduction practices]] when using this substance.
===Lethal dosage===
===Tolerance and addiction potential===
===Dangerous interactions===
{{DangerousInteractions}}
{{DangerousInteractions/Intro}}
*'''[[Psychedelics]]''' - This combination has been reported by many users to cause seizures and psychotic breaks, notably with [[LSD]]. In an unconfirmed anecdote, one death was reported to be triggered by the combination of LSD and lithium.<ref>http://www.erowid.org/chemicals/lsd/lsd_health3.shtml</ref> Note the same Erowid article has anecdotes of lithium users using psychedelics multiple times safely and even a published studies done with no ill effects reported. Article Title: ''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):pg 229-33, Bonson KR; Murphy DL. Also ''Chronic administration of serotonergic antidepressants attenuates the subjective effects of LSD in humans.'' Bonson KR, Buckholtz JW, Murphy DL. Neuropsychopharmacology. 1996 Jun;14(6):425-36. doi: 10.1016/0893-133X(95)00145-4. PMID: 8726753
*'''[[SSRIs]]''' - Combination with Lithium has a potential to cause serotonin syndrome,  in people concurrently on serotonergic medications such as [[sertaline]] (Zoloft), and [[fluoxetine]] (Prozac). <ref>Lithium Interaction with SSRI's | https://en.wikipedia.org/wiki/Lithium_(medication)#Interactions</ref>


==Legal status==
## Legal status
{{LegalStub}}


==See also==
Lithium is a prescription-only medication in most countries. It is not scheduled under international drug control conventions.
*[[Responsible use]]
==External links==
*[[wikipedia:Lithium (medication)|Lithium (medication) (Wikipedia)]]


==Literature==
## References
==References==
[Include standard references]
<references />


[[Category:Psychoactive substance]][[Category:Proofread]][[Category:Approval]]
[[Category:Mood stabilizers]]
[[Category:Prescription drugs]]
[[Category:Psychoactive substance]]
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