1) therapeutic doses of lithium as a prescription medicine for mood disorders are MUCH higher than doses occurring through lithium in the water supply, and yet
2) there is perhaps some epidemiological signal suggesting differing rates of suicide and depression in places where lithium levels in the water supply are higher.
Kay Redfield Jamison, author of some of the most compassionate books about depression you will ever read,[1] credits lithium with saving her life. I'm glad her life was spared so that she could write from the inside about what it is like to have a severe mood disorder, and apply her creativity to communicating with people who cannot directly understanding her personal experiences or the experiences of other patients.
I think the article's call for further research, at a minimum, is worth taking seriously. The neuroprotective effect of lithium demonstrated in animal studies (verified by necropsy and examination of the animal's brains after the animals die) is well established, so we may as well check whether adjustment of water supplies by intentional supplementation has a beneficial effect if (and only if) epidemiological studies and animal experiments suggest doing so. This is, after all, how the beneficial effects of fluoride on tooth enamel strength and resistance to decay were discovered.
The "benefits" of lithium come at a cost, which this article doesn't really address. Lithium evens out your emotions, good and bad, some describe it as "turning into a soulless robot." That could mean a more docile society (the legal, behavioral, etc benefits described) but sounds pretty close to THX 1138 to me.
I am bipolar. What you describe is why it's a "hard sell" to patients with mood disorders.
Yes, others will point to the higher dose for psychiatric patients.
I would point to the soulless robot, the empty husk of a once vibrant, creative brain.
We are devs, and our brain is our livelihood. In me it killed my creativity and my passion. Not only did I not want to code anything new, I could not conceive of new things. I stopped improv jams on guitar, I could not write songs. I became wonderfully adept at doing scales. Scales over and over.
I'll take my mood disorder- because it comes WITH emotions.
This is just to give you a 'crazy person's' impression of Lithium. Your results may vary.
Over the past 14 years I've taken Lamictal, Lithium, Depakote, Seroquel, Zyprexa, Geodon, etc. I still take the first 3. I also got a masters, a PhD, recorded 3 albums with my band, played on plenty of others and worked on plenty of creative outputs (including programming).
I agree that when I first got on those meds at 21 after a psychotic break I was totally torn up. Now at 35 I couldn't imagine my life any other way. Have I become less creative? I honestly don't know and it's kind of frightening to think that perhaps I have. How would I ever know?
If you haven't seen what your life you be like permanently institutionalized (I've been hospitalized for mania 6 times) perhaps strong drugs aren't for you. If you have seen the other option (life inside a hospital), it makes a lot of sense.
If you think Li makes you a zombie, try intramuscular haldol or seroquel or even ativan. Those will knock you out, the first one literally. :)
Thanks for sharing your experience. I am curious about the hospitalization for mania. If you don't mind saying, what happened exactly? Were you so "up" that you were taking dangerous risks? What types of behavior does mania induce that make it a threat?
In my case, delusions, paranoia, and the occasional inappropriate remark that could be construed as homicidal or suicidal ideation. Depression genuinely caused the latter ideation.
Lithium is a very harsh mistress, but if you have type 1, which is akin to emotional epilepsy, she will bring you to heel.
Unlike the other commenter, every hospitalization was for mania, not depression. When I'm depressed I'm essentially bed-ridden.
I guess I took dangerous risks, depending on who you talk to. :) I was never suicidal or homicidal, but I definitely did things that were out of character and scary to people outside. One of the most interesting things is that I remember everything and it all seemed 'rational' at the time. Not rational per the normal definition of rational, but following my line of reasoning everything made sense. I don't want to go into too much details online as it wouldn't take Sherlock Holmes to figure out who I am. As it is you can google stalk me and eventually figure out my story. Regardless it isn't that interesting.
The threat part is that 1/5 people with bipolar die of suicide w/ 25% to 50% attempting. That is so, so scary. I was deeply affected by the passing of Robin Williams for that reason. That's almost always on the depression side.
For me, my mania was just ... extra happy ... going right up into the mystical amazement with life, the universe and everything that people typically associate with psychedelics, etc. 14 days into a hospital stay (my longest was 17 I think) that happy go lucky feeling sleeping ~1-3 hours max on heavy sedation becomes... much more agitated and frustrated.
Not attempting to edit this post for clarity, but yeah, that's a rough sketch of my situation. It's been 6 years since I was last hospitalized (I had my friends take me in), but I'd say the feeling coming on is like an electric charge of infinite energy reverberating from the base of my skull. Sounds awesome in theory, but it doesn't convert to tangible output when the smoke clears. I could write on and on about these experiences, but so can many others... /r/bipolarreddit and /r/bipolar are some spaces where people let loose on their experiences.
Absolutely. I have taken the same list of meds as the post above yours, and thankfully as he did I have found the right medicine for me. I perceive the tone of the post above yours to be condescending, as if my experience is trumped by his life experience (which, I assure you, isn't unique to his bipolar).
I described my experience with lithium, and while there were sedatives and antipsychotics that I was prescribed which had a far greater numbing effects, I was not speaking to them.
All of the medications I tried had different consequences, Lithium's were not the worst (Lamictals were the most interesting musically).
I currently take lamictal for BP 1 - can you elaborate what you mean by lamictal being 'most interesting, musically'? I've found it to be without any discernible side effects, at least compared to depakote/valproate and lithium.
I'm terribly condescending online. I'm glad that you have found a good mix for you and sorry I was an asshole there. I just didn't want people to get the picture that psych med X destroys everyone it touches. They all hit people differently. Possibly because the exact causes of these diseases aren't tacked down.
Be well. I can only hope our life experiences both rock regardless of whatever bumps in the road we hit. I didn't put the low-lights of my life on meds into my post, but they are legion. Leeeeeeegion.
I have been taking bipolar meds for a dozen years. Compared to atypical antipsychotics, benzos or other mood stabilizers, lithium is a walk in the park. I think the x hours of TV or internet 'use' a day makes a more docile society than a little lithium would.
Psychiatric doses, perhaps, but I don't think trace doses have any meaningful effect. The doses are an order of magnitude or two smaller, and my personal experience doesn't agree: when I ran a blind self-experiment for around a year using lithium orotate doses higher than the trace water proposals, I noticed nothing subjectively and none of my recorded data changed (http://www.gwern.net/Nootropics#lithium-experiment), so I'm fairly skeptical of the claim.
But if the only reason decreased suicide rates are observed is that the members of society become slightly more docile (obviously to a much lesser degree than those on prescription doses), it makes it a lot more questionable whether this is a valid way to tackle the suicide problem.
It would be one thing if micro-doses of lithium were sold as a supplement, which individuals can opt to take. But the article goes as far as to suggest adding it to drinking water -- it seems very irresponsible in my eyes to leave it to the government to decide "how docile" the population should be above the natural level / what trade-off with suicide rate is acceptable.
There are better ways to deal with the problem of suicide than pushing society slightly closer to the "souless robot" end of the spectrum.
Biology isn't made of perfect sliding scales between two extreme problems, where in the middle you have 50% of both problems. Instead, in the middle, you usually have neither problem.
For example, the amount of moisture in your skin: too little and it cracks and bleeds, too much and you get fungal infections. But adding moisture to cracked-and-bleeding skin isn't making it "a bit more fungal" -- it's pushing it into the healthy buffer range.
And what suggests that we aren't "in the middle" already? With your hand moisture analogy - for the majority of the population, natural levels of moisture are perfectly fine, and no intervention is required. Perhaps natural levels of lithium are optimal too.
I'd imagine there are many, more complex, factors involved in brain chemistry / mood suppression, so it would be a lot more difficult to determine where this middle lies.
If you're using high suicide rates to suggest we're not in the middle and need more lithium in everyone's water, I'd have to disagree. In the vast majority of cases, a better healthcare system which ensures those who need it are connected with mental health professionals would help nip the problem in the bud. Rather than solving it with these lithium microdoses, causing to those on the verge of suicide to not have the lucidity of emotion to commit to the act, and the rest of the population having their brain chemistry played with too.
Usually "the middle" makes up the vast majority of the scale.
Here's a useful comparison:
Before we were iodizing salt, most people were actually in "the middle" of iodine-consumption. Anywhere from "nearly none" to "tons and tons" was "the middle"--your body can work miracles to create homeostasis from random inputs. But some people were getting no iodine at all, and these people would get very sick.
So we added just a little bit of iodine to salt. The iodine-deficient people--the people who were previously getting utterly no iodine--stopped getting sick, because now they were getting a little bit of iodine, and that was enough. Everyone else was getting slightly more iodine--but this didn't push anyone from "getting a tolerable amount of iodine with the excess just excreted" to "having a hyperiodine problem." There was nobody exactly one dose away from having too much iodine, because we just don't consume that much iodine.
This same story holds for any vitamin or mineral. Calcium, phosphorous, iron, etc. are all things most people get the right amount of--but "the right amount" is almost any amount, because the body knows how to take just the right amount from the stream of input it's getting, and throw the rest out. The only wrong amounts are either zero, or more than exists in any human-friendly environment.
> but this didn't push anyone from "getting a tolerable amount of iodine with the excess just excreted" to "having a hyperiodine problem." There was nobody exactly one dose away from having too much iodine, because we just don't consume that much iodine.
Actually, there was: 'thyroid shock'. Iodization in the USA was accompanied by a wave of, I think, a few thousand deaths on net when people who grew up iodine-deficient were suddenly exposed to iodized salt. (This was covered by one of the historical papers I cite in http://www.gwern.net/Iodine although I forget which.)
Of course, the benefits of iodization were on net huge and I'm very much a fan of iodization, but it would be wrong to say nobody was hurt by the introduction of iodized salt.
Interesting. That sounds less like "being one dose away from having too much iodine" and more like "having no tolerance for iodine, such that even one dose is too much."
I guess another way to think about environmental chemicals is by analogy to poisons: if they were common in the environment, you'd have a tolerance to them, but since they aren't, you don't. You can build up a tolerance by parts, at which point the poison stops being one and just becomes another chemical the body handles.
Maybe. I don't know what the mechanism of thyroid shock is; as I said, iodization is such a good idea overall that it's merely a footnote in the cost-benefit.
That makes sense with your example - but I really don't think suicide can be seen as a symptom of lack of lithium in the same way as sickness from a lack of iodine.
What is there to show that "this same story holds for any vitamin or mineral"?! Surely there are many which have no positive effect on the body, where zero would be the best dosage. What law of biology suggests that every mineral is in some way beneficial to the human body?
Lithium happens to have an effect on moods in the brain in such a way that suicide is less likely - but the mood dampening effects may well diminish people's positive emotions too (for example). For someone with no mental health issues or risk of suicide, this could well be an overall negative effect, and therefore makes no sense to force on the entire population.
Where do you get this idea of lithium making people "docile"? It does not; you may be confusing it with antipsychotic medication. In any case as the comment you are responding to states, these are very low doses, such effects could not occur. Your emotional language of "soulless robots" is really just an uninformed, knee jerk reaction.
I can see why the drinking water suggestion invites paranoia. As the article mentions a solution like adding it to salt could also work.
No, mine wasn't an "uninformed, knee jerk reaction" - it's was the informed conclusion I came to after some research (prior to this article) into prescription doses of lithium. Becoming docile, turning into a soulless robot, mood supressions - whatever you want to call it - is an extremely commonly reported side-effect by those with first-hand experience. Several people in this thread (go right up to the top parent comment by hammock) have already backed this up with their own experience, yet you still seem to be dismissing it.
As to why that is relevant to microdosing...
- High doses: major mood suppression -> practically no chance of suicide
- Micro doses: (?) -> lower chance of suicide
Simple reasoning would suggest that (?) == some degree of mood suppression. I'm not sure how you've concluded that this "could not occur" with lower doses?
Putting it in salt is hardly better than putting it in the water supply, it's still systematic mass "medication" which would become difficult to avoid.
I won't discount that therapeutic doses may have such side-effects, but the question is whether that is relevant to the present discussion. I claim that the side effect of being docile would not occur at a dosage of 100 times smaller than therapeutic doses. Maybe there is such a thing as a "1/100th as docile" effect, but it doesn't always make sense to extrapolate effects linearly; it can also be that the effect just isn't there. The way I arrive at that intuition is by making an analogy with water: you can drown in a bathtub of water, but no person can drown in a droplet of water.
You call it "simple reasoning" to make your inference about microdosing, but actually we have no idea how lithium even affects the brain / mind, so it's not possible to arrive at the conclusion by reason. It would have to come from evidence from controlled studies, and I believe these indicate that side-effects are restricted to high doses.
Also, "practically no chance of suicide" -- you can't be serious about that; no drug can guarantee or even come close to that.
You already have salt with and without iodine, so no, wouldn't be difficult to avoid. Whether you should call it "medication" is debatable; giving someone vitamin C is not necessarily medication, it can be a food supplement. The same could be argued for lithium which occurs naturally in certain water springs.
i have, for years, and i currently take "antipsychotic medication", which is actually a yet another term that, thanks to marketing, has lost all meaning. the comments about lithium making you "docile", and "soulless robots" are spot on. and there are "antipsychotics" that act as mood stabilizers that are a lot less soul-sucking than lithium is.
You are projecting your experience with therapeutic doses on the current discussion about doses that would be orders of magnitude lower, similar to naturally occurring levels in some water supplies. Even at therapeutic doses I think you are generalizing too much, as many people do not experience such side effects.
> Where do you get this idea of lithium making people "docile"? It does not; you may be confusing it with antipsychotic medication.
that is the statement i was responding to.
> Even at therapeutic doses I think you are generalizing too much, as many people do not experience such side effects.
that's cool and all, but that's just, like, your opinion, man. if you're going to accuse me of generalizing, you could at least do so with something other than a sweeping, unqualified generalization. i find it amusing that this thread is full of people who don't actually take this medication telling people who actually have what its effects are. in fact, lithium has been documented both anecdotally and in research[2] to have measurable effects on cognition, and a dulling effect on mood.
> > Where do you get this idea of lithium making people "docile"? It does not;
Granted, I was overstating my case there. But I maintain, not everyone has those side effects. The more pertinent point was that the article is advocating trace amounts.
Yeah, I am also bothered by the fact that the options only seem to be 'it remains a controlled substance which people have to show a significant need for in order to acquire' and 'put it in the drinking water'. I realize it is very popular in modern society to think that if something has benefits that it should be forced on everyone, and if benefits can't be shown then the government should step in and forbid anyone from doing it, but I can't get comfortable with that. I would think what should be aimed for is easy availability of low-dose lithium supplements paired with education. Give people a choice. This isn't like vaccines where we have a legitimate reason to exert control over people (herd immunity, the safety of those too young or immunocompromised to be vaccinated, etc).
Lithium is not like you describe. I've taken half a dozen SSRI's, which at times made me feel totally empty and without motivation. I've taken one antipsychotic (risperidone) and it made me feel like an utterly stupid zombie, so much so that I stopped taking it against my doctor's orders. I was put on lithium and I found that I'm completely capable of feeling a full range of emotions, but what I don't experience is the accelerated spiraling of emotions that can send me into depression or mania. Compared to more recent psychotropic medications, lithium is pretty mild in terms of unwanted side effects; the only drawback is that if you're on a high dose, you have to stay hydrated to avoid lithium toxicity. That's a pretty small price to pay to stay level.
Quite a lot of psychiatric drugs affect different people in different ways; I would be very unsurprised if the people the grandparent post recounts describing it as "turning into a soulless robot" are fairly describing their own experience, while the parent post fairly describes that poster's experience.
One probably should avoid hastily generalizing one's own experience to what the drug's effects are like generally.
We'll agree to disagree then. I've heard several complaints about lithium but none of them was "it turns me into a soulless robot." The way lithium works is by stabilizing mood, not by inducing a different mood like other medications (i.e. antidepressants). So I'm going to be facetious and say the people making those claims were soulless robots before taking lithium.
I'm not so sure a "more docile society" is a good thing - given that one of the definitions is "easily led or managed", which brings to mind dystopian government controls...
At prescription amounts, yes it pretty much turns the patient into a robot. My stepfather is bipolar, and his doctor had to stop prescribing him lithium because it stripped away his normally upbeat (when not in a depressive state) personality, to the point that he was difficult to interact with.
Again though, that's at prescription levels. Trace levels in drinking water probably won't make us all into soulless robots ripe for totalitarian rule.
Good timing. It happens I'm going to Ashland, OR next week. The town is famous for the Shakespeare Festival (world-class performances) and Lithia Park. The latter is a natural lithium containing mineral water source. It's easy to sample, just a short stroll from the Elizabethan theater, a drinking fountain bubbles up the spring water.
ATM I'm not sure of the exact concentration of the minerals, but from prior years, saying it tastes really bad isn't nearly a strong enough description. Other water supplies containing Li may be quite acceptable, but except for Ashland palatability isn't the main issue.
In the article, the cited concentration of Li at 0.170 mg/L, if referring to Li+ ion alone, the water supply would actually contain ~1/100 of the lowest therapeutic dose of Li. Medicinally Li is provided as the carbonate salt. A minimal dose is 300 mg/day, which contains ~ 30 mg elemental Li. Consuming Li-fortified water 2 L/d -> 0.34 mg Li or >1/100 of low medicinal Li dose .
Of course in nature Li is always in ionic or combined form, but the article didn't give details about Li concentrations, so it muddies the water trying to parse Li effects in any number of ways.
Here in Portland OR, city water is sourced high up near Mt. Hood from condensation of atmospheric water (mist or rain) and piped the short distance to the city. It's basically like distilled water, very low in mineral content. So low in fact, the federal government insists that alkaline minerals are added to the supply since distilled water is acidic and leaches lead from old plumbing.
Other data would show something different re: suicidal behavior but contradictory data sets are kind of the point.
Li could be a factor but I'm skeptical. We must remain alert to the hazards of drawing conclusions from population-based observational data. In this domain, experimental studies are difficult to design and conduct, but further study to narrow down confounding factors would be useful.
What I do know is water purity is sacred here. The last fluoridation campaign failed by about a 3:1 lopsided vote.
What chance would there be of adding lithium to our water supply? I think it would not be voted in.
Distilled water is neutral, it is the reference point against which acidic and alkaline solutions are compared.
Technically one could argue that it is acidic, because any concentration of [H+] is acidic, but this is like arguing that Jiminy Cricket is tall because he has height.
However, rainwater will naturally absorb CO2 in the air (and since the industrial revolution, NO2 and SO3), making it acidic.
The reason given was leeching. Neutral is not good enough for that sometimes; you need slightly basic. Some things will corrode at pH 7, but not higher.
Distilled water being very low in dissolved ions will be more prone to picking up metal ions from pipes than water that already has a natural/normal level of dissolved ions. So in that way it is more "corrosive" than ordinary tap water.
Distilled water is neutral, but natural surface water with low mineral content still has CO2 disolved in it, and usually also some SO2 and NOx, which makes the water acidic, so what's wrong is the comparison with distilled water, not that it is acidic.
I should have expressed this more carefully. Distilled water is by itself neutral, but as you note, CO2 and other gases will dissolve in it, forming weak acids.
That happens when rain falls, but will also occur in the lab when distilled water is exposed to air. In that case, pH will be variably slightly less than 7.0. That's the reason calibration of pH meters relies on carefully prepared buffer solutions which are much less affected by airborne gases.
Neutrality of distilled water could be improved by boiling it to drive off atmospheric CO2, and storing it in full, sealed containers. If its pH were measured without exposure to air, it would be 7.0, or very close to it.
> Medicinally Li is provided as the carbonate salt. A minimal dose is 300 mg/day, which contains ~ 30 mg elemental Li.
Lithium carbonate is about 19 % elemental lithium by mass (lithium carbonate contains two lithium atoms per molecule), so 300 mg would be ~ 57 mg lithium.
Also, to my knowledge, the typical therapeutic doses are at least 900 mg/d in adults.
Thanks, I did miscalculate and your figure is right. That means that Li+ concentration of 0.17 mg/L is ~1/160 of a minimal therapeutic dose.
As a drug Li carbonate comes in 300 and 450 mg doses. Dosing is determined by monitoring the blood level of Li since only a narrow range of levels represent optimal therapeutic effect, and above that range toxicity can develop.
There is no "standard" dose of Li. It's necessary to start at lowest dose and increase gradually while monitoring the blood level. While 900-1200 mg/day is common, there are many individuals who need lower or higher dosage to have measured Li levels fall within acceptable limits.
Occasionally 300 mg/day is sufficient to get a good level, so that's the reason I used it for estimating the ratio of the natural vs. medicinal Li intake.
Li has those studies (US, JP, UK) going for it, with only 1/6 going against in the UK but having the lowest doses in the study. fluoride in drinking water have zero reputable academic sources confirming any efficacy.
So, just because some people are conspiracy theory nuts/paranoids/etc does not make them instantly wrong.
I used to check this more often, even before there was a WWW, when I was home-brewing beer. Then, as now, the water was so low in dissolved minerals, it was necessary to add Ca++, Mg++, etc. as yeast nutrients. All of Portland's big microbreweries probably still have do the same thing.
Gwern's writings on nootropics are particularly fascinating. They read like the works of a mad scientist (in a good way). Erudite, meticulous, and also a tiny bit reckless. Gwern treats himself like a human guinea pig, then documents and analyzes the results more carefully than I've seen in some research papers. The whole process, furthermore, reads like a dialogue between Gwern and the reader. To be more precise, it reads like a dialogue between Gwern and Gwern's imagined idea of a highly intelligent reader -- a reader whose place you find yourself wanting to fill.
Gwern's archive is eccentric, to say the least. But it's one of the best places on the web to lose oneself for an afternoon.
I live about 3 miles away from Lithia Springs, but I can't seem to find any information online about how much lithium is actually in our drinking water.
I know our water and sewer authority publishes a report on water quality each year, but I don't remember seeing lithium content in the report.
I'm just inside Paulding County with a Powder Springs address, and that's who I pay my water bill to, but the yearly water quality reports I get come from Cobb County. It makes me wonder if Lithia Springs even gets their municipal supply from the spring, or from a Douglas County source.
> It makes me wonder if Lithia Springs even gets their municipal supply from the spring, or from a Douglas County source.
The spring is privately owned. Here it is on google street view [1]. Lithia Springs gets their tap water from from the Dog River Reservoir in the southern part of Douglas County.
> I can't seem to find any information online about how much lithium is actually in our drinking water.
Not too surprising: I've done some poking around looking for datasets measuring lithium in drinking waters (the existing epidemiological work is, IMO, surprisingly small-n for something that seems to be routinely measured by drinking water systems), and it's pretty hard to find any lithium measurements.
Not to detract from the flow of the conversation, but do any of us Atlanta-area hackers have any formal events or get-togethers? I'd love to meet some of you and hack on stuff.
Other uses for very-sensitive analysis of waste water include real time drug sampling. We can tell that it's the weekend by the amounts of MDMA and cocaine (metabolites?) in the water; where heroin doesn't show weekend spikes. This can be used at festivals to see if "legal highs" are actually used and in what kind of quantities.
The programme is better than this page makes it out to be.
I live just a couple of miles from Lithia Springs, Georgia, and oddly enough I've never seen "Lithia Water" on sale anywhere around here. I suppose it gets bottled and sold to retailers in other states.
As for lithium-infused water chilling people out; well, I've lived here long enough to know that I wouldn't walk the streets of Lithia Springs at night. There are some rowdy people living there. Maybe they all drink Dasani or Aquafina instead of the local tap water.
> The authors discovered that people whose water had the least amount of lithium had significantly greater levels of suicide, homicide and rape than the people whose water had the higher levels of lithium. The group whose water had the highest lithium level had nearly 40 percent fewer suicides than that with the lowest lithium level.
I can't but help wonder whether higher levels of lithium also correlate with a clean water supply, which would indicate a more affluent community. It may simply be the case that those areas with cleaner water have a better economy, and thus less crime, etc. Although lithium undoubtedly has antidepressant effects.
It's funny this article popped up on here. Today I was actually reading about how chromium picolinate was found to have a positive effect on those with atypical depression. It can be purchased from any vitamin store. It makes me wonder if trace elements (lithium, chromium, etc.) are vital to the brain's proper functioning via some as yet undiscovered mechanism.
Also, why is it that you have to have a prescription to get certain compounds, but other ones you can just purchase yourself? Is it simply the potential for toxicity?
> I can't but help wonder whether higher levels of lithium also correlate with a clean water supply, which would indicate a more affluent community.
Not likely, because the water supply of an affluent community would have highly filtered water containing few "impurities" including lithium. Further, if the community in question were conservative in their political views, the water might even lack fluoride, another component with known beneficial traits but one that has become a political issue in some places.
> Also, why is it that you have to have a prescription to get certain compounds, but other ones you can just purchase yourself? Is it simply the potential for toxicity?
No, it revolves around the issue of medical applications. If a substance has known medical applications, then its dissemination will likely be controlled by the FDA. Even advertising a substance's possible medical benefits is not permitted in the general case, without FDA approval and substantial controls. For example, if I sell willow bark as writing paper, no problem. If I sell it as a pain-killer without possessing medical authority, I will be in a heap of trouble.
> I can't but help wonder whether higher levels of lithium also correlate with a clean water supply, which would indicate a more affluent community. It may simply be the case that those areas with cleaner water have a better economy, and thus less crime, etc.
I don't think it would. Typically both rich and poor communities would only be enforcing the FDA ceiling on lithium levels, which seems to be high enough that remediation is rarely (ever?) necessary, so rich/poor wouldn't correlate with levels much if all. The confounds which have come up as particularly plausible tend to deal with locations of mental hospitals, urban vs rural, and local food consumption.
Mostly a reasonable and interesting article. But when you talk about adding something psychoactive to the drinking water, it's just a horrible idea.
It doesn't matter if it's otherwise natural. Nature is inconsistent in dosages (so diverse perspectives can flourish) and doesn't have ulterior motives.
Maybe it brings down suicide rates, but what other effects does it have? Does it affect the likelihood of voting for a political party or cause? Does it affect the likelihood of political participation in general?
It's kind of like CO2 levels in the atmosphere. Higher levels will have some effect; we're basically arguing over the significance of it, what to do about it (if anything), and whether politicians can be trusted with the power to make those changes.
Similarly, mind-altering substances will affect aggregate political behavior. Once someone finds out how, they will use it to their advantage.
Exactly. If it's a bad idea to add any lithium to water (anywhere up to the FDA-approved safe levels), doesn't that imply it would be a good idea to control randomly-varying* lithium levels to even lower levels? See also http://en.wikipedia.org/wiki/Reversal_test
* lithium levels in drinking water change constantly, in part due to variations in rainfall in a region
No, I think you missed my point. Humans can't be trusted with the power to add mind-altering substances to the drinking water. Once someone figures out how to use it to their advantage, they will.
Well, people will notice if concentrations change unless there is a real conspiracy. But if it's declared "good" to add something to water, it's much easier to manipulate the dosage.
I think you've hit on something very fundamental here. When the government has well targeted interventions that achieve specific goals, this can be a good thing.
But the cumulative effect of many social interventions can give the government excessive power. Even beside purely political concerns, I think we have to ask whether we prefer the random hand dealt by nature, to a hand carefully chosen by the government.
Nate Silver gives a talk [1] describing how we could design cities to make people less "racist". If this was possible, it would represent an overtly political manipulation of the populace. Chemicals probably can't have such target effects, but they still raise the question of what rights the government has to manipulate people's behavior.
I'm not sure whether you can call it psychoactive. I think psychoactive substances have an immediate, noticeable effect. Especially at the doses suggested, lithium does not. What do you call psychoactive? Tomato sauce can make me happy, but it's not sensible to call it psychoactive. On the contrary, it is widely reported that lead plumbing causes higher crime levels, lower IQs, and all sorts of bad things. Should we then resign and say we should not mess with the "psychoactive properties" of our drinking water? No, most things in our society are already artificial and engineered to achieve certain ends. I don't see the point in being paranoid about affecting political behavior, first it's something which should first be established, second, people couldn't possibly get more apathetic than they already are.
If there is a concrete correlation between trace amounts of Lithium in the water supply and lower suicide rates, surely there are other effects? The studies done seem quite one sided to me (or more likely, this article is). For serious consideration, not only do more studies have to be undertaken for other cities, but other factors have to be measured as well. Other psychological problems, rate of divorce, physical activity (sport etc), unemployment, debt, other drug use, education etc. Perhaps there's a lower incidence of suicide because people are much less active? Unemployed, no ambition, but not enough drive to end it all as well?
The answer is that, as one moves into more behaviors and more detail, the chance to meaningfully correlate outcomes with lithium exposure becomes more difficult. Also, because no one knows why those correlations exist (why lithium has the effect it does), it's not possible to turn a correlation into a rigorous, scientific cause-effect relationship.
The gold standard in science is not a correlation, but a cause-effect relationship accompanied by an explanation. With respect to lithium, we're a long way from that goal.
"But there are undoubtedly other reasons for its neglect. Pharmaceutical companies have nothing to gain from this cheap, ubiquitous element."
It's a tragic condemnation of the way we do health and nutrition that if no one profits from marketing and selling something, the masses typically won't hear about the benefits of it.
Because bottled water doesn't have real or imagined therapeutic properties, and lithium does. Eventually someone unfamiliar with the rules will advertise a lithium/water product as having medical effects, and that will end the game (advertising medical benefits is a no-no without both research backing and FDA approval).
EDIT: this is another example of the "fact rule" -- if you post something factual and uncontroversial, you will be downvoted with a probability of 1.
I disagree. There is a market for supplements, as long as they walk a careful line of avoiding the promise of any medical benefit. Lithium could be sold this way, in low dosages ("Lithia Springs water"), but it's probably not allowed? I remember that 7-up once contained lithium, but it was banned, even though the amount was very small.
BTW: There is indeed an annoying level of unnecessary downvoting going on.
It's not patented, and it's cheap. (I think it's less than my insurance copay for a month's supply) Yes, they're making money off of it, but it's nowhere near levels where it's worth doing any marketing for it.
Actually, nowhere near "everyone working for Big Pharma" needs to be a sociopath for the industry to act sociopathically. In fact, it can happen with as few as one or even zero sociopaths, since the organization has properties of its own independent of the constituent humans. My favorite exploration of this idea is the TV show "The Wire."
It presupposes that there are no defectors, in a game-theoretic sense: Every company that could develop a cure or cheap therapy doesn't, even though that would be a very lucrative product: A cheap lithium pill would sell in huge volume and be profitable even with a minimal markup.
> A cheap lithium pill would sell in huge volume and be profitable even with a minimal markup.
The problem should be obvious -- lithium is an element that cannot be protected by trademark, patent or copyright. Anyone marketing it is sure to be undercut as soon as the product begins to win public acceptance and show a profit.
The other issue is toxicity. Without professional advice, people might think that, because a small amount confers benefit, therefore more is better. But, not unlike vitamin A, lithium becomes toxic above relatively low levels. For that reason it's not likely to be sold over the counter.
By your logic no one could make money selling Vitamin C.
Also, the article talked about the benefits of consuming lithium at a tiny fraction of the therapeutic level. There are plenty of legal, common supplements that are similarly toxic if consumed in those amounts.
> By your logic no one could make money selling Vitamin C.
One can make money selling vitamin C - after someone (such as the government) has spent a lot of money running experiments and publishing the results, yielding a public good of the knowledge 'vitamin C may be good for some things'.
One will have a much more difficult time making money by investing in research establishing 'substance X is good for something', publishing that information, and then selling substance X - when substance X is cheap, widely available, and one's competitors will instantly match and undercut any of your offerings of X.
Just because something is an element doesn't mean it can't be patented as a medicine. There are use patents and formulation patents that can protect a drug that contains a chemical that itself can't be patented.
http://en.wikipedia.org/wiki/Lithium_(medication)#Side_effec...
The dosages required to achieve "beneficial" psychoactive effects will probably result in adverse side effects in a significant portion of the population. Lithium should be prescribed by a doctor on a case by case basis, not indiscriminately dumped into the water supply.
The dose makes the poison, the higher PPM of lithium, the larger the percentage of individuals that will be affected. Even if it affects a tiny fraction of the population at the proposed concentrations, it's still unfair to that demographic. Would you wan't to have to buy special non-lithium supplemented water?
Yeah, she was way too gung-ho about potentially forcing this stuff on people via the water supply. But I'm not surprised that an academic would want to social-engineer this way.
In some place, running water has more lithium. For example, there was a recent study that correlates the suicide rates with the content of lithium in water in some cities of Japan: http://bjp.rcpsych.org/content/194/5/464.full
Quote: "But there are undoubtedly other reasons for its neglect. Pharmaceutical companies have nothing to gain from this cheap, ubiquitous element."
Ah, of course. This is why lithium is ignored or actively disparaged, while drugs whose ineffectiveness has been demonstrated in a now-famous meta-analysis --
"Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance." [emphasis added]
-- continue to be aggressively marketed.
This is not to say that lithium is a panacea or not dangerous if mishandled. It is to say that it has measurable beneficial effects in the right doses, on the right people. No one knows why this is true, but that's true of all such medications.
1) therapeutic doses of lithium as a prescription medicine for mood disorders are MUCH higher than doses occurring through lithium in the water supply, and yet
2) there is perhaps some epidemiological signal suggesting differing rates of suicide and depression in places where lithium levels in the water supply are higher.
Kay Redfield Jamison, author of some of the most compassionate books about depression you will ever read,[1] credits lithium with saving her life. I'm glad her life was spared so that she could write from the inside about what it is like to have a severe mood disorder, and apply her creativity to communicating with people who cannot directly understanding her personal experiences or the experiences of other patients.
I think the article's call for further research, at a minimum, is worth taking seriously. The neuroprotective effect of lithium demonstrated in animal studies (verified by necropsy and examination of the animal's brains after the animals die) is well established, so we may as well check whether adjustment of water supplies by intentional supplementation has a beneficial effect if (and only if) epidemiological studies and animal experiments suggest doing so. This is, after all, how the beneficial effects of fluoride on tooth enamel strength and resistance to decay were discovered.
[1] http://www.amazon.com/Kay-Redfield-Jamison/e/B000AQ1IC8