Lithium helps anxiety


The role of lithium treatment on comorbid anxiety symptoms in patients with bipolar depression

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. 2022 Jul 1;308:71-75.

doi: 10.1016/j.jad.2022.04.025. Epub 2022 Apr 12.

Gregory Jones  1 , Carola Rong  2 , Courtney M Vecera  2 , Christopher I Gurguis  2 , Roshan Chudal  2 , Rushaniya Khairova  3 , Edison Leung  2 , Ana C Ruiz  2 , Lokesh Shahani  2 , Marcus V Zanetti  4 , Rafael T de Sousa  5 , Geraldo Busatto  6 , Jair Soares  2 , Wagner F Gattaz  5 , Rodrigo Machado-Vieira  2

Affiliations

Affiliations

  • 1 Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: [email protected].
  • 2 Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
  • 3 Saint Louis School of Medicine, Department of Psychiatry and Behavioral Neuroscience, Saint Louis, MO, USA.
  • 4 LIM27, Department of Psychiatry, University of São Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo, Brazil.
  • 5 LIM27, Department of Psychiatry, University of São Paulo, Brazil.
  • 6 Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo, Brazil.
  • PMID: 35427708
  • DOI: 10.1016/j.jad.2022.04.025

Gregory Jones et al. J Affect Disord. .

. 2022 Jul 1;308:71-75.

doi: 10.1016/j.jad.2022.04.025. Epub 2022 Apr 12.

Authors

Gregory Jones  1 , Carola Rong  2 , Courtney M Vecera  2 , Christopher I Gurguis  2 , Roshan Chudal  2 , Rushaniya Khairova  3 , Edison Leung  2 , Ana C Ruiz  2 , Lokesh Shahani  2 , Marcus V Zanetti  4 , Rafael T de Sousa  5 , Geraldo Busatto  6 , Jair Soares  2 , Wagner F Gattaz  5 , Rodrigo Machado-Vieira  2

Affiliations

  • 1 Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: [email protected].
  • 2 Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
  • 3 Saint Louis School of Medicine, Department of Psychiatry and Behavioral Neuroscience, Saint Louis, MO, USA.
  • 4 LIM27, Department of Psychiatry, University of São Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo, Brazil.
  • 5 LIM27, Department of Psychiatry, University of São Paulo, Brazil.
  • 6 Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo, Brazil.
  • PMID: 35427708
  • DOI: 10.1016/j.jad.2022.04.025

Abstract

Background: Comorbid anxiety is pervasive and carries an immense psychosocial burden for patients with bipolar disorder. Despite this, trials reporting anxiety-related outcomes in this population are uncommon, particularly with regards to monotherapies.

Methods: Patients (n = 31) with both bipolar I or II disorder in current depressive episodes were enrolled in a six-week, open-label, single-center trial assessing the efficacy of lithium monotherapy in treating symptoms depression and comorbid anxiety. Patients were mostly medication-free and lithium-naïve at baseline.

Results: Significant improvements in depression (HAMD) and anxiety (HAM-A) were observed at the six-week endpoint, with remission and response rates greater than 50%. There was a positive correlation between endpoint HAM-A scores and HAM-D scores, r = 0.80, (p < 0.01). Improvements were realized at low serum lithium concentrations (0.49 ± 0.20 mEq/L).

Limitations: Lack of placebo control and small sample size warrants validation in larger randomized studies.

Conclusions: Taken in the context of prior evidence, lithium may have an important role in treating comorbid anxiety in bipolar disorder, both as adjunct and monotherapy. Lower doses of lithium may provide equivalent efficacy and enhance tolerability and compliance.

Keywords: Anxiety; Bipolar disorder; Depression; Lithium; Monotherapy.

Copyright © 2022 Elsevier B.V. All rights reserved.

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Risks and Benefits of Taking Lithium for Anxiety

Many medications designed to treat depression-related conditions are often also prescribed for anxiety conditions. Lithium salts are a component of many psychiatric medications for depression-related conditions including mania and bipolar depression, and their effectiveness is the standard against which other medications for these conditions have been measured since even before anxiety disorders were recognized as psychiatrically treatable.

The article below will explore the effects of lithium on the brain, as well as its potential negative side effects, to help gauge its potential benefits as well as its risk factors for people suffering from anxiety.

What is Lithium?

Lithium is just one of many options that a doctor may prescribe for your anxiety. It should never be taken without a prescription, and is not right for everyone.

In its purest form, lithium is a soft, light and silvery-white metal belonging to the alkali group on the periodic table. Knowing this, it may seem strange that the lithium salts lithium carbonate, lithium citrate and lithium sulfate, all inorganic substances, are often prescribed by psychiatrists for oral ingestion. So why exactly do professionals suggest eating metallic compounds to overcome psychiatric conditions, and what are the risks?

Lithium in Your Body

While ingesting metallic substances can be dangerous, a dosage of 15–20 mg of lithium per kg of body weight falls below the level of toxicity for anyone eight years old and over, though in children the levels of lithium in the blood need to be closely monitored. In addition, when taken in the correct dosage, lithium is processed and released by the body usually within 24 hours, meaning that the metal will not become a part of your body in any harmful way if you take no more than the required dose.

While lithium is in your body, it affects neurotransmitters that are involved in the body’s stress reactions. The function of these neurotransmitters in stress reactions and lithium’s effects on them are outlined below.

  • Norepinephrine Norepinephrine is usually responsible for increasing the heart rate and sending blood enriched with sugar energy or glucose to tensing muscles during the fight or flight response that can occur when you are afraid of something, sometimes resulting in panic attacks. Lithium limits the amount of norepinephrine that the body can process, which decreases the severity of the anxiety symptoms caused by the body’s fear response.
  • Serotonin The more serotonin is present in your brain, the more relaxed you are. Research has discovered that men have more serotonin receptors in their brains than women, which is part of the reason why women are more prone to anxiety disorders than men. Lithium improves the body’s ability to synthesize serotonin. This simply means that the body’s levels of serotonin increase in response to lithium, which has the effect of improving mood and reducing feelings of anxiousness.

Possible Side Effects

During the early stages of lithium treatment, side effects may include:

  • Dryness of the mouth
  • Mild weakness and/or shaking
  • More frequent urination
  • Dehydration (headaches, nausea)

In the long term, lithium may also cause:

  • Increased appetite and thirst
  • Weight gain
  • Hypothyroidism

Drinking extra water to compensate for dehydration can reduce the number of symptoms experiences early on, while regular exercise and a healthy diet can help to control any weight gain that results. The lowest possible dose of lithium is recommended in order to limit and reduce the likelihood of negative side effects.

It is still important to note that weight gain and hypothyroidism (a condition that can also cause weight gain) can increase feelings of depression and may pose a risk if your anxiety is complicated by depression.

Though lithium is not addictive, overdosing can be highly dangerous. Too much lithium in the body functions as a poison, which is why it can be a risky medication if you suffer from anxiety complicated by depression. Similarly, lithium itself can have what's known as a "paradoxical" reaction where it actually creates more anxiety and depression, which is another important reason not to use lithium without talking to your doctor.

Lithium can take weeks to reach its full effectiveness. For this reason, supplementing lithium medication with healthy anxiety-reducing activities may help you to feel better in the meantime. Knowing about these potential alternatives to medication may help to prevent relapses if you are stopping lithium treatment, and are also useful to know about if you are looking to avoid medication entirely.

  • Pick an Enjoyable Exercise Going to a gym can be pricey and sound like a lot of work. Fortunately, exercise can come in almost any form you can think of. Whether you choose swimming, biking, jumping rope or mountain climbing, doing it for at least 30 minutes 3 times a week will help your body stay fit, as well as causing it to naturally trigger the release of serotonin in the brain, mimicking the effects of lithium without any dangerous potential side effects. NOTE: If you are taking lithium and also exercising regularly, it is especially important that you drink extra water to compensate for lithium’s side effect of dehydration.
  • Make a Diet Plan Most people cringe when they hear the word “diet,” but usually it’s because they associate it with fad diets that involve something like eating only carrots or starving themselves. A good diet should require neither. Picking a diet that is right for you means picking one that allows you to eat a healthy amount as well as a healthy variety of foods, giving your body the nutrients it needs while keeping your mood from being affected by malnutrition. Eating right will keep your body feeling good and better suited to handle any anxiety symptoms that crop up unexpectedly.
  • Write About It When you are feeling anxious or undergoing the physical and mental changes that can occur while starting or stopping a medication, writing about it can help to settle your mind. While it’s funny to think that what essentially amounts to “talking to yourself” can actually make you feel less crazy, it is absolutely true. Seeing your thought patterns written out can help you spot the parts where your logic seems fuzzy, or catch obsessive thoughts that repeat themselves and address those parts directly, either by writing about them specifically or by consulting with a mental health professional.

Lithium can have beneficial effects for people suffering from anxiety. However, because people with anxiety are at a higher risk for depression, it is good to bear in mind that special care must be taken to offset the potential side effects that may aggravate this condition even as the medication works to treat it. Supplementing your treatment with the above activities can help with this, as well as providing you with good anti-anxiety habits to carry with you into the future.

As always, please make sure that you consult with your doctor before considering lithium for your mental health issue.

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Normotim - to increase stress resistance, reduce anxiety and improve mood

  • Increase stress resistance
  • Mood improvement
  • Reduced urge to smoke

Action

  • Improved emotional state with diet
  • Improving the effectiveness of weight loss programs
  • Anxiety reduction
  • nine0003 Correction of mild depression
  • Reducing emotional instability
  • Sleep stabilization
  • Normalization of the nervous system
  • Improvement of psycho-emotional state in old age
  • Improving memory and thinking abilities

Differences from competitors

Lithium preparations have been used in medicine for more than half a century, but most of them are based on lithium carbonate, a salt that is toxic and effective only in high doses, which creates a risk of side effects. Therefore, world science does not stop searching for more effective and safe lithium salts. nine0011

In Russia, the development and study of new non-toxic and broad-spectrum lithium salts began in the 2000s at the Department of Psychiatry, Narcology and Psychotherapy of the Siberian State Medical University. Lithium ascorbate, an innovative organic salt of lithium, was synthesized there, where one molecule contains two active active substances - ascorbic acid and lithium - which have a synergistic (that is, mutually reinforcing and complementary) effect, expanding the scope of the new compound. nine0011

Further research has shown that lithium ascorbate is safe, effective at low doses, and has a broad spectrum of activity not found in other lithium salts.

This is how the Normoteam project started in 2011. The scientific group of the project was headed by Doctor of Medical Sciences, Professor Gromova Olga Alekseevna. A number of clinical studies have been conducted. Their results showed that Normotim reduces the level of anxiety and depression, increases the body's resistance to stress, increases emotional stability, and has a positive effect on cognitive functions. nine0011

Based on the results of the research, more than 15 articles were published in scientific medical journals and 4 patents of the Russian Federation were received:

  1. RU 2617512 "An agent with anti-stress, anxiolytic and antidepressant activity and a composition based on it."
  2. EN 2614737 "Method of improving memory".
  3. EN 2614697 "Neuroprotective agent".
  4. EN 2639496 "The use of lithium ascorbate for the prevention and treatment of chronic alcohol intoxication." nine0004

The absence of toxicity and a minimum of contraindications made it possible to register Normotim as a vitamin-mineral complex (biologically active supplement). Currently, Normotim* is the only over-the-counter complex with lithium in Russia and the EAEU countries.


* All rights to the Normoteam trademark belong to Normofarm, a resident of the Skolkovo Innovation Center. Normotim is produced by the Artlife Pharmaceutical Company by order of Normofarm LLC. nine0011

Advantages

  • Contains a unique lithium salt for maximum efficacy and safety

  • The only vitamin and mineral complex on the Russian market
    with lithium ascorbate

  • Clinically proven

  • Unique
    proprietary compound

  • Easy to use -
    absorbable tablets
    pleasant tasting no drinking required

  • Passed
    voluntary certification based on the results of
    clinical trials

Application

  • Increasing stress tolerance

    Effective in unstable state of emotional background, reduction of adaptive properties, irritability and other types of active apathy. nine0011 More

  • Anxiety reduction


    Stable action in anxiety-depressive conditions: the severity of not only situationally provoked anxious fears and doubts decreases, but also generalized anxiety.

    More
  • Mood stabilization

    Effective for severe mental lability.

    More
  • nine0102 Correction of mild depression

    Has a mild antidepressant effect in anxiety-depressive conditions, mild depressive episodes.

    More
  • Improvement


    mood

    For the normal functioning of the nervous system in general and a good mood in particular, the body must receive a sufficient amount of the trace element lithium daily.

    More
  • nine0003

    Performance enhancement

    Stress, mood swings and depressive states negatively affect performance. Normotim contributes to the stabilization of the emotional status, preventing a decrease in personal effectiveness.

    More
  • IMPROVEMENT OF EMOTIONAL STATE WITH DIET

    Normotim contains vitamins and a special dosage of lithium to improve mood and emotional stability during diets and other stressful situations. nine0011 More

  • INCREASING THE EFFECTIVENESS OF WEIGHT LOSS PROGRAMS

    The use of Normotim increases the effectiveness of weight loss programs by 38%.

    More

Healthy Longevity

  • PROTECTION AGAINST PREMATURE AGING

    Lithium has been proven to:

    • protects brain cells from aging;
    • promotes the regeneration of brain and heart vessels; nine0004
    • improves memory and other cognitive functions;
    • increases bone density, reducing the risk of fractures.
    Read more
  • IMPROVEMENT OF PSYCHO-EMOTIONAL STATE IN OLDER AGE

    Reduces the risk of dementia (senile dementia). Normalizes the work of the nervous system.

    More
  • COGNITIVE IMPROVEMENT

    nine0036 Lithium increases the level of N-acetyl aspartate, which can be considered as an indicator of creativity and which correlates with IQ values.

    More
  • SLEEP STABILIZATION

    Lithium is involved in the regulation of circadian rhythms that ensure the processes of sleep and wakefulness. A sufficient level of lithium in the body ensures productive sleep with a pronounced feeling of relaxation.

    More

COMPOSITION OF 1 TABLET:

  • lithium ascorbate 6.36 mg
  • Vitamin B1 (Thiamin Mononitrate) 1.2 mg
  • Vitamin B6 (Pyridoxine Hydrochloride) 1.8 mg

HOW TO USE:

For adults and children over 12 years old, 2 tablets in the morning and 1 tablet in the afternoon.
In stressful situations - 2 tablets in the morning, 2 tablets in the afternoon.
Tablets preferably suckable

CONTRAINDICATIONS:

Individual intolerance to the components, pregnancy, breastfeeding.

Action of components

  • Lithium ascorbate:

    The lithium ascorbate molecule consists of two active active substances - lithium and ascorbic acid, which have a synergistic effect - that is, they reinforce each other

  • Vitamin B1:

    Optimizes cognitive activity and cognitive functions of the brain

    Demand rises sharply in stressful situations

  • Vitamin B6:

    Participates in the synthesis of neurotransmitters (including serotonin)

LITHIUM and HEALTH

Lithium is an indispensable trace element for the human body, necessary for the correct flow of many physiological processes, but first of all - for the normal functioning of the nervous system.

Lithium has a beneficial effect on the nervous system and emotional background, increases stress resistance, mood, and makes the emotional state stable. nine0011

In particular, one of the mineral springs in Tuscany, which has an unusually high concentration of lithium in its water, is very popular among tourists for its amazing effect: after bathing, it improves mood.

And Canadian scientists have found that lithium can increase life expectancy!

Read more

Lithium ascorbate

Lithium ascorbate, which is part of Normotim, has the highest efficiency and safety indicators among all lithium salts known to science and is the only lithium salt approved for over-the-counter sale in Russia and the EAEU countries. nine0011

Effectiveness compared to existing lithium salts

Lithium ascorbate is active

Psychiatric block

Bipolar affective disorders

Depression

Stress

Emotional instability

Neuroprotection

Stroke (post-stroke conditions)

Protection of brain neurons

Toxicology

Refers to the V class of toxicity (non-toxic substance), approved for use in over-the-counter drugs and dietary supplements

The safest lithium salt (lithium carbonate toxicity* is 12 times higher)

Therapeutic dosage

Effective at low doses, therapeutic dosage is 10 times lower than lithium carbonate*

Pass test

BEC DEPRESSION SCALE
Anxiety Test
(Taylor) Determination of the level of depression
on the Montgomery-Asberg scale

Research

INCREASING THE EFFICIENCY OF THE WEIGHT REDUCTION PROGRAM OF THE DOCTOR BORMENTAL CENTER


WITH THE APPLICATION OF THE DRUG NORMOTIM®

The study was conducted for 7 months. The study involved 132 people, of which 92 people (69.7%) had signs of depression.

As a result of the study:
  • It was possible to increase the rate of weight loss.
  • The effectiveness of the Weight Loss Program for participants with emotional instability (signs of depression) increased by 38%.
  • The responses of the participants showed that the drug Normotim® has the necessary normothymic effect - stabilization of the emotional background. As established during the study, the normothymic (mood stabilization) effect of Normotim® appears starting from 2-3 weeks from the start of administration and is observed throughout the entire period of administration. nine0004
  • No side effects or complaints were found.

In the control group, 46 people completed the Program, in the Normotim® group, 46 people completed the Program.

Members of the
program without Normatim®
Average age 41
Starting weight 92. 7

Members of the
program using Normotim®
Average age 38
Starting weight 89.3


Clinical study "The use of dietary supplement NORMOTIM® for mood disorder


, adaptation, depressive episodes"

Features of well-being, activity, mood according to the SAN method at the first stage.

Features of well-being, activity, mood according to the SAN method at the third stage.

Dynamics of the level of anxiety on the Taylor scale during the study. nine0011

Dynamics of the level of depression on the MARDS scale during the study.


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Reviews

Reviews

Igor S. 19 years old. 2 course. IvGMA

When recruiting volunteers for the Normotim group, I doubted my participation. I thought that vitamins and lithium could change my condition in 2 months. Now I realized that I would take Normotim for more than one course. During the time of taking Normotim, I felt cheerful, active, attentive both at school and at home. In the classroom, he memorized the data of presentations, graphs, diagrams well. At lectures, it was easier to perceive the illustrative material, and the text too. Admission Normotim coincided with the pre-examination period. I practically didn’t worry, didn’t fuss, but “got together” and calmly passed all my debts and offsets well. A somewhat unusual effect - my palms were sweating, and either a coincidence, or the drug helped, by the end of the course I noted that my hands are always dry. Thank you for the invitation to participate in the study. nine0011

Vladimir T. 20 years old. 3 course. IVGMA

When taking the drug Normotim began to notice an improvement in memory, namely visual perception. This happened clearly at 3 weeks of admission. It is easier to memorize the given material. Increased focus in class. In addition, when using Normotim, I notice a leveling of mood, a decrease in anxiety, this was especially useful during a session when there was high emotional stress. Sometimes there was even indifference to previously disturbing events. Sleep became longer and deeper. Sometimes during the day there was spontaneous drowsiness. I really liked the drug Normotim. I don't notice any side effects. I will recommend Normotim to my friends. Yes, more! A very important point! Stop being rude to your parents. Apparently the drug helps to grow up. In a good way. nine0011

Andrey R., student, 19 years old. 3 course. treatment factor IvGMA

I took Normotim 1 tab 3 times a day. autumn 2015. After 2 weeks, and especially the first month of admission, I felt a surge of strength, I remembered the educational material better. Especially diagrams and drawings. He became somewhat calmer, his sleep improved (he quickly fell asleep).
I will continue to receive, especially before the session.

Julia Sh.

Hello, I would like to leave a positive review about the drug: wonderful results. My mood improved, energy appeared, I smile more often. I recommend it to anyone who has noticed the first signs of depression! nine0011

Elena Sh. According to the Beck scale before the appointment - moderate depression.

I began to fall asleep earlier and faster, I feel better, I even seem to have more energy.

Larisa L. Severe depression according to the Beck scale. Insomnia, headaches, anxiety, apathy.

My headaches are gone, my sleep has improved, my general condition has improved, and I have more energy. I noticed that 2 tablets a day are enough for me, then I feel better, if I take 3, then there is no where to put my energy. nine0011

Ekaterina B. According to the Beck scale before the appointment - severe depression

The condition has improved, if until recently I lashed out at my husband over trifles, got annoyed over all sorts of trifles, now I feel better, calmer, my mood seems to have improved, I began to sleep better .

Elena G.

I became calmer, even my husband noticed and became interested.

Irina S.

It seems to me that only thanks to Normotim I lose weight so well. I became less irritable, calmer. If earlier my mood changed very sharply, now I have become much more balanced

Mood


is normal!

Stabilizes mood, significantly reducing the amplitude of affective fluctuations; suppresses anxiety, anxiety, reduces emotional stress and increases adaptive reactions and stability
to emotional stress. Has a mild antidepressant effect,
in anxiety-depressive cases.

NORMOTIM® is a source of highly bioavailable lithium (a new lithium salt with unique properties), vitamin C and B vitamins (B1, B6). nine0011

The drug has passed voluntary
certification based on the results of clinical trials.

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