Lithium is in your drinking water (and that may be a good thing)

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Atlantic Ocean

A psychiatric medication is in the drinking water:

Lithium is a highly reactive metal on the periodic table. Lithium in salt forms can be used as a medication for bipolar disorder. Just like how real estate is about location, location, location, medicines are about dose, dose, dose. Lithium is found naturally in water sources in very small amounts that range from 0-160 micrograms per liter. Lithium can be bought over the counter at a usual dose of 5 milligrams. To get this amount from drinking water, you would have to drink over 31 liters of water. The dose used to treat bipolar disorder is usually 300-900 milligrams. You would have to drink a lot of water to get that amount!

A few medical trials have shown that counties with more lithium in the water have  lower suicide rates. In fact, only 2 medications have been shown to decrease suicide rates, one being lithium and the other being a pretty intense antipsychotic medication, Clozapine. That’s right, no antidepressant has been shown to decrease suicide rates.

Evidence

(1) An old study from Texas in 1990 assessed the levels of Lithium in the drinking water and the incidence of crimes, suicides and arrests related to drug addictions. Interestingly, counties that had little to no lithium had higher rates of suicide, homicide and rape compared to counties that had lithium water levels between 70-170 micrograms/L.

(2) Another study in Texas from 2013 looked to replicate the findings in regards to suicide rates. This study analyzed 3,123 water samples to assess lithium levels and looked at 226 Texas counties. This provided confirmatory evidence that higher lithium levels in the drinking water is associated with lower suicide rates.

(3) It is not just Texas that shows this connection. A study in Austria had similar findings. 6,460 water samples were analyzed across all Austrian districts. Again, higher lithium water levels was associated with a lower overall suicide rate.

The evidence is not all positive though.

(4) A study in Japan looked at the association between lithium in tap water and suicide rates. This study found that only females benefited from the protective effects of lithium.

(5) A study in East England looked to replicate the previous studies. 47 subdivisions were examined between 2006 and 2008. No association was found between lithium in the water and suicide rates. The lithium range in the water was 1–21 micrograms/L. This is much less than the levels in Texas.

Conclusion:

So does lithium protect against suicide? Evidence of the prescription strength medication points to yes. Lithium in the drinking water has more positive studies than negative studies. It may all come back to dose, dose, dose. The amount of lithium in water most likely would need to reach a certain threshold to be effective. Should the government add lithium to the water supply like how fluoride is added? Probably not quite yet and you can always supplement with over the counter lithium if you are a strong believer yourself (and if you check with your doctor).

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Sources:

  1. Schrauzer GN, Shrestha KP. Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions. Biol Trace Elem Res. 1990 May;25(2):105-13.
  2. Blüml V, Regier MD, Hlavin G, et al. Lithium in the public water supply and suicide mortality in Texas. J Psychiatr Res. 2013 Mar;47(3):407-11.
  3. Kapusta ND, Mossaheb N, Etzersdorfer E, et al. Lithium in drinking water and suicide mortality. Br J Psychiatry. 2011 May;198(5):346-50
  4. Sugawara N, Yasui-Furukori N, Ishii N, et al. Lithium in tap water and suicide mortality in Japan. Int J Environ Res Public Health. 2013 Nov 12;10(11):6044-8.
  5. Kabacs N, Memon A, Obinwa T, et al. Lithium in drinking water and suicide rates across the East of England. Br J Psychiatry. 2011 May;198(5):406-7.

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