Lithium Rumors and Falsehoods

Rumor 1Mineral waters promised quack remedies, like it helped in the treatment of diabetes, in the late 1800′s In 1868, Colonel Richard Dunbar (2:4,11) was gravely ill with diabetes. His NYC doctor told him his only hope was with French doctors in Paris who were the most advanced in treating this illness. The French not only gave him no hope but said he would soon die. Dunbar put his NY   estate in order and was heading West to die at his family homestead when he got word of the death of a relative in Waukesha, Wisconsin. Once there he consumed a quantity of mineral spring water and seemed to recover. Rejuvinated, he returned to NYC where he had a relapse. Again he visited Waukesha and was revitalized by the spring water. This water he developed into Bethesda Spring water, an important water in the area and the begining of the Waukesha mineral water and spa era. Waukesha became the Saratoga of the west (without the massive doses of sodium chloride of Saratoga and other mineral waters). Dunbar did what his doctors told him and went off to die. Waukesha water water is credited with extending his life. If the word “Quack” is to be attributed, should we attributed it to Waukesha medicinal water or Dunbar’s doctors.

In 1910, Still Rock Spa was formed on the White Rock Mineral Spring property for the treatment of diabetes. The compassionate founder (1:4,27-28) Dr Hodgson used a high protein – low carbohydrate diet in conjunction with Still Rock Spring water (another Waukesha spring similar to Dunbar’s Bethesda Spring). Doctor’s from all over the country came to study Hodgson’s methods. Still Rock Spa was the only institution of its type approved by the American Medical Association. Interestingly, the Waukesha superintendent of schools was related to Frederick Banting who discovered insulin in Canada in 1922. Clearly something beneficial was happening with Waukesha water. This is contrasted by what Dr. Frederick Allen was doing to Diabetics in 1919 in Morristown, NJ. … he starved them … as little as 400 calories per day. (The Bittersweet Science, NY Times, Magazine, March 16, 2003. Sec 6)

What was claimed that White Rock’s low sodium, high calcium, & magnesium matched the specific gravity of the body fluids and therefore a diabetic’s excess consumption of (White Rock, Still Rock, or Waukesha) water would not deplete the body of minerals nor build up a toxic level.

While one can easily dismiss an anecdotal story, we see little difference between what Dunbar did in 1868 with a counted number of glasses (12) of a specific mineral water and what Dr SA Cleaveland did with 8 grams of lithium chloride (5:1,40). Both Dunbar and Cleaveland repeated their experiencies at a later date with similar results. Dunbar published his results locally and Cleaveland in a medical journal. Cleaveland was ignored and Dunbar’s report started an industry. Now both are ignored and the usefulness of lithium chloride has been put on hold.

The mineral water industry has been accused of making wacko medical claims in an era when doctor’s medical understanding, practices and explainations are now considered more “out of favor” (medicinal mercury, blood letting) than some of the medicinal claims for mineral waters that we are slowly coming back to. Colonel Dunbar lived 10 more yars finally dying of a heart atteck in 1878.

Interesting, the FDA historically went after any lithia water claiming to have an effect on diabetes. While lithiated White Rock did not claim to have an effect on diabetes, and thus stayed out of the sights of the FDA, the effect (could there be one?) was possibly known to the AMA recognized doctors at Still Rock Sanitarium. Why was theirs the only recognized hospital and the only one used for training? Was their limited success (insulin is the only true full treatment) the result of the diet, the alkaline water with the same specific gravity as the human body fluids, or the effect of the high lithium content of White Rock water on the body of diabetics.

According to [25] Hu, Wu & Chao, in “Assisting Effects of Lithium on Hypoglycemic Treatment in Patients with Diabetes”, Institute of Metabolism and Endocrinology, Hunana Medical University, Hunan, China; “Combined with other therapy, lithium could improve glucose metabolism in most patients with diabetes. Lithium has an assisting hypoglycemic effect”(lowers blood sugar) [25].

Acording to “Bipolar Disorders: A Guide to Helping Children and Adolescents” by Mitzi Walsh, 2000, O’Reilly & Associates. [17] Inositol is present in organ meats, whole grains, vegetables, nuts, beans, and is produced within the body. People on lithium appear to better regulate this internal inositol level [17].

Without insulin, perhaps lithium wasn’t a quack treatment! With insulin, perhaps lithium is an necessary associative.

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Rumor 2The consumption or use of mineral waters spa water was hoakum, even fraudulent.

According to JB Lippincott, Phil, “Quick Reference Book for Medicine & Surgery” part 11, 1924. [49] “Gout Spas – a sojourn of several weeks at one of the following mineral springs is of the greatest benefit [elsewhere stated: usually the benefit is to get away from "local water" and habitual foods]: Saratoga, Bedford, and White Sulphur in the United States; Buxton, Bath, Strathpeffer, and Landrindod in Britain; Aix-les-Bains, Contrexeville and Vichy in France; and Carlsbad, Wildbad, Badenweiler, Homburg, Schlangenbad, and Marienbad in Germany.” [49]

Many of the spas in the United States were started and owned by doctors. Most “patients” were referred by doctors. In October of 1887, the Congress of Physicians held their annual convention at Lithia Springs in Georgia. Where historical records exist from various lithia water suppliers, they clearly show that doctors, important doctors of the day, doctors at medical schools, even doctors who were college presidents, all prescribed lithia water for certain patients. If the consumption of lithia mineral waters, or even mineral waters in general, was falsely promoted it was done so by the hundreds, if not thousands of doctors who owned or managed lithia mineral water plants or spas supplying bottled water, used & prescribed lithia water to their patients, or wrote testimonials and lent the use of their name and reputation to help market waters they believed beneficial.

In the case of lithia water, if there was hoakum, it was created by physicians. Either lithia water had some truly medicinal effect, or it was an effective placebo for use by doctor for psychosomatic diseases (that they failed to recognize), or had a psychotropic affect on the doctors who used it leaving them convinced lithia water was effective. I wonder if the current negative opinion of many doctors in American toward spa treatment and mineral waters might suddenly change should medical insurance companies begin to cover spa costs as they do in Europe. This may not be too far from the truth as more and more studies show Americans with mineral deficiencies.

Recommendations Prominent Physicians and Professors State Inspectors Presidents

Buffalo Lithia Springs Water “What The Doctor’s Take”, Dr Edward McGuire, Professor of Gynecology, University College of Medicine, Richmond, Virginia, “The best evidence I can give of my evidence of the value of Buffalo Lithia Water is that I drink it myself”

Dr John Medcalf, Professor of Clinical Medicine in the College of Physicians and Surgeons, New York, “I have for years prescribed Buffalo Lithia Water for patients, with beneficial results, and I regard it certainly as a very valuable remedy.”

Dr Hunter McGuire, MD, LLD, President, University College of Medicine, Richmond, Virginia & President of American Medical Association, said, “Buffalo Lithia Water, as an alkaline diuretic, is invaluable. I have used it also in my own case, being a great sufferer from Rheumatic Gout, and have derived more benefit from it than from any other remedy. I prescribe this water ten times where I prescribe any other source.”

Dr Benjamin Johnson, MD, LLD, President Southern Surgical & Gynecological Association, President Virginia Medical Society, Professor of Surgery, Medical College of Virginia, “Buffalo Lithia water has the widest range of usefulness.” “I have had the evidence of the undoubted disintegrating , solvent and eliminating powers of this water in Renal Calculus and have known its long continued use to permanently break up the gravel forming habit.”

Dr Joseph Holt, President of the State Board of Health of Louisiana, “I have prescribed Buffalo Lithia Water particularly in gouty subjects. The results satisfy me of its extraordinary value in a large class of cases usually most difficult to treat.”

Buffalo Lithia Springs Water, is bottled in a modern sanitary plant right at the springs under the direction of a competent bacteriologist, is put up in new sterilized half-gallon bottles, which are never refilled, each cork bears a seal with trademark. Guaranteed under the Pure Food and Drug Act, June 30, 1906, Serial No. 15,055

News Ferry Lithia Water Co., News Ferry, Halifax County, VA. Founded in 1890, this excellent lithia mineral water has testimonials from the Governor of Virginia and US President Benjamin Harrison.

Lithia Springs, Georgia, Presidents McKinley, Cleveland, Taft, and Theodore Roosevelt drank the Lithia Spring water. Grover Cleveland had the water shipped to the Executive Mansion by the case. Other exclusive testimonials came in from Ferdinand Seeger, MD, Editor “Medical Classics” NYC, RF Evans, MD, President of the Tennessee State Medical Society, Isaac Hopkins, MD, PhD, DD, President of Emory College, and William Douglass, MD, Editor, “Second Opinion Monthly”, Atlanta. In 1889, Lithia Springs Mineral Water won the “Gold Metal Par Excellence” at the Piedmont Exposition in Atlanta.

Lithiated White Rock was also winning medals in America and abroad. The records show numerous doctors prescribed White Rock lithia and White Rock Lithiated Water, since White Rock did not promote it as a medicinal water after the mid-1890′s it did not track endorsements.

CR Boyd, State Geologist, Virginia 1897, “There is probably no neighborhood in Grayson County in which there is not a good curative spring. Mineral waters showing the best curative character, are those issuing from rock formations which either slightly or heavily impregnate the water with solutions (dissolved or ions) of their own constituents, such as phosphates, carbonates, sulphates of lithia, potash, sodium, iron, manganese.”

Dr Lapponi Recommends Buffalo Lithia Water which he gave to Pope Leo XIII and now gives to Pope Pius X.

Dr William Hammond, Surgeon General, Washington DC gives Buffalo Lithia water to his patients.

In 1897, “more than 200 professors in medical colleges indorse Londonderry LIthia over their own signature.” The list is available on request.

Lithia Spring (Georgia) water proved not only to be rich in lithia but also potassium, calcium, magnesium, and fluoride ….”

The latter are now recognized as being essential with fluoride only recently being recognized and added to our water supply. Despite mineral supplements, we have not yet caught up with where our ancestors were in the daily consumption of “ionized” (dissolved) minerals.

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Rumor 3 “False medicinal claims killed the lithia water era.” False Rumor C (goes with Rumor 1) False Statement

False Statement Failure of promises on lithium water ads failed and lithia water fell out of favor and as an “old and flourishing blunder in medicinal chemistry” [1] End Jefferson [1] *F*

[1] Dr. James W. Jefferson of the Lithium Information Center at Madison Institute of Medicine in Wisconsin says in M. J. Friedrich’s article “Lithium: Proving its Mettle for 50 Years” (JAMA Vol 281, No 24, June 23/30, 1999) that, “unfulfilled claims of lithium to “cure just about anything” caused lithium to fall out of favor. [1]

Yet the article goes on to show a Bear Lithia Water ad/label that makes no claim for curing mental illness or mood swings. I think Jefferson is using his current knowledge of Lithia to impute meaning into Lithia Water advertising that was not there, at least in the case of the most popular brand, White Rock. It also seems to denigrate the treatment of high levels of uric acid with large quantities of water, with alkaline water specifically, and with lithia water. Perhaps the specifics of some of these old ad claims still hold more than a grain of truth. [1]

In fact, in his article [39] “Lithium Continues to Work For Mania,” Ian M Smith MD, www.vh.org/Patients/IHB/IntMed/ABA30/ 2000/2-17-00Lithium) article, Dr Smith claims “Lithium may be responsible for the reputed benefit of certain spring waters to patients with mental disease”. [39]

… and Doctor Elson Hass says in [40] “Lithium”, from “Staying Healthy with Nutrition” (www.healthy.net/asp/templates) “Some natural mineral waters are high in lithium, these are said to calm the nerves, cheer the spirit, and soothe the digestion”.

These comments could lead us to think there was some benefit for normal people in historical lithium containing beverages.

Before 1850, food and beverage products along with most other products were delivered in bulk to local suppliers. Hence the proverbial “cracker barrel” never has a brand name attached to it. After the Civil War conscientious American manufacturers became disgusted with poor quality, unsanitary, even dangerous unidentified bulk supplies. They incorporated three inovations for Americans: small quantity packaging for consumer purchasing; trade or brand naming of the product, and advertising to promote the trade name.

There is a distinct difference between phony claims for patent medicines without an address by fly by night vendors). Quality companies like Proctor & Gamble, Bordens, Quaker Oats, & White Rock put their company reputations behind the purity of their products.

Originally lithia water was sold in bulk. White Rock still shipped 1-3 RR tank cars of mineral water to Hinckley & Schmitt, Chicago every day for bulk delivery from the circa 1905 until 1970 , when the buyer switched its customers to Chicago municipal water (WR3:9-14), depriving them of mineral spring water. By 1900, as the lithia water industry grew, some companies got bigger and bigger (from advertising) and unknown names declined or remained local suppliers. This was the era of bank and stock market panics and failures, and any operations not financially secure just disappeared. More important the crown bottle cap was the shot in the arm the sugery sweet soda industry needed. Some suppliers of lithia water didn’t have the funds to open carbonation and bottling operations. Bottled soda, including lithiated sodas, gradually replaced the alkaline lithia waters.

Only a few lithia waters made it to the Great Depression and then WWII. Of course, White Rock Lithiated Water became the best selling in American. White Rock’s massive advertising campaign using full page, color ads in popular national magazines was unbeatable by smaller suppliers who were more likely to remain local. Despite the shrinkage of lithia waters (by number of bottlers), the lithiated beverage market was exploding. By the early years of the depresion there were over 600 brands of lithiated drinks with at least 1,500 bottlers. Lithia water didn’t disappear because of false medical claims, it evolved by being sweetened, flavored, carbonated. Sales were dampened by lack of sugar during WWII but with peace an upward spiral of sales continued until 1949. White Rock, 7Up, Canada Dry, Mountain Dew, Upper 10, Schweppes were at the top of their game.

Uric Acid stones make up about 5% of kidney stones and are related to gout. Current anti-gout medications are allopurinal and probenecid. For Uric acid and cystine (2%) stones high fluid intake and bicarbonate of soda (changes the urines acidity making stone formation less likely) is recommended. Note the bicarbonate of soda greatly raises one’s internal salt (sodium chloride) level and is not a good long term solution. There is no evidence that lithium carbonate would not be a better treatment, as it historically was, other then the standard argument against orphan drugs an fear of using lithium. According to Peter Gott, MD (Ct Post, 5/13/03) “diet is probably not an effective therapy, whereas a high fluid intake and certain medicines are.” Since a non- calcium antacid and plenty of water (more than a quart a day) are currently prescribed as a treatment for calcium stones (80%) the historical recommendation to drink plenty of lithia water for stones and gout cannot be faulted.

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Rumor 4 “The government is wise, looks after our best interests, and saved us from lithium poisoning.”

During the Civil War the US Government gave wounded soldiers huge free bottles of opiates and sent them home. Prior to the Civil War there was almost no drug addition in America. By the end of the war, the government had addicted thousands of American heros and sent them to every corner of the country. Former soldiers and members of their families besieged doctors for laudanum (opium tincture) prescriptions. Doctors and researchers of the period took some fifty years to detect morphine and opiates were addictive 1830-1880. During that time opiate drugs were freely available over the counter and were common contents in cough medicine and baby syrups (cough, croup, and sleeping medications).

The government then gave our ancestors cocaine and it took another fifty years (1870-1920) to determine cocaine was addictive. During that time period the government gave those addicted to opiates, Heroin to use as a non addictive drug. Patent medicines then added Herion to cough medicines, even for babies, because the government declared it non-addictive. By the end of the century, things were desperate (except for those using lithia, as studies show its use reduces opiate or narcotic use).

Our government approved for wide distribution a new non-addictive pain killer called Heroin. It was in all kinds of medicines for adults, children and babies produced by respected companies like Bayer. Only after new generations of Americans were treated did the government finally begin to listen to doctors who had been screaming from years that their patients and co-workers were addicted to Heroin and Cocaine.

During this period (1900-1020), the same government people who were insisting Heroin and Cocaine were safe for the general public ouer the counter sales, were also waging war on lithium containing comsumables, particularily mineral spring water which did not have large amounts of lithium in it. Perhaps, on one hand the use of lithia water was keeping the majority of the USA population, who were using opiates, from becoming addicted. On the other hand, the widespread use of lithia water might have reduced mood disorders that led to opiate use. The majority of providers of lithia water could no longer mention “lithium” or “lithia” in their advertising. This would be like telling brewers of 3.2 beer (or less alcohol) that they no longer could use the word “beer” in their name, bottle label, or advertising. An immaginary line was drawn but no-one seemed to know where or why. Buffalo and White Rock made it through fine but Londonderry (with a lithia content in between the two) was shut down. The FDA never did show that any of these lithia waters (or mineral spring waters) violated the Hippocratic Oath of “do no harm”. They went after advertisement claims for advertising ineffective minerals without any studies to show the claims were scientifically false. The FDA’s resulting charge was that there was too little lithium in the most mineral water to do any good. Now it seems that 2 mg/ liter should have been that line in the sand.

Almost all the rest of the mineral and lithia spring water business was shut down by the government for potentially dangerous organic material (all mineral springs by definition contain organic material, as did all historically available drinking water). These springs are still being used by local residents and tourists. Likewise, a large amount of rural Americans are still on untreated well water. Surviving spring water bottlers had to install artesian wells (so it was no longer spring water) or treat the water with sanitizers.

Lithium is non-addictive.

NY Times, Science Times, March 4, 2003 [38] “Seeking to Shed Fat, She lost Her Liver, Denise Grady, “By law the government must prove an unreasonable risk of harm to ban a dietary supplement.” The FDA “cannot take a supplement off the markeet unless there is proof that consumers have been harmed. As long as manufacturers do not claim that their products can be used to treat or cure disease, they are not regarded as drugs.” “Kava has been reported to cassue a dozen cases of liver failure since 1999. It was taken off the market in Europe and Canada but not the US.” “The FDA left ephedra on the market despite the fact it received more than 100 reports of deaths and 16,000 reports of other problems including strokes, seizures, heart disease, and psychotic episodes.”

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A.

FDA

Legal Citation 48F2d.378 concerns a bottled “healing” mineral water from a spring well regarded by the Catawba Indians, called “Healing Water” was prosecuted by the FDA without a hearing. The district judge wrote, “We make the finding that this water at the time of the trial was free from the criticisms made of it and will continue to be free. We make this finding because the claimants have introduced evidence through the testimony of experts to this effect, which is uncontradicted. “Clearly, the FDA was on an unjustified witch-hunt against this “healing water”, and attempted to use the Department of Justice as a tool for this persecution.” [19]

The FDA destroyed the mineral water industry perhaps because of biological contamination. Yes, all springs always contain micro- organisms, though these are generally harmless and historically used locally (even if offically the water can’t be sold) without complaint. In Europe, “live” water is widely believe healthier then American chlorinated biologically dead water. [19]

The AMA archives has a fair amount of material on the mineral water industry in their historical health fraud collection. [19]

John Swann, Historian FDA jswann@ora.fda.gov Fda’s actions against cure-all-claims such as Crab Orchard Mineral Water, “World’s Greatest Remedy” for typhoid fever, malaria, rheumatism. Cases persued against assorted mineral water are summarized in Mastin G White And Otis H Gates 1934. [19]

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A. RDA

“Lithium” EM Haas, MD ” Staying Healthy with Nutrition” [20] Deficiency of lithium is not really known. [20]

There is no specific RDA for lithium, nor is it known how much, if any, we need. [20]

“Lithium in Drinking Water and the Incidences of Crimes, Suicides, and Arrests Related To Drug Addictions” GN Schrauzer and KP Shrestha. Dept of Chemistry and Biochemistry, University of California at San Diego, Revelle College, La Jolla Ca 92093. October 20, 1989. Biological Trace Element Research 1990 May;25(2):105-13 [21]

Conclusion: Lithium at low dosage levels has a generally beneficial effect on human behavior, which may be associated with the functions of lithium as a nutritionally essential trace element. [21] Increasing the human lithium intakes by supplementation, or the lithiation of drinking water is suggested …” [21]

Forrest Neilsen of the US Department of Agriculture suggested that lithium should be classified as a DAMM (Dietary Allowances of Minuscule Minerals) nutrient. FH Neilsen, “How Should Dietary Guidance be Given for Mineral Elements with Beneficial Actions or Suspected of Being Essential”, Journal of Nutrition, 126, 2377s- 2385s, 1996 Because of its low molecular weight, lithium is more abundant in the body than six of the minerals commonly in supplements in terms of number of atoms. M Winter, University of Sheffield, England, www.WebElements.com[23]

The normal daily intake of lithium by the EPA ranges from 0.65mg to 3.10 mg. [25]

Typical daily lithium uptake in the US is estimated to be 0.060- 0.070 mg/day. The mean intake of Turkish diets is 0.102 mg/day and Finnish diets 0.035 mg/day. [25]

Lithium’s many contributions to human health and function has increased interest in declaring lithium an “essential trace element”. [26]

Lithium occurs in all tissues and fluids of the body in low concentrations. [25] It is inconceivable that no intake amount can be established for something already in everyone’s body. It is even more inconceivable to forceable remove it from the food and beverage (including public drinking water and private mineral water).

Human intake studies for lithium have been reported from 2 mg/day (Bowen, “Trace Elements in Biochemistry”, Academic Press, NY 1966) to 0.160-0.054 mg/day (Hamilton & Minski, Science Total Environment, 1972/1973) [25]

The averge dietary intake is estimated to be about 2 mg per day (Beliles, 1994). [28]

Daily Values for Vitamins & Minerals A hodge podge of dietary advice was created by the Food and Nutrition Board subsidiary of the National Research Council, which is part of the National Academy of Sciences. Recommended Dietary Allowances (RDA) (Also called, Recommended Daily Allowances) Estimated Safe and Adequate Daily Dietary Intakes, (ESADDI) Dietary References Intakes (RDI) CA Rinzler, “Nutrition for Dummies, IDG Books, 1999 Lithium does not make any of the lists. [23]

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B.

True Rumor A Lithium prevents or helps prevent Suicide

Other prescription drugs equivalent to lithium [1]

Suicide Prevention Kay Redfield Jamison PhD suicide 2-4 highest cause of death depending on age, sex, and country. 90% had disgnosable major psychiatric illness. According to Bruno Muller- Oerlinghausen MD, Berlin worldwide epidemiological studies show rigorous treatment with antidepressants did not reduce suicide risk. [1]

Multicenter Study of Affective Psychoses (MAP) 2.5 year study of bipolar, schizoaffective, and unipolar disorders. 146 on lithium 139 carbamazepine. 4 suicides, 5 attempts on carb… None on lithium. [1]

conclusion lithium has unique serotoninergic and antiaggressive properties … and serotonin agnonistic effects (not in other mood stablizers and antidepressants. [1]

Even people not good responders at Berlin Lithium Clinic showed reduced suicide rates. [1]

Second study involved only patients who had attempted suicide before trying lithium. Three groups; excellent, questionable, & poor responders as to reduction of depression episodes. suicide attempts in all three groups were significantle reduced. Conclusion only lithium has a specific antisuicide effect. [1]

Changing patient off lithium to optimize mood disorder treatment may result in the death of the patient. [1]

Major drug of choice has switched from lithium to anticonvulsant divalproex sodium in USA may have major public health implications for suicide. No data indicates anticonvulsants have any effect against suicide. [1]

Divorce After 1950, divorce rates soared but blamed on social and not chemical factors. Divorce and suicide rates grew together on a ratio of one suicide for each 25 divorces.

Suicide Rates Year Combined Male Female 1950 7.6 17.7 2.5 1990 12.4 20.4 4.8 1995 11.9 19.8 4.4

From 1979-1999 there were 626,225 suicides in America.

Harris Poll May, 2003, 7% of adults or 15 million Americans admitted to attempting suicide.

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False Rumor B DOES LITHIUM STILL WORK?

Lithium is less effective than early studies showed. The decline in the drugs efficiency, according to Samuel Gershon MD, maybe due to atypical academic medical center cases which fail to respond to lithium. [1]

Replaced ineffective lithium with Tegretol & Depakote. Lithium helps 80% reverse acute mania people and 60-70% stablize mood. Strong anti-manic mild antidepressant. [3]

Rumor dispelled Excellent responders

Paul Groff MD Study shows lithium just as effective as ever, Lithium still works for people who have cycled on and off, Excellent response for Classical bipolar & Cycloid bipolar disorders. [1]

The American Psychiatric Association’s Working Group (“The Pink Sheet”, 1994) recommended lithium as the first-line treatment for acute and maintenance treatment of bipolar illness. [6]

Googwin and Zis, 1979 413 patients (in ten groups) reported lithium produced an average improvement of 81% (range 68-100%) [6]

Millions of prescriptions later, lithium remains the most popular choice for treating manic depression, although scientists do not understand how it quells mania or relieves depression. [7]

Was lithium treatment overvalued or no longer as effective as formally? [11]

“Evidence of Stable Response Over Three Decades” RJ Baldessssarini, MD & L Tondo, MD Archives of General Psychiatry February, 2000;Vol 57 No. 2:187-190 [11]

“We reviewed published reports on long term lithium treatment (1970-1996) as well as clinical effects on 360 patients with DSM- IV bipolar disorder on lithium monotherapy after 1970. There was no significant difference over 25 years. Unfavorable results in specialized hospitals may reflect the accumulation over time of patients with complex, less treatment responsive illnesses. Lithium is unmatched in research support for long term clinical effectiveness against morbidity and mortality (suicide) associated with depression or mania in bipolar I and II disorders. Data did not support suggestions that benefits of lithium have been exaggerated in the past or have been lost recently.” [11]

Orphan Drug In fact by FDA proclamation, studies involving Lithium were illegal from the late 1940′s until the 1970′s. Legal or not, no pharmaceutical company will study it because it can’t patent Lithium compounds.

“Lithium: An Orphan Drug Archives of General Psychiatry, October 2001 Vol 58, No 10, NE Rosenthal, MD, National Institutes of Mental Health, Clinical Psychobiology Branch, Bldg 10, Room 4S239, Bethesda, MD 20892. [12]

“One factor that may be responsible for lithium’s fall from grace among clinicians and patients is its status as an “orphan” or “poor relative” drug. Since lithium is cheap and unpatented, no wealthy drug company has any interest in demonstrating its merits as a mood stabilizer. There are no lavishly catered all-star symposia at major psychiatric meetings to sing the praises of this humble salt. When did you last see a pen, calendar, or trinket with “Lithium” embossed on it. Finally, lithium is regarded as old news (either 1970 USA or 1950 for the rest of the world) and , as such, is less appealing to psychiatric researchers eager to make their mark on the field. My patients wince when I recommend it to them and often require a lecture on the economics and sociology of modern medicine before they are willing to leave my office with a prescription in hand.” [12]

P. Grof & M. Alda “Discrepancies in the Efficacy of Lithium (letter) Archive of General Psychiatry 2000; 57:191. [12a] Reinforces effectiveness of lithium.

Ian Smith, MD, “Lithium Continues to Work Well for Mania”, Depr of Internal Medicine, University of Iowa Hospital, Feb, 2000, www.vh.org/Patients/IHB/IntMed. [29]

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False Statement 1

Lithium bromide, a sedative, went out of favor in 1948 when it killed three heart patients using it as a salt substitute. Carol Turkington & Eliot Kaplan MD [3]

False Statement 2

Westsal The calming effect of lithium in mania was first reported in 1949. That same year lithium was recommended as a salt substitute and liberal use lead to several deaths, which slowed its acceptance in the US. FDA did not approve lithium until 1970. [6]

False Statement 3

The Stanley Center for the Innovative of Bipolar Disorder. ??? In 1975, one year after lithium received FDA approval as a prophylactic treatment for bipolar disease. ??? [13] Now at the Madison (Wisconsin) Institute of Medicine. [17] Bipolar Disorders: A Guide to Helping Children and Adolescents by Mitzi Walsh, 2000, O’Reilly & Associates. [17]

False Statement 4: Lithium was not discovered by modern medicine until 1949. [17]

Lithia Springs, Georgia, “In 1890, Doctors Robert B Cloud, Christopher Columbus Garrett, and W. H. Whitehead established the first Hospital in American, the Lithia Springs Sanitarium, using natural lithium water in treating alcoholism, opium addiction, and compulsive behavior. Manic depression had not had not yet been identified as a form of mental illness at the time.

Lithium Bromide was used as a sedative and anticonvulsant. [16] See (WR5:1, ) for list of drugs from the 1800′s.

See (WR5:1,35-36) for Compounds (1880-1900) and Doctor Thomas’s recommendations for Lithium compounds for Lithemia (Gout). The following prescription recommendations were taken from [49] JB Lippincott, Phil, “Quick Reference Book for Medicine & Surgery” part 11, 1924. [49]

Lithii Benzoas (Lithium Benzoate) (C6H5COOLi) 3 grain per dram aqueous, 2 drams in water every 2-4 hours. Urinary acidifier and antiseptic, diuretic, intestinal antiseptic.

Lithii Bicarbonas. (Lithium Bicarbonate) Tablet 5 or 10 grains, 3- 4 times daily as antiacid.

Lithii Carbonas (Lithium Carbonate Li2C03) 2 grains minimum, 8 grains average, 15 grains maximum; 5 or 10 grain tablet, 3-4 times daily, antiacid.

Lithii Citras (Lithium Citrate Li3C6H5O7) Min 5 to Max 20 grains 5 or 10 grain tablet, 3-4 times daily, Systemic alkali and diuretic.

Lithii Citras Effervescens, (Lithium Citrate Li3C6H5O7) plus lithium plus citrate 5, sodium bicarbonate 57, tartaric Acid 30, citric acid 19.5), ) two drams in glass of water, 3-4 times daily, Systemic alkali and diuretic.

Lithium Salicylas (Lithium Salicylate) very soluble in water, 5-20 grains, Inferior to sodium salicylate because of the toxic action of the lithium with adequate doses. Antirheumatic, analgesic, antipyretic, diaphoretic, cholagogue, biliary antiesptic, increases nitrogenous metabolism and the excretion of uric acid.

“Gout Treatment -Alkaline water should be drunk freely” “copiously” Drink 1.5 quarts daily of water containing effervescent lithium carbonate or lithium citrate 5-10 grains 3-4 times daily.

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