Lithium Supplementation for the Psychotherapy Patient

"Interest in lithium has been renewed in recent years, not only as a classic mood stabilizer for bipolar illness but also as a potential low-dose supplement with broader health benefits. Some studies suggest that even trace amounts of lithium may improve cognition, promote longevity, and reduce suicide risk (Hamstra et al., 2023). Because psychotherapy often involves patients who struggle with suicidality, self-harm, or emotional dysregulation, it is worth asking whether clinicians should consider recommending low-dose elemental lithium supplementation to patients seen in therapy."

"Lithium has a distinguished place in psychiatry (Ruffalo, 2017). At therapeutic doses, it is one of the most effective treatments for bipolar disorder and recurrent depression. More importantly, lithium is the only psychiatric medication that has been consistently shown to prevent suicide (Lewitzka et al., 2015). Observational studies and clinical trials have repeatedly demonstrated this protective effect, a property that sets it apart from every other psychotropic drug."

"The more speculative question is whether some of these benefits might be realized at far lower doses, perhaps even in populations outside of Diagnostic and Statistical Manual of Mental Disorders-defined mood disorders, including individuals who present in psychotherapy with subsyndromal mood symptoms, chronic suicidal ideation, impulsivity, or self-harming behavior. Lithium is the only psychiatric drug proven to prevent suicide. Low-dose lithium may aid patients at risk of suicide or self-harm. Lithium supplementation shows promise as an adjunct to psychotherapy but requires more evidence."

Lithium functions as a classic mood stabilizer, effective at therapeutic doses for bipolar disorder and recurrent depression. Lithium is the only psychiatric medication consistently shown to prevent suicide, supported by observational studies and clinical trials. Renewed interest includes low-dose elemental lithium, with some studies suggesting trace amounts may improve cognition, promote longevity, and reduce suicide risk. Psychotherapy patients frequently present with suicidality, self-harm, emotional dysregulation, or subsyndromal mood symptoms, populations that could benefit from low-dose supplementation. Low-dose lithium shows promise as an adjunct to psychotherapy for reducing suicidal behavior and emotional dysregulation, but robust randomized evidence and safety data remain limited.

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