Lithium is a naturally occurring element that can affect cell signaling in the brain. The medication can help treat psychiatric disorders, but patients must be carefully monitored because serious side effects can occur. Some studies suggest that a low pharmaceutical dose of lithium may provide some cognitive benefit to patients with mild cognitive impairment or dementia, but findings are inconsistent. Ongoing studies may shed new light on the use of lithium for cognitive health and dementia. The safety of even low doses of lithium for elderly people is uncertain.
No clinical trials have studied whether lithium prevents cognitive decline in healthy older adults. Some observational studies have examined the relationship between lithium intake and incidence of dementia. Our search identified:
The clinical trials that have evaluated lithium treatment for mild cognitive impairment have reported mixed results; some, particularly longer-term studies, found benefits of lithium treatment such as disease stabilization [1]. While this study tested lithium over years and compared to a placebo, the people in the placebo group were older than the people in the lithium treatment group, making it difficult to say whether the lithium treatment helped or whether the older patients were declining more quickly.
Long-term pharmaceutical use of lithium has been associated with a lower risk of dementia in several observational studies [2; 3; 4] and reduced rates of brain aging [5] for bipolar patients, though this pattern has not been seen in all studies [6]. Additionally, some studies have found that geographically varying levels of lithium in groundwater may be associated with dementia incidence [7], though other studies have not replicated these results [8], and geographic location can introduce many other factors that can influence risk of dementia.
Preclinical studies suggest several ways lithium can improve brain health, including increasing stem cell activity, accelerating the absorption of vitamin B12 and folate, and increasing the elimination of aggregated proteins such as beta-amyloid that are associated with Alzheimer's and other brain disorders [9; 10]. Most of these mechanisms, however, have not been validated in humans and lithium has not yet lived up to its promise as an effective treatment for ALS [11; 12]
Several small clinical trials of lithium treatment for dementia have been conducted. Some trials have reported disease stabilization [13] whereas some trials find no benefit [14; 15]. The trial that reported benefit was larger and longer than the trials that reported no benefit. Safety concerns and the conflicting evidence on brain health warrant more research.
At doses that are too high, lithium can cause toxicity and severe long-term side effects, including kidney damage, especially if not treated appropriately. Safety risks are generally higher at higher doses, but the dosage risk varies by individual. Elderly people must be careful with lithium, particularly if they use multiple medications or have other health risks and diseases that interact with lithium. Safety risks are particularly high for people with kidney or cardiovascular disease, dehydration, or sodium depletion, or for people taking diuretics or haloperidol. Common drugs such as over-the-counter anti-inflammatory medications, caffeine, theophylline, antidepressants, and anti-hypertensive medications can interact with lithium [16; 17; 18].
NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.
Lithium is usually prescribed as lithium carbonate in the form of capsules, solutions, syrups, tablets, or extended-release tablets. Dosage must be tailored on an individual basis (depending on age and drug formulation). Typically, the lowest possible dose is prescribed and then adjusted to achieve a certain range of lithium levels in the blood serum, while carefully monitoring for side effects.
Full scientific report (PDF) on Cognitive Vitality Reports
Dietary Lithium rating on Cognitive Vitality Reports
Check for drug-drug and drug-supplement interactions on Drugs.com