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Lithium for ADHD


Lithium for ADHD

1. Lithium application areas

  • Acute treatment of mania
  • Prophylaxis of manic-depressive and unipolar affective psychoses

2. Mechanisms of action of lithium

Lithium influences

  • Functionality of nerve cells

  • Ion channels

  • Neurotransmitters, et al:

    • Serotonin
    • Dopamine
    • Norepinephrine
  • “second messenger systems,” e.g.

    • based on phosphoinositol
    • based on cAMP
  • protects / increases the volume of brain structures involved in emotional regulation, such as

    • PFC
    • Hippocampus
    • Amygdala
  • reduces the excitatory activity

    • Dopamine
    • Glutamate
  • increases inhibitory neurotransmission

    • GABA
  • reduces oxidative stress

  • increases protective proteins

    • Neutrotrophins
    • Bcl-2 increased
  • reduces apoptotic processes through

    • Glycogen synthase kinase 3 (GSK-3) inhibition
    • Inhibition of autophagocytosis

3. Lithium for ADHD

A randomized, double-blind, crossover design study of 32 adults with ADHD compared 8 weeks of MPH (up to 40 mg/day) and 8 weeks of lithium (up to 1 200 mg/day). In this study, 48% showed good improvement in ADHD symptoms with MPH and 37% with lithium.1

One study of response to lithium in bipolar disorder found a correlation between poorer response and increased Polygenic Risc Score of ADHD, MDD, or (especially) schizophrenia.2

We are not aware of any other studies. The use of lithium in ADHD cannot be recommended on this basis.

4. Lithium side effects

Especially at the beginning of lithium treatment:

  • fine-beat tremor
  • Polyuria
  • Polydipsia
  • Nausea

With long-term therapy damage to

  • Kidneys
  • Thyroid gland
  • Parathyroid glands

Lithium is said to promote weight gain.3

  1. Dorrego, Canevaro, Kuzis, Sabe, Starkstein (2002): A randomized, double-blind, crossover study of methylphenidate and lithium in adults with attention-deficit/hyperactivity disorder: preliminary findings. J Neuropsychiatry Clin Neurosci. 2002 Summer;14(3):289-95. doi: 10.1176/jnp.14.3.289. PMID: 12154153. n = 32

  2. Coombes BJ, Millischer V, Batzler A, Larrabee B, Hou L, Papiol S, Heilbronner U, Adli M, Akiyama K, Akula N, Amare AT, Ardau R, Arias B, Aubry JM, Backlund L, Bauer M, Baune BT, Bellivier F, Benabarre A, Bengesser S, Bhattacharjee AK, Cervantes P, Chen HC, Chillotti C, Cichon S, Clark SR, Colom F, Cruceanu C, Czerski PM, Dalkner N, Degenhardt F, Del Zompo M, DePaulo JR, Étain B, Falkai P, Ferensztajn-Rochowiak E, Forstner AJ, Frisen L, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hauser J, Herms S, Hoffmann P, Jamain S, Jiménez E, Kahn JP, Kassem L, Kato T, Kelsoe JR, Kittel-Schneider S, König B, Kuo PH, Kusumi I, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Maj M, Manchia M, Martinsson L, McCarthy MJ, McElroy SL, Mitchell PB, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O’Donovan C, Osby U, Ozaki N, Pfennig A, Pisanu C, Potash JB, Reif A, Reininghaus E, Rietschel M, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schubert KO, Schweizer BW, Severino G, Shekhtman T, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Tortorella A, Turecki G, Vieta E, Witt SH, Zandi PP, Fullerton JM, Alda M, Frye MA, Schulze TG, McMahon FJ, Biernacka JM (2022): Association of Attention-Deficit/Hyperactivity Disorder and Depression Polygenic Scores with Lithium Response: A Consortium for Lithium Genetics Study. Complex Psychiatry. 2021 Dec;7(3-4):80-89. doi: 10.1159/000519707. PMID: 36408127; PMCID: PMC8740189. n = 2.510

  3. Sanego: Gewichtszunahme bei Lithium. Abgerufen 15.09.22