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Lithium in ADHD


Lithium in 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 in 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

Further studies are not known to us. 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.2