Hardcore archive play for now — back to ’03 thinkin’ with no sense of dignity,
“Lithium … is the lightest of the solid elements, and it is
perhaps not surprising that it should in consequence possess
certain modest magical qualities.” —G. P. Hartigan, psychiatrist
Lithium is used routinely to even out the extreme mood swings of patients with manic-depressive illness, or bipolar disorder. Increasingly, however, it is also offered to people with depression. But a growing body of evidence indicates that this compound can literally keep people who are at risk of suicide alive. In 1998 lithium pioneer Mogens Schou of the Psychiatric Hospital in Risskov, Denmark, pulled together the results of various studies of lithium as a suicide preventive and observed that people not taking the drug were three to 17 times as likely to end their own lives as depressed people who took the medication. Likewise, Schou determined that lithium reduced suicide attempts by a factor of between six and 15.
It can cause hand tremors, constant thirst, frequent urination, weight gain, lethargy, reduced muscle coordination, blurred thinking and short-term memory deficits. People on it must also have its concentration in their blood assessed regularly to ensure that it is within the therapeutic range: the drug is usually ineffective below 0.6 millimole per liter of blood serum and can cause life threatening toxic reactions if the level becomes higher than two millimoles per liter.
How does it exert its salutary effects? Despite a number of tantalizing leads, researchers are still not certain. “It’s hard to say at this time,” says Ghanshyam N. Pandey of the University of Illinois. “There are so many modes of action.” Lithium is thought to affect tiny ports called ion channels on the surfaces of nerve cells, or neurons. As they open and close, ion channels admit or bar charged atoms that determine the electrical potential within the cells, thereby dictating their activity and ability to communicate with other neurons. Scientists posit that the drug stabilizes the excitability of the neurons by influencing the ion channels or by skewing the chain reaction of biochemical events that occur within an excited cell.
A drug only works, though, if someone takes it properly. In the May 2002 issue of the Journal of Clinical Psychiatry, Jan Scott and Marie Pope of the University of Glasgow reported that half of a group of 98 patients who were taking a moodstabilizing drug such as lithium failed to stick with their drug regimen. Yet, the researchers noted, just 1 percent of scientific publications on the subject of mood stabilizers looked at why patients did not take their lithium as prescribed. J. John Mann of the New York State Psychiatric Institute says that a major factor in noncompliance is the human desire not to want to think of oneself as ill. “There’s a natural reluctance to take any medicine long-term,” Mann explains. “When a person is depressed, they have a problem imagining ever getting better. When they’re well, they can’t imagine getting sick again.”
The side effects of lithium also play a role. Kay Redfield Jamison, a psychiatrist at Johns Hopkins University who studies manic-depression and suicide—and who is a manicdepressive herself—has found that the most common reasons patients stop taking the drug are cognitive side effects, weight gain and impaired coordination. In her moving memoir, An Unquiet Mind, she recounts her own struggle to come to terms with the fact that she will probably be coping with lithium’s side effects for the rest of her life.
Copyright © 2003 by Scientific American,
part of –” Why? The Neuroscience of Suicide” by Carol Ezzell –
FG and go with it