Lithium in the Drinking Water: A Systematic Review

Abstract

Background: Long since Australia’s revolutionary work with lithium and bipolar disorder, its remarkable neuroprotective effects and wide-reaching scope has been postulated. Lithium occurs naturally within drinking water, with a large variation in concentration geographically. Given the worldwide prevalence of neuropsychiatric disorders, the potential benefits of this naturally occurring mineral is one of substantial public health interest.

Objectives: We aimed to investigate the rates of neuropsychiatric conditions among people exposed to higher levels of lithium in drinking water compared to those exposed to lower levels.

Methods: A systematic search of PubMed, Embase, Web of Science, PsycINFO and CINAHL was conducted using MeSH terms and text words of lithium-related terms and neuropsychiatric outcomes.

Findings: There were 1203 published articles relating lithium with neuropsychiatric outcomes, of which 23 met the inclusion criteria. Ten out of 13 epidemiological studies found an association between higher lithium levels and reduced suicide rates. Three studies using a cross-sectional survey or patient interview demonstrated an inverse correlation between lithium levels and depressive symptoms, while one study showed decreased anxiety symptoms. Two out of four studies showed lower mental health hospital admissions. One study out of three showed a significant association between increased lithium levels in drinking water and reduced dementia or bipolar disorder rates.

Conclusions: Our findings suggests higher lithium levels in drinking water is associated with a lower incidence of suicidality, depression, anxiety, mental health hospital admissions and dementia.