[jamesisaac]

But if the only reason decreased suicide rates are observed is that the members of society become slightly more docile (obviously to a much lesser degree than those on prescription doses), it makes it a lot more questionable whether this is a valid way to tackle the suicide problem.

It would be one thing if micro-doses of lithium were sold as a supplement, which individuals can opt to take. But the article goes as far as to suggest adding it to drinking water -- it seems very irresponsible in my eyes to leave it to the government to decide "how docile" the population should be above the natural level / what trade-off with suicide rate is acceptable.

There are better ways to deal with the problem of suicide than pushing society slightly closer to the "souless robot" end of the spectrum.

[derefr]

Biology isn't made of perfect sliding scales between two extreme problems, where in the middle you have 50% of both problems. Instead, in the middle, you usually have neither problem.

For example, the amount of moisture in your skin: too little and it cracks and bleeds, too much and you get fungal infections. But adding moisture to cracked-and-bleeding skin isn't making it "a bit more fungal" -- it's pushing it into the healthy buffer range.

[jamesisaac]

And what suggests that we aren't "in the middle" already? With your hand moisture analogy - for the majority of the population, natural levels of moisture are perfectly fine, and no intervention is required. Perhaps natural levels of lithium are optimal too.

I'd imagine there are many, more complex, factors involved in brain chemistry / mood suppression, so it would be a lot more difficult to determine where this middle lies.

If you're using high suicide rates to suggest we're not in the middle and need more lithium in everyone's water, I'd have to disagree. In the vast majority of cases, a better healthcare system which ensures those who need it are connected with mental health professionals would help nip the problem in the bud. Rather than solving it with these lithium microdoses, causing to those on the verge of suicide to not have the lucidity of emotion to commit to the act, and the rest of the population having their brain chemistry played with too.

[derefr]

Usually "the middle" makes up the vast majority of the scale.

Here's a useful comparison:

Before we were iodizing salt, most people were actually in "the middle" of iodine-consumption. Anywhere from "nearly none" to "tons and tons" was "the middle"--your body can work miracles to create homeostasis from random inputs. But some people were getting no iodine at all, and these people would get very sick.

So we added just a little bit of iodine to salt. The iodine-deficient people--the people who were previously getting utterly no iodine--stopped getting sick, because now they were getting a little bit of iodine, and that was enough. Everyone else was getting slightly more iodine--but this didn't push anyone from "getting a tolerable amount of iodine with the excess just excreted" to "having a hyperiodine problem." There was nobody exactly one dose away from having too much iodine, because we just don't consume that much iodine.

This same story holds for any vitamin or mineral. Calcium, phosphorous, iron, etc. are all things most people get the right amount of--but "the right amount" is almost any amount, because the body knows how to take just the right amount from the stream of input it's getting, and throw the rest out. The only wrong amounts are either zero, or more than exists in any human-friendly environment.

[gwern]

> but this didn't push anyone from "getting a tolerable amount of iodine with the excess just excreted" to "having a hyperiodine problem." There was nobody exactly one dose away from having too much iodine, because we just don't consume that much iodine.

Actually, there was: 'thyroid shock'. Iodization in the USA was accompanied by a wave of, I think, a few thousand deaths on net when people who grew up iodine-deficient were suddenly exposed to iodized salt. (This was covered by one of the historical papers I cite in http://www.gwern.net/Iodine although I forget which.)

Of course, the benefits of iodization were on net huge and I'm very much a fan of iodization, but it would be wrong to say nobody was hurt by the introduction of iodized salt.

[derefr]

Interesting. That sounds less like "being one dose away from having too much iodine" and more like "having no tolerance for iodine, such that even one dose is too much."

I guess another way to think about environmental chemicals is by analogy to poisons: if they were common in the environment, you'd have a tolerance to them, but since they aren't, you don't. You can build up a tolerance by parts, at which point the poison stops being one and just becomes another chemical the body handles.

[gwern]

Maybe. I don't know what the mechanism of thyroid shock is; as I said, iodization is such a good idea overall that it's merely a footnote in the cost-benefit.

[jamesisaac]

That makes sense with your example - but I really don't think suicide can be seen as a symptom of lack of lithium in the same way as sickness from a lack of iodine.

What is there to show that "this same story holds for any vitamin or mineral"?! Surely there are many which have no positive effect on the body, where zero would be the best dosage. What law of biology suggests that every mineral is in some way beneficial to the human body?

Lithium happens to have an effect on moods in the brain in such a way that suicide is less likely - but the mood dampening effects may well diminish people's positive emotions too (for example). For someone with no mental health issues or risk of suicide, this could well be an overall negative effect, and therefore makes no sense to force on the entire population.

[andreasvc]

Where do you get this idea of lithium making people "docile"? It does not; you may be confusing it with antipsychotic medication. In any case as the comment you are responding to states, these are very low doses, such effects could not occur. Your emotional language of "soulless robots" is really just an uninformed, knee jerk reaction.

I can see why the drinking water suggestion invites paranoia. As the article mentions a solution like adding it to salt could also work.

[jamesisaac]

No, mine wasn't an "uninformed, knee jerk reaction" - it's was the informed conclusion I came to after some research (prior to this article) into prescription doses of lithium. Becoming docile, turning into a soulless robot, mood supressions - whatever you want to call it - is an extremely commonly reported side-effect by those with first-hand experience. Several people in this thread (go right up to the top parent comment by hammock) have already backed this up with their own experience, yet you still seem to be dismissing it.

As to why that is relevant to microdosing...

- High doses: major mood suppression -> practically no chance of suicide

- Micro doses: (?) -> lower chance of suicide

Simple reasoning would suggest that (?) == some degree of mood suppression. I'm not sure how you've concluded that this "could not occur" with lower doses?

Putting it in salt is hardly better than putting it in the water supply, it's still systematic mass "medication" which would become difficult to avoid.

[andreasvc]

I won't discount that therapeutic doses may have such side-effects, but the question is whether that is relevant to the present discussion. I claim that the side effect of being docile would not occur at a dosage of 100 times smaller than therapeutic doses. Maybe there is such a thing as a "1/100th as docile" effect, but it doesn't always make sense to extrapolate effects linearly; it can also be that the effect just isn't there. The way I arrive at that intuition is by making an analogy with water: you can drown in a bathtub of water, but no person can drown in a droplet of water.

You call it "simple reasoning" to make your inference about microdosing, but actually we have no idea how lithium even affects the brain / mind, so it's not possible to arrive at the conclusion by reason. It would have to come from evidence from controlled studies, and I believe these indicate that side-effects are restricted to high doses.

Also, "practically no chance of suicide" -- you can't be serious about that; no drug can guarantee or even come close to that.

You already have salt with and without iodine, so no, wouldn't be difficult to avoid. Whether you should call it "medication" is debatable; giving someone vitamin C is not necessarily medication, it can be a food supplement. The same could be argued for lithium which occurs naturally in certain water springs.

[milkshakes]

have you taken lithium?

i have, for years, and i currently take "antipsychotic medication", which is actually a yet another term that, thanks to marketing, has lost all meaning. the comments about lithium making you "docile", and "soulless robots" are spot on. and there are "antipsychotics" that act as mood stabilizers that are a lot less soul-sucking than lithium is.

respectfully, it is you who are misinformed.

[andreasvc]

You are projecting your experience with therapeutic doses on the current discussion about doses that would be orders of magnitude lower, similar to naturally occurring levels in some water supplies. Even at therapeutic doses I think you are generalizing too much, as many people do not experience such side effects.

[milkshakes]

> Where do you get this idea of lithium making people "docile"? It does not; you may be confusing it with antipsychotic medication.

that is the statement i was responding to.

> Even at therapeutic doses I think you are generalizing too much, as many people do not experience such side effects.

that's cool and all, but that's just, like, your opinion, man. if you're going to accuse me of generalizing, you could at least do so with something other than a sweeping, unqualified generalization. i find it amusing that this thread is full of people who don't actually take this medication telling people who actually have what its effects are. in fact, lithium has been documented both anecdotally and in research[2] to have measurable effects on cognition, and a dulling effect on mood.

[2]: http://scholar.google.com/scholar?q=lithium+cognitive+effect...

[andreasvc]

> > Where do you get this idea of lithium making people "docile"? It does not;

Granted, I was overstating my case there. But I maintain, not everyone has those side effects. The more pertinent point was that the article is advocating trace amounts.

[otakucode]

Yeah, I am also bothered by the fact that the options only seem to be 'it remains a controlled substance which people have to show a significant need for in order to acquire' and 'put it in the drinking water'. I realize it is very popular in modern society to think that if something has benefits that it should be forced on everyone, and if benefits can't be shown then the government should step in and forbid anyone from doing it, but I can't get comfortable with that. I would think what should be aimed for is easy availability of low-dose lithium supplements paired with education. Give people a choice. This isn't like vaccines where we have a legitimate reason to exert control over people (herd immunity, the safety of those too young or immunocompromised to be vaccinated, etc).