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Lithium in drinking water

  • Mark A. Huthwaite (a1) and James Stanley (a2)
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References

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1 Ohgami, H, Terao, T, Shiotsuki, I, Ishii, N, Iwata, N. Lithium levels in drinking water and risk of suicide. Br J Psychiatry 2009; 194: 464–5.
2 Chandra, PS, Babu, GN. Lithium in drinking water and food, and risk of suicide. Br J Psychiatry 2009; 195: 271.
3 Young, AH. Invited commentary on … Lithium levels in drinking water and risk of suicide. Br J Psychiatry 2009; 194: 466.
4 Desai, G, Chaturvedi, SK. Lithium in drinking water and food, and risk of suicide. Br J Psychiatry 2009; 195: 271.

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Lithium in drinking water

  • Mark A. Huthwaite (a1) and James Stanley (a2)
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eLetters

Chemical Thinking

Temi Metseagharun, Locum Staff Grade Psychiatrist
26 February 2010

The possibility of Lithium in drinking water reducing suicide rates is the best example of chemical thinking that I have read about in a long time! The link between serotonin and happiness is the most popular form ofchemical thinking in circulation.I note Allan Young’s statement that “It would be most unfortunate if thesefindings became little more than a factual curiosity, of the sort that bright students sometimes use to highlight the limitations of a professor’s wisdom,” but it is incredible to see how psychologically implausible conjectures find their way into mainstream thinking. Chemicals indisputably modulate the expression of emotions, but to directly link any specific chemical or its lack to a specific emotional state (it is important to note that specificity is the main issue) such assadness is a well-established fallacy of chemical thinking. The vague impression that Lithium reduces suicide rates (without any knowledge of the effect size compared to the obvious number 1, if not the only cause oftrue suicides in the general population – social problems) appears to haveled to a schizophrenic jumping-to-conclusion (JTC) link between Lithium and reduced suicide rate. Let us assume that Lithium indeed reduces suicide in the general population. What could possibly be the fathomable biological and psychological mechanism? As with SSRIs, other antidepressants and Lithium affecting mood, biological plausibility has noissue, but it is simply psychologically implausible to make the direct leap from sub-therapeutic amounts of lithium in the blood to better moods and then on to reduced suicide irrespective of whether or not (for example) a relationship break-up preceded the suicide. Any research with this kind of conjecture will be a waste of resources.

References1.Young A. Invited commentary on... Lithium levels in drinking water and risk of suicide The British Journal of Psychiatry (2009) 194: 466. doi: 10.1192/bjp.bp.108.0619862.Oghami et al. Lithium levels in drinking water and risk of suicide. TheBritish Journal of Psychiatry (2009) 194: 464-465. doi: 10.1192/bjp.bp.108.055798

Declaration of interests: None

Temi Metseagharun is a Locum Staff Grade Psychiatrist, Ten Acres Centre, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham.
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Conflict of interest: None Declared

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