Sometimes, it’s amazing (and a little bit terrifying) to think about how little we know about a medication before it hits the market and is given to patients. Of course, the medication has gone through rigorous trials to ensure that it is both effective in treating the targeted disease, and that it is safe to be taken, but the exact mechanism often remains a mystery for a long time, and we may still be working on figuring it out. For example, lithium has been used to effectively treat bipolar disorder for over fifty years, but we still don’t know every detail regarding how this happens.
We do know that it plays a role in providing protection for neurons, and also that it aids in providing trophic support, which means that it helps to provide the nutrients that the neuron needs to function properly. Two major mechanisms are at play in lithium’s actions. Lithium blocks the actions of glycogen synthase kinase-3 and kick-starts the actions of brain-derived neurotrophic factor. It also regulates the amount of calcium which can freely enter the neuron, which is a good thing as in some cases, calcium can cause the cell to undergo apoptosis, or programmed cell death. Lastly, lithium will lower levels of something called 1,4,5-trisphosphate by blocking the thing that helps to produce these, called phosphoinositol phosphatases. This stops the cell from inducing autophagy, which is another mechanism by which the cell might destroy itself.
The applications of lithiums effects seemed nearly limitless while we were discussing this paper in class. It can help to limit the adverse effects of diseases ranging from stroke to Huntington’s disease, and everything inbetween, including amytrophic lateral sclerosis (otherwise known as Lou Gehrig’s disease), fragile X syndrome, Alzheimer’s disease, and Parkinson’s disease. In fact, as we were studying lithium, it began to seem as if there was nothing it couldn’t do. We began to ask ourselves why we weren’t taking lithium as a regular supplement, and it only became apparent after a little research that though lithium has many beneficial effects in treating disease, it also isn’t necessarily something we want floating around in our bodies at extremely high concentrations. As we reached this realization that there is certainly too much of a good thing, I began to think about how easily the public conscious is swayed by information like this in the same way that we were.
I recently saw a post by a friend on Facebook cautioning everyone against vaccines, and as I clicked on the link to see what so-called evidence lay behind this proclamation, I realized how any of us can be easily swayed by information that we are presented with, especially when we aren’t familiar enough with the content to know what the right questions to ask even are. If we take a little time to familiarize ourselves with the topic broadly, we can start to see where the holes in the logic are. I’m not saying that we have to know everything about every single topic—to say such a thing and believe that this is a real possibility seems almost ignorant—but knowing enough to figure out what questions to ask and then exploring those is certainly the first step. All those years ago when it was discovered that lithium was beneficial in treating bipolar disorder, the researchers certainly did not know everything about it. Even today, we are still discovering more every day. However, they learned enough to figure out what the right questions to ask were in both the short and long term. First, is it safe and effective to use in treating bipolar disorder, and then later, how does it work and what else might it be used for? I think this skill of learning to ask the right questions is one that we all (myself included) undervalue, but is one that can be extremely helpful in gaining a clearer picture of the topic at hand.
Lithium: Still a little sketchy…
