Navigating Treatment Options: The Role Of Lithium For Depression

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By Dr. David Woo - February 19, 2024

Depression is a complex and challenging mental health condition that often requires a personalized approach to treatment. Not everyone responds well to every treatment, and it can take some time to find the right treatment—or combination of treatments—that works for you.

While traditional types of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) are frequently prescribed, there is a growing interest in using lithium for depression treatment. However, that is not the typical use of the drug, and there may be good reasons to choose alternatives to lithium for depression. In this article, we will look at the current situation surrounding the use of lithium for depression and anxiety and explore alternative treatments, such as transcranial magnetic stimulation (TMS).

Lithium For Depression

Lithium has been used for decades to treat bipolar disorder, a condition characterized by extreme manic and depressive episodes (1). But should you take lithium for depression?

Researchers are investigating the drug’s potential for individuals experiencing unipolar depression, also known as major depressive disorder (MDD), particularly when it comes to using lithium for treatment-resistant depression. Initial findings have indicated benefits such as reduced risk of hospitalization (2, 3). However, the relationship between lithium and depression is complex; researchers are still unsure about whether lithium is only effective for patients whose symptoms specifically overlap with bipolar disorder (4, 5). Your doctor may prescribe lithium for depression and anxiety symptoms, as the drug has shown effectiveness in reducing symptoms, especially suicidal ideation (6).

How does Lithium help with depression?

Lithium’s exact mechanism of action is not fully understood, but it is believed to impact the brain’s neurotransmitters and cellular processes, acting as a mood stabilizer (7). As such, it is sometimes considered for unipolar depression when conventional antidepressants are not providing the desired outcomes. However, like any medication, lithium may have side effects and requires careful monitoring to ensure its effectiveness and safety.

Side Effects Of Lithium

Like any drug, lithium can have undesirable side effects on the body. Lithium side effects can include:

Diarrhea
Dizziness or drowsiness
Hand tremors
Lowered libido
Nausea
Rash
Thirst or dry mouth
Short-term memory loss
Weakness
Weight gain

Because of this, patients on lithium should have their bloodwork taken to monitor the drug’s systemic effects, as well as have their thyroid and renal function (kidneys) regularly checked.

Alternatives To Lithium For Depression

While lithium can be a valuable tool in treating depression, it may not be suitable for everyone due to potential side effects or individual variations in response. The good news is that drug-free alternatives to lithium for depression are becoming increasingly accessible.

For those seeking alternatives beyond traditional medications, innovative treatments like TMS offer a noninvasive and well-tolerated option.

Depression Medication Management

Antidepressant medications are usually the first line of treatment for depression. However, there are many classes of antidepressants, and it can take time to find out which one, if any, is best for you.

Is lithium an SSRI or SNRI?

Lithium is actually neither of these commonly prescribed types of antidepressants. Lithium is classified as an atypical antipsychotic (AAP), and lithium treatment for depression is sometimes combined with traditional antidepressants.

What should I know about depression medications?

Everyone responds to medications differently. Some patients tolerate some antidepressant drugs better than others, but some people may find medications ineffective or suffer intolerable side effects. When taking medication, it’s important to have regular consultations with a mental health professional who can evaluate the effectiveness of the drug and either change the medication, adjust the dosage, or recommend alternatives as needed.

That’s why at Madison Avenue TMS & Psychiatry, we provide medication management services to help you find the right prescription or determine if you’re eligible for a drug-free depression treatment like TMS. Our consultations are conveniently available via telehealth video chats, allowing you to manage your treatment plan on your schedule, all from the comfort of your home.

TMS For Treatment-Resistant Depression

Transcranial magnetic stimulation is a revolutionary depression treatment that utilizes a helmet-like device to deliver gentle magnetic pulses to the brain. These pulses can be targeted to stimulate specific areas of the brain associated with mood regulation to restore balanced, healthy activity in the brain. TMS is an FDA-approved alternative to lithium for treatment-resistant depression, providing a drug-free depression therapy with a high success rate.

At Madison Avenue TMS & Psychiatry, we offer TMS as part of our comprehensive approach to mental health care. TMS sessions are conducted in a comfortable outpatient setting, and the treatment is well-tolerated with minimal side effects. It is a viable option for individuals who may be seeking alternatives to lithium for depression or have not found relief with conventional treatments.

Seeking Treatment For Depression

Depression is a multifaceted condition, and finding the right treatment requires a personalized approach. While lithium can be beneficial for some, TMS is a safe alternative for individuals seeking effective and well-tolerated solutions.

If you or a loved one is exploring treatment options for depression in New York, Madison Avenue TMS & Psychiatry is here to help. Our experienced team offers various services, including TMS and medication management, ensuring patients receive the personalized care they deserve. Take the first step toward improved mental health by contacting us online or calling (212) 731-2033 to schedule an appointment or consultation. Let us help you on your journey to a depression-free life!

Resources:

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BJPsych Open. 2023;9(3):e98.
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Pompili, M., Berardelli, I., Sarubbi, S., Rogante, E., Germano, L., Sarli, G., Erbuto, D., & Baldessarini, R. J. Lithium treatment versus hospitalization in bipolar disorder and major depression patients.
Journal of Affective Disorders. 2023;340, 245-249.
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Rybakowski JK, Ferensztajn-Rochowiak E. Updated perspectives on how and when lithium should be used in the treatment of mood disorders.
Expert Rev Neurother. 2023 Feb;23(2):157-167.
Link. Accessed January 22, 2025.
Szałach, Ł. P., Lisowska, K. A., Cubała, W. J., Barbuti, M., & Perugi, G. The immunomodulatory effect of lithium as a mechanism of action in bipolar disorder.
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Bschor T. Lithium in the treatment of major depressive disorder.
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Jones, G., Rong, C., Vecera, C. M., Gurguis, C. I., Chudal, R., Khairova, R., Leung, E., Ruiz, A. C., Shahani, L., Zanetti, M. V., De Sousa, R. T., Busatto, G., Soares, J., Gattaz, W. F., & Machado-Vieira, R.
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Dr. David Woo

Dr. David Woo is the owner and head clinical psychiatrist at Madison Avenue TMS and Therapy in New York City. Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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