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 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, depression is a complex, multifaceted illness, and researchers are still unsure about whether lithium is only effective for patients whose symptoms specifically overlap with bipolar disorder (4, 5).

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 (5). 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
• 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.

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 FDA-approved for treatment-resistant depression, providing an alternative for those who have not responded well to traditional medications.

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, Madison Avenue TMS & Psychiatry is here to help. Our experienced team offers a range of services, including TMS, ensuring that individuals 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:

1. Ulrichsen A, Hampsey E, Taylor RH, Gadelrab R, Strawbridge R, Young AH. Comparing measurements of lithium treatment efficacy in people with bipolar disorder: systematic review and meta-analysis. BJPsych Open. 2023;9(3):e98. Link. Accessed January 13, 2024.
2. 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. Link. Accessed January 13, 2024. 
3. 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 13, 2024.
4. 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. Frontiers in Neuroscience. 2023;17.  Link. Accessed January 13, 2024.
5. Bschor T. Lithium in the treatment of major depressive disorder. Drugs. 2014 Jun;74(8):855-62. Link. Accessed January 13, 2024.
6. Undurraga J, Sim K, Tondo L, Gorodischer A, Azua E, Tay KH, Tan D, Baldessarini RJ. Lithium treatment for unipolar major depressive disorder: Systematic review. J Psychopharmacol. 2019 Feb;33(2):167-176. Link. Accessed January 13, 2024.

Dr. David Woo

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.