Psychopharmacology and Lithium

I’ve been doing some research on Lithium and its beneficial effects on us humans…8)

The following is where my understanding of why Lithium works for me is heading. It makes a lot of sense when you just look at what it does on paper.

Much of the early research on the actions of lithium focused on modulation of neurotransmitter synthesis, release, and uptake. Lithium was found to influence to some extent virtually EVERY neurotransmitter that was investigated, although most research focused on the catecholamines and acetylcholine.

synthesis pathway of serotonin and catecholamines

PDF List – Serotonin Transporter Inhibitors/Modulators

Lithium is a serotonin–norepinephrine–dopamine reuptake inhibitor. A triple reuptake inhibitor (TRI).

Lithium acts as a combined reuptake inhibitor of the monoamine neurotransmitters serotonin, norepinephrine, and dopamine. It does this by concomitantly inhibiting the serotonin transporter (SERT), norepinephrine transporter (NET), and dopamine transporter (DAT), respectively. Inhibition of the reuptake of these neurotransmitters increases their extracellular concentrations and, therefore, results in an increase in serotonergic, adrenergic, and dopaminergic neurotransmission.

SNDRI’s increase the action of all three of the major monoamine neurotransmitters.

SNDRIs were developed as potential antidepressants and treatments for other disorders, such as obesity, cocaine addiction, attention-deficit hyperactivity disorder (ADHD), and chronic pain.

They are an extension of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) whereby the addition of dopaminergic action is thought to have the possibility of heightening therapeutic benefit.

However, increased side effects and abuse potential are potential concerns of these agents relative to their SSRI and SNRI counterparts.

They are also similar to serotonin-norepinephrine-dopamine releasing agents (SNDRAs) like MDMA (“ecstasy”) and α-ethyltryptamine (etryptamine) for the same reason, although they act via a different mechanism and have differing physiological and qualitative effects.

Cocaine is a naturally occurring SNDRI with a fast onset and short duration (about two hours) that is widely encountered as a drug of abuse. Although their primary mechanisms of action are as NMDA receptor antagonists, ketamine and phencyclidine are also SNDRIs and are similarly encountered as drugs of abuse.
Hmmm…Lithium is an interesting tool in the bag of a skilled alchemist…8)

No wonder I feel like I’m in a better mood.