It has been claimed that taking dietary lithium supplements has mental health benefits, but the doses are far lower than those prescribed for the treatment of psychiatric disorders. It is not known if such low doses result in measurable levels of lithium in the brain. We have developed a magnetic resonance imaging scan that can show the distribution of lithium in the brain when taken at prescribed doses and have been using it to study people with bipolar disorder. We now want to find out if we can detect lithium in the brain after dietary lithium supplementation. The project will provide new insights into the use of such supplements.
Team Lithium is involved in a major project which aims to identify early predictors of a good response to lithium in individuals with Bipolar Disorder. This EU funding represents the largest single investment in lithium-related research and will link together at least 15 centres in Europe.
The Response to Li Network (R-LiNK) proposes the detailed assessment of people before and after lithium treatment is initiated, to better understand early biomarkers of response. Response will be measured over a two year follow-up period and will likely lead to us being able to help people make an informed choice about starting lithium based on their likelihood of response. This study will link a multidisciplinary international network of experts, who will pool resources and skills to ensure that the most cutting edge technologies are being developed and used.
People with Bipolar Disorder are eligible to join the study if their usual care team has suggested that they start lithium – the study simply adds to that by doing a more in depth assessment and follow up. Assessments include blood tests, brain scans and charting of mood with smartphones and activity trackers. More specifically, the blood tests include cutting edge assessments with measures of blood “omics” (genes, mRNA, proteins and metabolites) whilst advanced structural brain imaging scans will be performed.
This project will also aim to develop a home-based device for measuring salivary lithium (to improve monitoring without frequent blood tests) and an interactive package that allows self-rating of mental state. It is hoped that these developments will aid adherence, while also contributing to cost-effective, individualised care.
Team Lithium have a major role in the project, leading on the set up of lithium imaging in key centres. Having developed the ability to chart the distribution of lithium in the brain, this project will permit other centres to conduct cutting edge research with the goal of better predicting response to lithium, and of course studies seeking to understand its mode of action. We currently have several patients involved and the initial scans are underway. But, we are still hoping for more recruits!
Many people with bipolar disorder do well with lithium and decide to take it in the long term, finding that it reduces the risk of relapse. Unfortunately, this is not the case for everyone – some notice only a slight benefit, others none at all. We are trying to find out if there are differences between responders and non-responders so that in the future, psychiatrists will have a better idea who should be offered lithium; patients will be able to make more informed choices. This is such an important topic that the Medical Research Council invested over £1M in our study.
Recruitment for MRC_BLISS is now closed and the study is in its final stages. Stay tuned for updates!