These findings only make sense in context: they are population-level patterns, not statements about any individual's risk. At the population level, most ecological studies report an inverse association between lithium in drinking water and suicide rates, and some adolescent data link higher water lithium to less depression. These studies cannot prove causation, several are null, and none describe what lithium does for a given person.
If you or someone you know is struggling or in crisis, help is available now. In the United States, call or text 988 to reach the Suicide & Crisis Lifeline, 24/7, or chat at 988lifeline.org. Outside the US, contact your local emergency number or a regional crisis line. The research summarized below is population-level and is not guidance about any individual's risk.
Does lithium in drinking water lower suicide rates?
Most ecological studies report an inverse association — higher drinking-water lithium, lower regional suicide rates — but the evidence is population-level and not unanimous. A 2020 systematic review (Del Matto and colleagues, Neuroscience & Biobehavioral Reviews) found that 11 of 16 ecological studies reported higher water lithium linked to lower suicide (DOI). A 2020 meta-analysis (Barjasteh-Askari and colleagues, Journal of Affective Disorders) pooling 13 ecological studies plus one cohort (939 regions; roughly 3.7 million people) reported an odds ratio of 0.42 (95% CI 0.27 to 0.67) for reduced suicide (DOI). A separate 2020 review (Memon and colleagues, British Journal of Psychiatry) found the association significant for total and female suicide (DOI).
Not all studies agree. England (Kabacs and colleagues, 2011) and Denmark after adjustment (Knudsen and colleagues, 2017) were null, and a large 2021 review (Eyre-Watt and colleagues, across 113 million people) reported a modest pooled correlation (r = −0.19) while flagging publication bias and noting the ecological signal conflicts with some randomized-trial meta-analyses (DOI).
This is population-level research and says nothing about any individual's risk.
Is there a sex difference in the suicide findings?
Several studies report stronger associations in one sex than the other, but not in a consistent direction. An Iranian ecological study (Rafsanjan district, 2022; mean water lithium 47.3 µg/L) reported an overall correlation of r = −0.55 that strengthened to −0.73 in women. A Lithuanian study (Liaugaudaite and colleagues, 2017) found the inverse association mainly in men, and the 2020 Memon meta-analysis found the female-suicide signal stronger (DOI). The sex pattern is inconsistent across studies and remains unexplained.
What does adolescent data show about lithium and mood?
The most direct individual-level mood data come from Japanese adolescent surveys. Shimodera and colleagues (2010), studying school tap-water lithium across 24 junior high schools, reported that higher lithium was associated with less depression and less interpersonal violence but showed no association with suicidal ideation or self-harm. Later work from the same group (2018) examined other adolescent mental-health outcomes; the findings there were less consistent, and the direction is not settled. These are observational, self-reported survey findings, not tests of any supplement.
Suicide and mood study summary
| Study | Year | Region | Outcome | Direction |
|---|---|---|---|---|
| Schrauzer & Shrestha | 1990 | Texas, USA | Suicide, crime | Inverse (protective at higher levels) |
| Ohgami and colleagues | 2009 | Japan | Suicide | Inverse |
| Kabacs and colleagues | 2011 | England | Suicide | Null |
| Blüml and colleagues | 2013 | Texas, USA | Suicide | Inverse (226 counties) |
| Pompili and colleagues | 2015 | Italy | Suicide | Inverse (sex differences) |
| Knudsen and colleagues | 2017 | Denmark | Suicide | Null (after adjustment) |
| Liaugaudaite and colleagues | 2017 | Lithuania | Suicide | Inverse (men) |
| Rafsanjan study | 2022 | Iran | Suicide attempts | Inverse (stronger in women) |
| Shimodera and colleagues | 2010 | Japan | Adolescent depression / violence | Protective; null for ideation / self-harm |
Does low-dose or microdose lithium stabilize mood?
There is no established evidence that low-dose or microdose lithium supplements stabilize mood in the general population. It is important to keep three different things separate, because evidence about one does not transfer to the others: trace lithium in drinking water (micrograms per liter), lithium orotate sold as a low-dose supplement (a few milligrams of elemental lithium), and prescription lithium carbonate or citrate (hundreds of milligrams per day). The population mood signal comes from ambient water concentrations, not from tested supplements, and the adolescent findings are observational and self-reported. Prescription lithium is an established mood stabilizer in psychiatry, but that is a monitored medication at far higher doses, not a supplement. Substituting a supplement for prescribed treatment of a mood disorder can be dangerous.
Limitations and safety
Nearly all suicide evidence here is ecological — regional water levels compared with regional suicide rates — which cannot establish individual causation and is vulnerable to region-level confounders such as socioeconomic status, geology, and longevity. Findings are inconsistent (two null suicide studies; conflicting sex patterns), publication bias has been flagged (Eyre-Watt and colleagues, 2021; DOI), and the ecological signal conflicts with some randomized-trial meta-analyses. None of this supports using lithium in any form to manage mood without medical care. This page is population-level research, not individual-risk guidance or medical advice.
Frequently asked questions
Does lithium in water reduce suicide rates?
Most ecological studies report lower regional suicide rates where drinking-water lithium is higher, and a 2020 meta-analysis estimated an odds ratio of 0.42. However, these are population-level correlations that cannot prove causation, and some studies found no association. This is not individual-risk information. If you are in crisis, call or text 988 in the US.
Can low-dose lithium treat depression?
No supplement claim is established. The population research is based on ambient water levels, not tested supplements, and adolescent findings are observational. Prescription lithium is used in psychiatry under medical supervision, but that is not the same as a supplement. Depression should be managed with a qualified clinician.
Why are some lithium-and-suicide studies negative?
Studies in England and Denmark (after adjustment) found no association, and reviews have flagged publication bias and conflict with some randomized-trial data. Ecological studies depend heavily on how well they adjust for regional differences, which may explain why results vary.
Is the mood effect stronger in women or men?
The sex pattern is inconsistent. Some studies report stronger associations in women (Iran, 2022; the Memon meta-analysis), others mainly in men (Lithuania, 2017). The reason is unknown, and the inconsistency is itself a limitation of the evidence.
Should I take lithium for my mood?
This page does not recommend taking lithium for mood. The evidence is population-level and unproven for individuals, supplemental lithium is not well studied for safety, and self-treating a mood disorder can be harmful. Discuss any concerns with a healthcare professional; in crisis, call or text 988 in the US.