Researchers have found links between lithium in drinking water and regional patterns in mood-related outcomes. These studies help generate questions, but they cannot tell an individual whether lithium will help them. They also differ from the research behind prescription lithium treatment.
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?
Several reviews report that regions with higher drinking-water lithium often have lower suicide rates. These are mostly ecological studies: they compare regional averages rather than test an intervention in individuals. A 2020 review found an inverse association, while a larger review also highlighted inconsistent findings and possible publication bias. The practical point is that this research does not show whether taking lithium will help an individual.
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?
Observational adolescent studies ask whether water exposure is associated with reported symptoms or behavior. They do not test a lithium supplement, and results about one outcome cannot be generalized to mood overall. The evidence reviewed here does not establish a reason to give teenagers supplemental lithium.
Suicide and mood study summary
| Study | Year | Region | Outcome | Direction |
|---|---|---|---|---|
| Schrauzer & Shrestha | 1990 | Texas, USA | Suicide, crime | Inverse association |
| 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 | Reported association; not a supplement trial |
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 (medication doses that must be distinguished from elemental-lithium content). 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?
Several studies found lower regional suicide rates where water lithium was higher; others did not. Regional associations cannot establish individual benefit or guide personal suicide-risk decisions.
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.
Related pages
- Lithium and the brain: the complete guide
- Lithium in drinking water
- Lithium orotate vs carbonate: forms, dosing, safety
- Lithium across the lifespan
- What the research actually says: the evidence
References
- Barjasteh-Askari, Davoudi, Amini et al. (2020). Relationship between suicide mortality and lithium in drinking water: A systematic review and meta-analysis. Journal of Affective Disorders.
- Del Matto, Muscas, Murru et al. (2020). Lithium and suicide prevention in mood disorders and in the general population: A systematic review. Neuroscience & Biobehavioral Reviews.
- Eyre-Watt, Mahendran, Suetani et al. (2020). The association between lithium in drinking water and neuropsychiatric outcomes: A systematic review and meta-analysis from across 2678 regions containing 113 million people. Australian & New Zealand Journal of Psychiatry.
- Memon, Rogers, Fitzsimmons et al. (2020). Association between naturally occurring lithium in drinking water and suicide rates: systematic review and meta-analysis of ecological studies. The British Journal of Psychiatry.
