Dr. Ruffalo at the home of Ronald Fieve, Palm
Beach, Florida. Dr. Fieve is the psychiatrist chiefly
responsible for the introduction of lithium to the
United States in the 1960s.
Lithium has been known to have beneficial effects on mood since the days of ancient Rome. Its discovery as an effective agent in psychiatry is credited to John Cade, who noted its antimanic properties in 1948. More recent studies have demonstrated lithium's effectiveness in depression and suicidality. A naturally occurring salt, lithium could never be patented by the pharmaceutical companies, and there is now widespread agreement in academic psychiatry that lithium is a vastly underutilized form of treatment.

Dr. Ruffalo has long had interest in the history of lithium therapy and authored a peer-reviewed article in 2017 titled, "A Brief History of Lithium Treatment in Psychiatry," published in the Primary Care Companion for Central Nervous System Disorders. He has also published relevant pieces on the history and benefits of lithium therapy in the popular media.

In recent years, there has been renewed interest in the potential use of low-dose lithium in the treatment of neurodegenerative diseases, major depression, and suicidality. Epidemiological research has consistently shown that higher trace amounts of lithium in the public water supply correlate with lower suicide rates, indicating that even tiny amounts of lithium can have effects on human mood. Anecdotal evidence supports the use of ultra-low-dose lithium for subthreshold bipolar disorder, depression, mood instability, anger, and irritability.

Since the side effects of lithium are dose-dependent, ultra-low-dose lithium is a safe and well-tolerated form of treatment. Its use does not necessitate the usual blood monitoring and thyroid testing required with full-dose lithium. There is good reason to believe that lithium itself is an element necessary for human survival, much like sodium and potassium.

Dr. Ruffalo is one of the few clinicians in the United States with interest in ultra-low-dose or "microdosing" of lithium. He has devoted a portion of his practice to the evaluation of patients for the appropriateness of ultra-low-dose lithium. For more information or to schedule an appointment, please click here.

Please note that ultra-low-dose lithium is not a suitable replacement for full-dose lithium. Not all patients are appropriate for ultra-low-dose lithium, and some may require other forms of pharmacotherapy, or psychotherapy.