Episode description

Lithium. Anyone who had a heartbeat in the 90s knows that Nirvana song backward. Speaking of, Rod’s claim to fame is meeting Kurt Cobain and the boys but that’s a story for another time. The lithium we speak of today is the light, flammable, silvery white metal found naturally in nearly all rocks. It rose to fame as the star ingredient in the first man-made nuclear reaction. But lithium is no one-hit-wonder.

Lithium is also a medication that helps to stabilise the moods of millions of people with bipolar disorder. How the heck did anyone discover that? Did someone take the term “eat rocks” literally?

Well, in the early 20th century, lithium was seen as a bit of a "cure-all". It was even in the original 7-Up recipe! But when it comes to using lithium to treat bipolar, the credit must go to Dr John Cade. Born in country Victoria in 1912, as a young boy, Cade actually lived in a number of asylums. He wasn’t a patient though. His father was a doctor who worked in the Mental Hygiene Department so the whole family lived together on campus. 

Every single day, he observed mentally ill patients and Cade eventually studied medicine and became a psychiatrist. However during World War II, while serving in Singapore as a surgeon, he became a prisoner of war for three and a half years. During this time, he obviously endured a brutal existence, but he also made some very interesting observations. 

See, up until that point, the standard wisdom was that serious mental illness was caused by a poor upbringing, bad morals and the like. Too much grunge music perhaps. But what Cade observed during those harrowing years in the POW camp, was that serious mental illness can be caused by biological changes. So upon returning to Australia, he got to work. 

Cade had a theory that mania and depression were caused by excess and deficiency of a naturally occurring substance in the body. The solution was of course… urine!

Being the supportive woman she was, Cade’s wife, Jean, started accumulating jars. Buttloads of them. Cade convinced her that if his research came to nothing, they could use them for pickling. Sooo many pickles. And yes, she stored them in the fridge. Eww.

Then, Cade got a bunch of guinea pigs and injected the urine into their abdominal cavities. Sadly, they all died. He thought perhaps the two toxic substances in urine, urea and uric acid might work in tandem to make the urine of manic patients more toxic. He just needed some way to convert urea into a substance that he could more easily manipulate. Enter lithium. 

Now, Cade needed to check if lithium was causing any confounds, so he injected the guinea pigs with a lithium carbonate solution. They didn’t die. In fact, they became docile and super chill. So he did what any dedicated scientist would do. He tested it on himself. 

In 1948, after not dying of lithium poisoning, Cade decided it was safe to give 10 of his patients the same treatment. One of his patients had been psychotic for more than 30 years and after two months of treatment, he walked out of the asylum back to his old job, perfectly sane. In fact, 5 out of the 10 people Dr Cade treated had improved enough to return to their homes and families. Nothing had been seen like it in mental health before. 

But what about side effects? 

Unfortunately, Cade was unaware that too much lithium is toxic and his pioneering patient died in 1950 due to lithium toxicity. Devastated, Cade abandoned his experiments with lithium, passing the chill pill over to psychiatrists Mogens Schou and Poul Baastrup to characterise its safety profile. Thanks to them all, this ubiquitous element, easily processed into medication and never patented by pharmaceutical companies, remains both cheap and invaluable as a treatment for troubling mental health diagnoses.

In 1980, Dr Cade died with many honours, including medical units, fellowships, and awards being named after him.

SOURCES:

• News.com.au: Finding Sanity: How an Australian doctor discovered the first drug to treat mental illness
• ABC: The history of lithium, and its remarkable impact on mood disorders
• ABC: Remembering John Cade, the Australian doctor who tamed bipolar disorder
• Live Science: What Is Lithium?
• Wikipedia: Lithium
• Nature: Lithium: the gripping history of a psychiatric success story
• PsychCentral: What Is Lithium-Induced Nephrogenic Diabetes Insipidus?
• Drugs.com: Lithium: 7 things you should know

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