Lithium – Power to the people
BY DR CLIVE FRASER
It’s been 70 years since an Australian ex-Changi POW named Dr John Cade treated his first patient with lithium.
On March 29, 1948, Dr Cade commenced treating Mr WB who was described as: “A male, aged fifty-one years, who had been in a state of chronic manic excitement for five years, restless, dirty, destructive, mischievous and interfering, (he) had long been regarded as the most troublesome patient in the ward.”
Cade went on to state that: “His response (to lithium) was highly gratifying. From the start of treatment … with lithium citrate he steadily settled down and in three weeks was enjoying the unaccustomed surroundings of the convalescent ward.”
Cade said that with lithium treatment Mr WB: “remained perfectly well and left hospital on July 9, 1948, on indefinite leave with instructions to take a maintenance dose of lithium carbonate, five grains twice a day.”
In today’s money that’s 330mg bd, which is uncannily similar to a 21st century lithium dose.
With bipolar disorder continually in the top ten in Global Burden of Disease reports one might have thought that Dr Cade was worthy of a Nobel Prize.
But his revelation went largely unheralded in the United States.
It seems that a big hurdle there was a US decision to ban lithium from soft drinks.
From 1929 until 1950 anyone who purchased 7 Up (aka Lithiated Lemon Soda) was getting an extra dose of lithium in their liquid refreshment.
Sure, from 1886 until 1929 Coca-Cola had actually contained cocaine, which was later replaced with caffeine.
So, the idea of removing drugs from food and beverages had merit.
But it wouldn’t be until 1970 that the US Food and Drug Administration would list lithium as a treatment for Bipolar Disorder, after it had already been approved by 49 other countries, and 21 years after Cade’s first publication in the Medical Journal of Australia.
Lithium was named from the Greek word lithos, meaning stone.
In its pure form it is shiny and metallic.
It was discovered in 1817 by a Swedish chemist (Johan August Arfwedson) in naturally occurring Petalite.
In 1923 a German company (Metallgesellschaft AG) began commercial production and by 1939 lithium was being added to grease to increase its usable temperature to 120 °C.
This ability to extend the thermal properties of a product saw its use in the production of CorningWare, a product that could withstand a sudden temperature differential of 450 °C.
In the form of petalite it was also used as a heat-resistant material for the nose cones of ballistic missiles.
Oh, and lithium turns up in all sorts of other places in weaponry.
If lithium 6 is bombarded with neutrons in nuclear reactions tritium is produced. Under extreme temperatures and pressures, tritium atoms fuse with deuterium to release both neutrons and large amounts of energy.
This fusion reaction is the key to the hydrogen bombs that are far more destructive than the atomic bombs used at Hiroshima and Nagasaki
The United States has a stockpile of 42,000 tonnes of lithium hydroxide, just in case.
With an atomic number of three and an outer available valence electron lithium has just the right chemical structure for use in batteries.
Lithium-ion batteries were being used in implantable medical devices long before they found their way into smartphones.
But lithium batteries in cars is really where the future lies
The price of lithium has surged by 45 per cent in the past year which might give some indication of where the use of lithium is heading.
Dr Cade is hopefully looking on with some degree of comfort that his pioneering research with lithium has helped so many.
Doctor Clive Fraser
Published: 09 Oct 2018