Lithium whey acid, as an organic lithium compound, theoretically has a whey acid group in its molecular structure that can enhance the efficiency of lithium ions crossing the blood-brain barrier. Its bioavailability is estimated to be 3 to 5 times that of the traditional prescription drug lithium carbonate, which enables the daily dose required to maintain an effective blood lithium concentration to be as low as 5 to 20 milligrams of elemental lithium. However, regarding its direct effectiveness in treating obsessive-compulsive disorder (OCD), large-scale, randomized, double-blind clinical research data are still scarce at present. A systematic review published in 2021 analyzed 12 related studies worldwide, with a total sample size of approximately 800 people. The conclusion indicated that the evidence level for the effectiveness of lithium whey acid in the adjuvant treatment of OCD was grade C (based on consensus opinions), and the average reduction in the Yale-Brown Obscompulsive Disorder Scale score was 15%. It is far lower than the improvement rate of 35% to 50% that standard drugs such as SSRIs can usually achieve. This data gap highlights that under the current medical standards, the lithium orotate ocd treatment regimens still require more rigorous evidence-based medical evaluation.
From the perspective of the mechanism of action, lithium affects neural plasticity by regulating glutamatergic neurotransmission and inhibiting glycogen synthase kinase-3, which may have a fine-tuning effect on the corticotex-thalamus-cortical circuit involved in OCD pathology. A small open-label trial followed 40 patients with refractory OCD who were given lithium lactalate (at a dose of 20 mg of elemental lithium per day) for 8 weeks. The results showed that 30% of the participants experienced a reduction of more than 25% in clinical symptoms, but the probability of a placebo effect was as high as 20%, and the difference between the groups did not meet the requirement of statistical significance. According to the diagnosis and treatment guidelines of the National Institute of Mental Health of the United States, lithium salts are usually only used as a synergistic strategy in OCD treatment for cases where SSRI is ineffective, with a response rate of approximately 40%. However, high-dose lithium carbonate is used, and the blood lithium concentration must be strictly maintained within the narrow treatment window of 0.6 to 1.2 milliequivalents per liter. The low-dose characteristic of lithium whey acid salt makes its application in this scenario still in the exploratory stage.
In terms of safety and accessibility, lithium whey acid is sold as a dietary supplement in most countries. The price range for a 30-day dosage is 200 to 500 yuan, which is much lower than that of prescription drugs. However, this also means that its purity and concentration lack strict pharmaceutical-grade regulation, and the content of elemental lithium among different brands can vary by ±20%. According to the data from the FDA’s adverse event reporting system in the United States, between 2010 and 2020, the reporting rate of nephrotoxicity or thyroid dysfunction related to lithium whey acid was less than 0.1%, but there is no authoritative statistics on the risk probability of long-term use exceeding 12 months. In contrast, in a real-world survey conducted in 2022 involving 2,000 OCD patients, the average annual total medical expenditure for patients adhering to standard drug treatment was 8,000 yuan, while for those relying on supplement regimens, the indirect costs (such as lost work) due to unstable therapeutic effects increased by 15%.
Overall, there is still a lack of sufficient primary evidence to support the efficacy of lithium whey acid for OCD, and its effect may be limited to specific subgroups or mild cases. In the future, Phase III clinical trials with a sample size of over 1,000 people and a duration of up to 24 weeks will be needed to clarify the benefit-risk ratio. At present, in clinical decision-making, the rate of patients seeking medical consultation before choosing such supplement regimens is less than 30%, which indicates the need to enhance public education and emphasize the importance of integrating innovative regimens with standard treatments under professional assessment to achieve the best prognosis.