CEimpact Podcast

Microdose Lithium in Alzheimer's Treatment

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Recent preclinical studies highlight the potential of micro‑dosed lithium to modulate Alzheimer’s disease pathology and support neuronal health. This episode examines the molecular mechanisms, current evidence in Alzheimer’s models, and emerging considerations for safe use and monitoring. You will gain insights to navigate this evolving topic and support informed discussions around lithium micro‑dosing in Alzheimer’s care.

HOST
Rachel Maynard, PharmD
GameChangers Podcast Host and Clinical Editor, CEimpact
Lead Editor, Pyrls

GUEST
Dawn Gerber, PharmD, BCGP, FASCP, FAzPA, CPAFH
Professor of Pharmacy Practice
Midwestern University

PRACTICE RESOURCE
Purchase this course to receive the exclusive downloadable practice resource handout to use as a reference guide to the podcast.

CPE REDEMPTION
This course is accredited for continuing pharmacy education! Click the link below that applies to you to take the exam and evaluation:


CPE INFORMATION
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Describe current evidence on the use of microdose lithium in Alzheimer's disease.
2. Identify pharmacist considerations for monitoring, patient selection, and safety in the context of lithium micro-dosing for Alzheimer's.

Rachel Maynard and Dawn Gerber have no relevant financial relationships to disclose.

0.05 CEU/0.5 Hr
UAN: 0107-0000-25-375-H01-P
Initial release date: 12/22/2025
Expiration date: 12/22/2026
Additional CPE details can be found here.

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SPEAKER_00:

Here on Game Changers, we're all about helping you stay ahead of pharmacy practice. But why stop at listening? You can earn CE credit for this episode and hundreds more by visiting CEimpact.com and logging into your account or creating a new one. Get credit, get inspired, and make your learning count. Hey CE Impact subscribers, and welcome to the Game Changers Clinical Conversations Podcast. I'm your host, Rachel Maynard, and I'm super excited about our discussion today. We're going to be talking about Alzheimer's disease. And about 7 million people in the U.S. are living with this condition. And I think many of us may have had our own experiences with Alzheimer's and seen its impact either directly with our own friends or family members or when interacting with our patients or their caregivers. And there's currently no cure for Alzheimer's, but there are strategies we can suggest to help improve symptoms. But it's still very challenging to manage, and that's what I think interests people in any potential new treatment option where they're looking for something, and we want to better understand any potential option so that we can put it in perspective. And so today we're going to be looking at whether microdosing of lithium plays a role in managing Alzheimer's because it's gotten some attention lately. And so we're going to be looking at whether there's any good evidence to support its use. And so I'm thrilled that our guest today can share her expertise in this area. And I'd now like to welcome Dr. Dawn Gerber to our discussion. So welcome, Dawn.

SPEAKER_02:

Thank you so much. Happy to be here.

SPEAKER_00:

Okay, great. And maybe you could share a little bit of background about yourself, your current role, and I think that might tie into why you're interested in this topic too.

SPEAKER_02:

Excellent. Yeah, happy to be here. So I'm Dr. Dawn Gerber. I'm a professor at Midwestern University in the lovely Arizona desert. And people may not realize this, but in Arizona, very similar to Florida, we have communities where you have to be 65 or 55 and above to live in those communities. And then even in those communities, a lot of the Phoenix and Tucson area are older adults. So I practiced for 17 and a half years in a primary care clinic in those cities. So working with geriatric patients, and you know, so much of our population because of the baby boomers is geriatric by default. So worked a lot in the primary care setting with polypharmacy and a lot of patients wanting to know, you know, you know, grandma's Alzheimer's medication isn't making any difference, or what can I do to prevent myself from Alzheimer's? So this is a topic that is near and dear to my heart.

SPEAKER_00:

Excellent. Well, very, very happy to have your perspective on this. And I'm sure you have a lot of you know personal experiences that you can bring to this discussion. So just very thankful for your time and for you sharing your expertise with us today. Let's go ahead and get started and just get on the same page about what Alzheimer's is. So, what causes it, what are the risk factors for it, you know, symptoms, and let's start there.

SPEAKER_02:

Sure. So definitely with the major risk factors, obviously connected with age. The older, the older the patient gets, the more risk that there is for Alzheimer's. Although we do see a decline if patients in general, if they don't develop Alzheimer's by about 80 to 85, then that that risk actually decreases. When it comes to the pathophysiology of Alzheimer's disease, we, the scientific community, we don't have a this is absolutely, you know, 100% what causes this disease. We talk a lot in science about how Alzheimer's disease is a diagnosis at post-mortem. Um, so a lot of what we talk about is, and especially if you really look into the literature about this, it's a lot of like highly probable Alzheimer's, likely, maybe, potentially. And so that is something that I think ties in nicely with this topic. And why there's probably a lot of frustration with patients of, you know, when we're talking to patients in a medical term, we use words like probably, likely, you know, and that's frustrating. You know, I get that. As a patient, you want black and white, and unfortunately, this disease just isn't. And then especially since 2020, we've had the new mabs of the monoclonal antibodies that have made huge headlines and related to tau tangles, plaques, and then along with that, the ApoE allele formation, where increase being a high risk factor with ApoE4 puts you at high risk for Alzheimer's disease. And you may have heard of like Chris Hemsworth getting tested and that being beta splash too. So we also know that cardiovascular disease, sedentary lifestyle, unfortunately, lower levels of education are also associated with Alzheimer's disease as well. And then unfortunately, because we don't really understand the true black and white nature, patients that you would just never guess can end up with Alzheimer's disease.

SPEAKER_00:

So, what are the most common? We might so it sounds like we don't have a good understanding of necessarily the pathophysiology. There is some proposed, you know, theories, right? And and you mentioned the plaques and the tangles. So maybe you could talk just a little bit more about that for our our understanding here. And I think that would help explain how those newer MABs, like you said, are coming into the picture too.

SPEAKER_02:

Yeah, so it actually ties back to that post-mortem diagnosis as looking at the patient's brain and seeing these plaques and and tau's, and the fact that we deaf we say that patients who have been diagnosed pre-mortem with Alzheimer's disease, or likely Alzheimer's disease, present with these changes. We also have the anticholinergicolinergic seesaw, and that's where some of our traditional medications, our oral traditional or I should say, oral medications like dinepazil and mementine, they come into play. And so there's a lot of discussion, but it's it's a little bit of a chicken in the egg. So do the tau and plaque do they cause or are they, you know, somehow correlated, but not a direct cause? And I think that ties into these newer medications, the maps. We only have, I think the longest research that's been published at this time is like 74, 75 months, right? We're not, and this is a disease of years, right? And so we still are trying to figure out a little bit of chicken and the egg. If we remove these, does it reverse the damage that's already done, or does removing them just leave the patient kind of where they are at, or does it cause reversal? We don't really know. I think we're gonna see a lot in the future, but I think it also does this this kind of nebulous discussion also lends itself to patients wanting to take matters into their maybe their own hands and trying to find you know answers that aren't out there, that you know, are are out there on the internet.

SPEAKER_00:

Yeah, and and I guess to to bring that home to some of the symptoms and common issues that patients have, because maybe you can also clarify there's Alzheimer's disease. Is that always dementia or are they sort of different concepts and or do they always happen together? Some of the symptoms and just the complications that patients have to manage on a daily basis. What does that look like?

SPEAKER_02:

Yeah, absolutely. So there's definitely dementia is an umbrella term, right? And we use it for so many conditions. In fact, I was just having a conversation with an older adult yesterday, and they were like, oh, so I have the same thing as maybe another celebrity that's that's pretty famous that has temporal lobe dementia versus the famous comedian who had Lewy body dementia, right? And those two, compared to Alzheimer's disease, are all very different in their symptoms and their pathology and what the speed of the condition is as well. But if we're just talking about general Alzheimer's, you know, it's memory loss plus is what I explained to patients. So if you look at the diagnostic criteria, it's memory loss plus maybe speech difficulty and executive function difficulty. So it's not just memory loss. There has to be that plus. Something else is going on that impairs the patient's ability. And I think most of us recognize that a little bit of memory loss is somewhat viewed as common, but when it starts impacting ability to, I always use the example of make a grocery list, go to the grocery store, buy the groceries you need, come home and come home, that's where we see the impact of Alzheimer's disease. I I had an uncle who ended up on the highway because he went to the grocery store, forgot where he parked, and then just started walking and then, you know, walking along the highway. I'm from a small community in Iowa. And thankfully, you know, somebody called my father and was like, hey, I saw your uncle walking on the road.

SPEAKER_01:

Right.

SPEAKER_02:

So that's where a lot of our, you know, people don't die from Alzheimer's disease. They die from accidents, just like what happened to my great uncle. They die from malnutrition, dehydration, because they forget to eat, right? They die from infections, pneumonia is really high. So people don't necessarily die from Alzheimer's, but they die from the consequences of what that causes.

SPEAKER_00:

Okay. All right. So you talked about how this can, you gave a very good example of how this can directly impact patients' lives and be a very devastating sort of illness. So to your point earlier about people looking for something to help manage this condition, I think that ties into why we're starting to see, you know, all kinds of things people might be interested in trying for Alzheimer's to help manage those symptoms. And that brings us to our discussion today, which is microdosing of lithium for Alzheimer's. And that's gotten a little bit of buzz lately. Some headlines have come out about this. So let's just first think about lithium, traditional use of lithium before we get into the microdosing side of things, and just again, quick overview of lithium and its traditional role, and then maybe how that has either led to some of its interest for Alzheimer's or where that sort of interest is coming from.

SPEAKER_02:

Sure. So, you know, current guidelines for Alzheimer's disease and current prescription FDA-approved medications, there's nothing for prevention, and we know that that that's a big area. So the history of microdosing, or even just looking at the history of lithium, and there's a great, there's a great publication that was published just recently, actually, in 2025, in the Journal of Pharmaceuticals, did a great job of kind of outlining this. And so the history is really kind of looking at some of those population models and observation, which we know from current discussions with you know vaccines and things like that, is that causation is not correlation is not causation. And so, really, where lithium kind of got its start with maybe some discussion about Alzheimer's disease is population studies looking at that populations that lived in areas and consumed water with because lithium is naturally occurring, that when they drank water that had very tiny concentrations of lithium, that these populations seemed to have lower incidence of Alzheimer's disease compared to populations that didn't live or in areas where lithium was naturally occurring and they were exposed to it via their environment or water. And so once again, causation, correlation, it's hard to say there. Another area where this has kind of come into play is that very early, going back all the way to the very early 1970s, patients being treated with lithium for bipolar disease seem to have less incidence of Alzheimer's disease as well. And so that is between the two of those, that's really I think where the conversation started. And if you look at lithium's traditional role, so it's a first-line mood stabilizer for acute mania, and then, if appropriate, maintenance and bipolar disorder. It's also used sometimes adjunct for treatment-resistant depression because it has some anti-suicidal benefits as well. It is involved with neurotransmitters. There's some very preliminary discussion about how does it affect possible plaques and tau's, right? Which are very similar to that pathology that's being explored for Alzheimer's disease. But really, that is in very early, early, early, you know, stages. We're talking cellular models, we're talking mice models, things like things like that. So I can see where there'd be an interest in, hey, we're seeing this with this condition, let's invest investigate it for another. But unfortunately, lithium is not the first line treatment for patients who are older adults. And I'm defining that as 55 depending on your disease states, or 65 kind of in general. And so we don't use lithium because of the very high risk of that narrow therapeutic index that lithium has. Um, you know, I reference, I did not work with, I worked with a general geriatric population, but we j I just did not see very much lithium being used even for patients with bipolar because of the risks associated with lithium, even in treating bipolar.

SPEAKER_00:

Interesting. Okay. So a few things you said. First of all, I find it really fascinating that some of the interest in lithium for Alzheimer's was generated by, as you say, like these epidemiological sort of studies, where they're seeing, okay, there's trace lithium in the water, and we're seeing lower rates of dementia. So maybe there's some link between lithium and dementia and reducing dementia risk. That's a very interesting sort of concept. And those sorts of things are always, you know, what may generate future research and evidence that then does support some broader role. So very interesting about how that came about. And then also, you know, how you're saying that that even patients who have been using lithium for bipolar, traditionally, there's been some link there as well, it sounds like so that some of those patients may have had lower rates of dementia, but for using lithium for a different condition. Okay. So that's all very interesting. And then also observational data.

SPEAKER_02:

So that's really important, right? Not head-to-head, not comparison, it's observational data.

SPEAKER_00:

Right, right. So not saying, okay, let's see if lithium is a is an effective treatment for Alzheimer's, that randomized controlled trial sort of format. Okay. So none of that out there. And then, but then the contrast that you also shared is is really good perspective. The fact that even regardless of the role of lithium potential role in Alzheimer's, you tend to steer away from the from lithium in general in older adults because of the risks that you mentioned, the neurotherapeutic index, risk of interactions, potential side effects. So, regardless of any potential benefit, it's generally a drug you tend to avoid otherwise. Is that right?

SPEAKER_02:

Yeah, especially in Arizona. We already have our older adults that are at risk for dehydration during our very intense summers. And dehydration is one of the number one risk factors for lithium toxicity leading to death. And so, you know, we worry about dehydration in older adults in general. Although my hope is with all these, you know, cups running around in the millennial generation, maybe we won't see the dehydration risk that we see in the baby boomer generation. So maybe that, you know, maybe all these, you know, fancy, fancy cups will help with that. Um, but yeah, we do worry about the long-term, right? It's risk and benefit. So always, yeah. The long-term exposure to lithium, even when it's it's within that narrow therapeutic window, there are still risks. And it doesn't even, it's, you know, I have patients who tell me, like, oh, well, I haven't been on this very long, or I, or I don't take it very often, just talking about medications in general.

SPEAKER_00:

Yeah, yeah.

SPEAKER_02:

But if if a patient becomes, you know, just a one-time just because of situation dehydrated and they're taking lithium, that can skyrocket their lithium levels. They take I wish I could get NSATs kind of that third category, you know, at pharmacy where you have to ask for it and there's some screening questions. Um, because you know, just even NSATs can increase that risk of toxicity with lithium. So even if the patient is monitored, they're within that narrow therapeutic window, and they, you know, roll an ankle doing pickleball with the grandkids, they go to the OTC aisle and they don't have to speak to anyone to purchase, you know, ibuprofen or neproxen uh, you know, medications in that category. And now suddenly a patient who is closely monitored by their physician can do something totally, and no one thinks, oh, well, this medication over the counter that's gonna affect my bipolar medication. Patients just don't have that connection. So even, you know, a couple of doses of NSAIDs because you rolled your ankle playing pickleball with the grandkids can suddenly lead to an acute emergency situation with um closely monitored lithium.

SPEAKER_00:

Yeah, yeah. And you know, I'd say I love that example because it is one of these things that just it can tip the balance for whatever reason. The you can tip that balance, and it could be dehydration from working out in the yard or having a bad diarrhea or whatever. You know, there's all kinds of things that these, you know, all these situations can come together and create the sort of perfect storms that causes an issue. So I think that's a really important point. But I think that's probably where some of the interest in microdosing is coming from, perhaps, because that, you know, in theory is using a lower dose. So maybe you can speak a little bit more about what that actually means and what this microdosing concept is.

SPEAKER_02:

So it really is a true concept, um, and that there is no standardized, we have a we have a lot of standardized. Studies looking at this, and there is not a standardized this is the therapeutic window in humans that we are looking at. In fact, one of the very, very few studies that actually did look at this in humans, unfortunately, was a 10 weeks. It was only 10 weeks study. And it was really looking at kind of what I call surrogate markers. So BDNF serum concentration. And so it was looking at 0.5 to 0.8 millimoles. So once again, kind of the dosing thing, right? We dose it based on serum levels. This is being able to say right, right, you know, one microgram is what you need. And so when you look at the actual doses that are being used, when you're looking at those, you know scattergrams, they're they're all over the place because it's based on serum levels that are being monitored through blood work. And I think that makes it hard to also come up with a you know what dose is effective, what dose is being studied, because that's not even how we dose, right? Let me find in my research I did have so microdosing in the research. When they look at what's the kind of that average dose for those people that are trying to get that serum level, keep in mind these are very tiny, tiny. That study that I just referenced was 27 people.

unknown:

Yeah.

SPEAKER_02:

Looks about 300 micrograms per day of lithium carbonate or lithium orate. Um, that was roughly, but once again, we're not talking thousands of people.

SPEAKER_03:

Right.

SPEAKER_02:

And we're looking at very a medication that really does need to be individualized. And this is about one third to one fifth of the average lithium dose for like bipolar. But once again, even for bipolar, you treat to the serum level, not the dose.

SPEAKER_00:

Right. So, bottom line is the theory of microdosing would be to use a lower dose to help minimize any of those potential side effects or interaction concerns, but we have no good data to say what that micro dose, even if we wanted to use a smaller dose, should be, or even what salts of lithium to use, because there are multiple salts and we don't know which one would be preferred either for that reason. Okay.

SPEAKER_02:

Okay. Absolutely. Absolutely. And most of the research that you know you talk about making a splash in in the press, they are, you know, I I love this title, lithium and neuroprotection. And that's all that you you hear, but then when you you know get into it, it's cell models and it's it's mice models. And none of our none of the studies were looking at what I call clinical outcomes, right? Right, right. Did we delay patients from going into the going into assisted care? Did we prevent emergency room visits? Did we prevent patients from you know, economics? So much of patients with Alzheimer's disease, it doesn't hit, you know, until something dramatic happens where a family member discovers there's no money to pay the bills. You know, none of those markers that actually mean something, none of that has been. Even in our cause, and even in our population models, they're not looking at those clinical outcomes that is what patients want, right? The P, the patient or the family member, they want to not go into them into the nursery. They don't want the finances of their loved one to be, you know, a mess. They don't want to, you know, have these, you know, where grandma doesn't remember, you know, the names of the grandchildren. That's what's important to the patients. And when you think about the four M's of geriatrics, of what matters most, mentation mobility. Well, even microdosing, there's always issues with, especially long term, of mobility issues, which ties into the fore Ms of geriatrics, the mentation. A lot of these studies talk about how there seems to be less cognitive decline, but reaction time slow down. And and and there's a slowing down of like ability to, you know, to complete activities. You know, that's that's that mobility piece is so important with geriatrics. And then unfortunately, the the continuing of the Alzheimer's disease, the worsening of cognitive dec of cognitive decline or the worsening of cognitive decline actually mimics what lithium toxicity can look like. And so unfortunately, you could get into this, you know, cycle of well, this it looks like the symptoms are getting worse. I'm gonna up the dose of the microdosing, but actually it's a sign of lithium toxicity. So that's you know a challenge as well.

SPEAKER_00:

That could be very hard to tease apart. So, bottom line in terms of the evidence, we only really have these population-based observational studies that have suggested a link to generate hypotheses, but not necessarily change practice. The we also have some animal studies or in vitro studies, again, not anything that would change practice necessarily, but then we also have some small human studies, but not looking at the outcomes that matter to patients. Is that sort of where we are in the state of the evidence currently? Okay, okay. Perfect sorry. All right. So, given that, if you had a patient who asked you today, or their caregiver, should I take I heard about microdosing lithium, I heard it's really great for managing Alzheimer symptoms. Is this a valid option that I should be considering? How would you respond to that patient or caregiver?

SPEAKER_02:

I would talk about how it's really too early in the science to talk about using low-dose lithium. I would also talk to them about how complicated lithium monitoring is. It is not a simple, I'll, you know, order this off the internet and a DIY talking about how important monitoring levels are. And that requires frequent blood work. And when we talk about, you know, healthcare burden, yeah, we have to have the risks and the and the benefits. I would talk about, and I think that's something that the lay press doesn't do a great job, that you know, we get splashy headlines. It was in 27 people, it was in mice, it was in cells, right? That being said, that the evidence is still preliminary, and that this a lot of this preliminary data, maybe in the future, maybe in the future we'll we'll see some benefit, but right now it's just not ready for prime time, and especially it's not ready for you know DIY off the internet.

SPEAKER_00:

Yeah, and so we didn't even really talk about that. So you're you mentioned you know, off the edge on that, it is something there are lithium supplements that people can buy online, and so that's uh maybe you could talk a little bit about that. Like say somebody has already bought it and they come up to the counter and say, Hey, I got this, I read about this, you know, is this the right product for me? Then, you know, say they've already sort of gone that extra step. Where would you take that conversation?

SPEAKER_02:

Yeah, so definitely if I had a patient coming to me and it was in their, you know, bag of medicines or dietary supplements or things like that. I I think I'm very conservative in my practice. I think I've seen way too many geriatric patients where things went horribly wrong. So I'm I'm I'm pretty, pretty conservative. So I think my first reaction would be contacting their primary care doctor and saying, we really need to get a blood level. Let's let's see, you know, how much you're actually being exposed to. Because, you know, as pharmacists, we know that what you what patients find off the internet, maybe it has zero lithium in it, and maybe I don't need to be concerned. Maybe it has 800, you know, grams of lithium in it. You know, I we don't know. So the first thing I would definitely do is I would contact their primary care physician and ask for a lithium level to see, you know, has the patient been exposed? I would also start asking about how they're how they're feeling. I would ask about NSAID use. I would ask about, you know, our common blood pressure medications. We didn't even, you know, we didn't even get a chance to talk about, you know, are they on any blood pressure medications? Are they on any diuretics? And then really talking about how if they're on diuretics, if they're on, you know, an ace or an R, then I would definitely talk about, hey, the long-term risk of you becoming toxic on this, even at a microdose, right, is is is pretty significant. And the adverse effects are are not they're not mild. You know, I always think back of you know, gum recession and having like zombie mouth due to when we didn't have any other options, right? And patients just had to deal with the adverse effects for medications that you know treated bipolar schizophrenia. We have so much better options. They don't have to do that. Now, if a patient came to me and they were they were on lithium, you know, and maybe I was having they were having compliance issues and they were having bipolar episodes that were damaging to their health or their financial well-being, maybe I would use that as a little bit of carrot if there were compliance issues that were leading to hospitalizations or you know, bad outcomes, and say, like, hey, you know, if if you take lithium for bipolar, there might be this added benefit. So I think there's two two two groups to approach the group who's trying to DIY, and then maybe there was some compliance issues, and lithium was treating effectively the bipolar use it as a case.

SPEAKER_00:

Yeah, and I think, you know, I in my mind, I'm really thinking about the people who have heard about this microdosing concept and have wanted to try it over the counter. And those people, like I think what you've made very clear in your discussion here is that even though it might be microdosing, it's over-the-counter, it's a supplement, it's not, you know, something I need a prescription for, it doesn't mean it's safe. There still still can be risks. And like you said, just with supplements in general, the fact that they are not regulated the same way as drugs, they might have nothing, they might have high doses, or they may have other contaminants or other ingredients that the patient may not even realize. And to your point about older adults being at higher risk for some of these issues because of polypharmacy and all these other things like that, supplements are not necessarily benign. So even though they might be thinking, oh, it's not gonna not harm me, or you know, there's minimal risk, it's over-the-counter, there still can be some risk. And I think that's a really important point to drive home in some of these conversations, too. And then to your point about adherence, too, even outside of the potential role in bipolar for lithium, you know, adding on a supplement in addition to the other medications they're taking is another pill to take, and could impact adherence to other medications that are actually providing benefits. So, so I guess what would you help steer patients toward if they were looking for something to help manage their symptoms? What could we suggest instead that might be a safer or more appropriate alternative for their Alzheimer symptoms?

SPEAKER_01:

Absolutely. So, you know, if we're we're following the lines of lithium microdosing or neuroprotection, we actually do have interventions that have been proven to have neuroprotection and actually do align with the forums of geriatrics. So mobility, so exercise has people who exercise have shown to have decreased risk of Alzheimer's disease. Once again, population models are similar to the you know observational studies, but what's the downside, right? What's the downside of exercising? And oftentimes when I talk to my geriatric patients about exercising, you know, sometimes there's this whole like oh, you know, I haven't, you know, I want a honor, I don't exercise. And the benefits that we see with exercise, it's literally going for a while, right? Just literally going three times a week, and it doesn't have to be a 5k. And for weightlifting for older for over here, over the ball females, there's so many benefits, and it doesn't have to be, you know, the weightlifting competition, it can literally be the mobility issues sitting in a chair and doing you know, two-pound weights or soup cans, or you know, what you have in the home. And so we do know consistent movement, and maybe that's a better way to describe it instead of exercise. Consistent movement does help prevent Alzheimer's disease, it increases balance, it creates it helps with medication. So those, you know, that's an easy answer right there. Also, with a lot of gyms and community centers, it hits the you know social aspect. And we know that patients that are invested in their community who are involved in things outside their home and giving to others have lower risk of Alzheimer's disease. So, you know, going to a community center and blocking the track and chatting with people and getting outside your home and maybe getting involved in a community service. All of those things have benefits across the four ends of geriatrics, including meditation and mobility, and very little outside. So I would say, you know, exercise. There's also learning something new, and it doesn't have to be academic. Learning a new learning, learning, you know, taking on new, you know, learning something new also seems to help have some neural protection as well. And so once again, you know, it's on all of those items of getting out of the community, doing something, learning something new, uh, you know, and then it could have management of symptoms for Alzheimer's disease, you know, maybe whatever who is getting frustrated because you know they expect problematic medications not and we don't scientific from the scientific community, we don't do a good enough job talking about pain. This is one of those disease dates and medications where no change medications, you know, California stop sign, they're just gonna slowly roll through Alzheimer's and we'll slow that down. But music theory or education, or you know, education to do a better job versus psychotics. Um so there's lots of non-medication options, whether it's treating symptoms or neural protection that have lots of benefits and none of the risks that come with you know.

SPEAKER_00:

I think you know, it's always hard, as you say. I think recognizing and empathizing with the the patient or their caregiver about the challenges with this condition, as you say, it's not well publicized that you know, any treatments that you might get are not expected to reverse it. You're not, you know, it's it's about slowing, slowing down the progression if if if the symptoms are going to be managed. And also that, you know, there are limitations with the the drugs that we have and recognizing that and some of those non-pharmacological options like the activity and social, you know, and you know, things like music therapy, or you know, I've I think I've seen about like animal therapy too, you know, animal um yeah, you know, just some of these things that it's a very difficult condition to manage, but there are some things that we can offer instead that might not that you say are low risk and can have benefits. So I think that's a great message to end this discussion with that there are other options available. And so maybe Dawn, as we wrap up, you know, we this is our Game Changers Clinical Conversations podcast. So, what is the game changer that you would take away and want people to leave with from our discussion today?

SPEAKER_01:

Microdosing lithium is not a game changer. I think we can talk to our patients about the limitations of the medication. We can talk about how there are safer options for our patients and that microdosing lithium, whether it's prescription or DIY, is just not ready for prime time.

SPEAKER_00:

Not ready for prime time. Promising does not equal proven, right? It's keeping that in perspective. Fantastic. Well, thank you so much, Dawn. Really appreciate your time, and this conversation has been super interesting. And I just think lots of practical practical pearls to walk away with. So thank you so much.

SPEAKER_01:

Thank you for having me.

SPEAKER_00:

Awesome. Well, listeners, be sure to claim your CE credit for this episode of Game Changers by logging in at ceimpact.com. And as always, have a great week and keep learning. I can't wait to dig into another game changing topic with you all next week.