Last year, Lady Gaga candidly shared her struggles with mental health, revealing that she experienced a psychotic break while working on her acclaimed film, A Star is Born, during a period when she was on a controversial medication.

A mental health specialist has since provided insights into the medication she used, highlighting its contentious reputation due to significant risks of misuse and toxicity. They also suggested a potentially safer and more affordable alternative.

In a November discussion with Rolling Stone, the 39-year-old pop sensation disclosed that she was taking lithium, a mood-stabilizing drug commonly prescribed for bipolar disorder, while filming her 2017 movie.

Bipolar disorder, which impacts between seven and ten million individuals in the United States, is characterized by severe mood swings ranging from manic highs to depressive lows.

While Lady Gaga has not publicly confirmed a bipolar diagnosis, she recounted experiencing a psychotic episode during her Joanne world tour in February 2018, leading to her hospitalization for intensive psychiatric treatment.

‘I had to step back. I was incapable of doing anything … I completely shut down,’ she shared. ‘It was terrifying. There was a point where I doubted my recovery.… I feel incredibly fortunate to be alive.’

Gaga has previously said she has been diagnosed with post-traumatic stress disorder (PTSD) and depression.

Lithium carbonate is a centuries-old mood stabilizer derived from the mineral lithium. It was discovered in 1817 and used as early as 1871 for mania. It was approved by the FDA in 1970 to treat manic episodes in people with bipolar disorder. 

Lady Gaga is pictured last month performing at the Super Bowl. In a recent Rolling Stone interview, the music icon said she has taken lithium in the past and has struggled with depression and post-traumatic stress disorder (PTSD)

Though it’s considered a gold standard therapy, it can come with a host of side effects such as shaky hands, frequent urination, nausea and excess thirst. 

Additionally, though lithium carbonate is not addictive or habit-forming, it is possible to overdose accidentally or intentionally.

Lithium orotate, meanwhile, is a dietary supplement form of lithium that emerging research suggests may have mood, cognitive function and stress benefits without a prescription. 

‘Lithium is one of the most truly amazing minerals,’ Dr James Greenblatt, a dual board-certified psychiatrist and assistant clinical professor of psychiatry at Tufts University School of Medicine and Dartmouth College’s Geisel School of Medicine, told the Daily Mail. 

Greenblatt, who has been studying the effects of low-dose lithium for 30 years, says he prescribes prescription lithium carbonate to patients with bipolar disorder based on their needs but recommends lithium orotate for more generalized mood swings, impulsivity and irritability that do not fall within bipolar.

One of the main differences between the two drugs is the dose, he said. Doses of prescription lithium vary for each patient, but it usually ranges from 600mg to 1,800mg once per day.

Supplements, meanwhile, are usually around 1mg to 5mg once daily.

Lower doses are less likely to cause side effects, Greenblatt says. 

‘I think most psychiatrists would agree that lithium is one of the best medications that we have in psychiatry,’ he said. ‘But it has potential side effects. So high-dose, long-term lithium has side effects that we need to worry about.’

With lithium orotate, however, ‘we see very few side effects,’ he added. 

Rare but potentially serious side effects of lithium carbonate include weight gain, thyroid dysfunction, kidney damage and cognitive impairment. Hair thinning, dizziness, confusion, severe nausea and tremors have also been reported.

Lithium orotate has been associated with more mild nausea, diarrhea, stomach pain, tremors, increased thirst, frequent urination and, in rare cases, kidney damage. 

Pictured above is one brand of lithium orotate supplements. One 90-count bottle of 5mg supplements from this brand costs $27.50

The above 100-count bottle of 1000mcg capsules costs $12

Greenblatt also noted that while there ‘are many, many roles for low-dose lithium, one of them is not treating bipolar.

‘You need, at least for a while, the prescription,’ he added. Prescription lithium must be given by a psychiatrist.

Cost is another factor. Lithium orotate costs between $10 to $30 per bottle, depending on the size and the brand, and does not require a prescription. 

Lithium carbonate, meanwhile, needs a prescription, and the cost depends on insurance coverage. Brand name lithium (sold as Lithobid) can cost as much as $800 for 60n pills without insurance, while generic versions are around $50 to $200 for a month’s supply without insurance and $20 to $30 with insurance. 

As part of its mental health benefits, recent research suggests low-dose lithium supplements may have profound effects on suicidal patients. 

A 2021 review encompassing nearly 2,700 global regions and 113 million people, for example, found higher concentrations of lithium in drinking water were associated with lower suicide rates and inpatient psychiatric admissions.

Lithium can enter drinking water through natural weathering of rocks and soil as it dissolves into groundwater. The Environmental Protection Agency (EPA) states that water-only exposure to lithium is unlikely to cause health concerns. Improperly disposing of lithium-ion batteries can also lead to more severe contamination in the water. 

Dr James Greenblatt, a dual board-certified psychiatrist and assistant clinical professor of psychiatry at Tufts University School of Medicine and Dartmouth College’s Geisel School of Medicine, told the Daily Mail that lithium ‘is one of the most truly amazing minerals,’ particularly for mental health

Greenblatt also pointed toward a 2025 study from Harvard University researchers, which studied the effect of lithium orotate supplements on Alzheimer’s disease, the most common form of dementia that affects about 7 million Americans. 

Based on mice and human models, they found when toxic amyloid beta begins to form brain deposits in the early stages of dementia, it binds to lithium and reduces lithium function in the brain, which may damage brain cells and trigger memory loss.

However, treating mice in the study with lithium orotate evaded amyloid beta, prevented brain cell damage and restored memory.  

‘Over many, many years, we know [lithium orotate] has many effects on the brain. It effects neurotransmitters, it decreases inflammation, it increases chemicals in the brain that help neurons grow,’ Greenblatt told the Daily Mail. 

‘It’s truly a remarkable mineral that we’re just accumulating more and more research as to what this micronutrient does in the brain. 

Greenblatt recommends anyone curious about lithium orotate to stick to doses between one to five milligrams. ‘Over that dose, they should be working with a medical professional,’ he said. 

And even at low doses, he urges potential patients to speak with a healthcare provider before starting.