it’s no reviewed yet and not formatted. The most interesting results are on page 17 and 41. There is no statistical significant difference in PACC score. The average blood level of Lithium is quite high; similar to mid-level Bipolar treatments - so it’s unlikely due to lack of exposure to Li.
The PACC score developed to the benefit of Li users. They started out with a larger gap (by randomization the Li people had worse AD status) and it narrowed over time. But the difference at start and at end between the groups is just too small to make it significant.
There is a strangely large benefit for hippocampal volume for Li users - controls had statistically significant clearly elevated decline in volume. But this didn’t translate into differences in PACC score.
There is some benefit for cognition. So it may still be worth it to take it as a supplement in addition to proven benefits in mood disorders. But it’s not the slam dunk that it seemed to be for a time.
They’re actually citing the Nature paper in their conclusion:
Alternative formulations of lithium, such as lithium orotate, also warrant further investigation in human RCTs since lithium orotate may be effective at concentrations orders of magnitude less than lithium carbonate with much less toxicity.
Yes, but if the Nature paper is correct, then aspartate (which falls between acetate and citrate per ChatGPT and Gemini) will be less effective than orotate: Lithium Supplementation - #333 by adssx
The PACC score is the “money maker” and the results weren’t available so far. But given the direction of some sub-metrics and long radio silence, it seemed likely, that is was inconclusive.
The previous trials all used Li-carbonate, as did the observational data. So it was the most reasonable version to design the LATTICE trial with in the year 2017. But given that the results are below expectations, chances are slim to find a sponsor for a larger clinical trial.