Toxicology of Song: ‘Lithium’ by Evanescence
Michelle Muscat MD MRCS(Ed) MSc, PG Dip, FRCPath, PhD
Writer: Amy Lee
Genre: alternative metal
Runtime: 3.44 minutes
The rock band ‘Evanescence’ dedicated a song to the alkali metal lithium, used as a mood stabilizer. Therapeutic drug levels in the blood are also closely monitored in the clinical laboratory to avert toxicity.
Lithium is a well-known drug used to treat affective illness such as bipolar disorder.(1) The American rock band ‘Evanescence’ released a song in 2007 with the alkali metal ‘Lithium’ as the title. The song has lyrics that are particularly apt, as well as having acoustics that are also in-keeping with related conditions. The lyrics state, ‘… I want to stay in love with my sorrow, Oh but God I want to let it go…’. The song portrays emotional fluctuations and numbness.
The song mainly focusses on clinical manifestations of the disorder itself and on the patient’s feelings and yearnings. What is also worthy of note from a biochemical point of view is that therapeutic drug monitoring of lithium is required to prevent the occurrence of toxicity in patients taking lithium, given the drug has a narrow therapeutic index. Levels are usually measured in a chemical pathology/clinical biochemistry laboratory or toxicology laboratory. Methods for determination include for example, electrochemical, such as via use of an ion selective electrode, as well as atomic absorption spectrophotometry. (2-4)
This review is partially funded through the Endeavour Scholarship Scheme
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- Leidinger M, Fieberg S, Waasem N, Kuhnemann F, Buse K, Breunig I. Comparative study on three highly sensitive absorption measurement techniques characterizing lithium niobate over its entire transparent spectral range. Opt Express. 2015;23(17):21690-705.
- Pybus J, Bowers GN, Jr. Measurement of serum lithium by atomic absorption spectroscopy. Clin Chem. 1970;16(2):139-43.
- Bertholf RL, Savory MG, Winborne KH, Hundley JC, Plummer GM, Savory J. Lithium determined in serum with an ion-selective electrode. Clin Chem. 1988;34(7):1500-2.