I am not a doctor or medical professional, and I am not recommending lithium orotate use.
Lithium orotate is not well known and not popular among doctors. This is because there are very few scientific studies and most evidence that it works is just anecdotal.
Lithium orotate is a supplement and available without prescription in the United States. There have only been a handful of studies that have been done on it. One study done on rats in 1979 concluded that lithium orotate can cause kidney fuction problems, but the rat was given the same dose of lithium carbonate as lithium orotate. Some people believe that this study is misleading because lithium orotate is effective at lower doses than lithium carbonate.
However, lithium orotate is puzzling because the doses that it is effective at don’t cause the person to reach the therapeutic range for their blood lithium level. When doctors prescribe lithium carbonate, they check the patient’s lithium level, and generally try to maintain a therapeutic blood level of 0.6 – 1.2 mmol/L. However, with lithium orotate, the effective dose often does not cause the person’s blood level to reach that range; in fact, the lithium blood level is so low that it may not be measurable. This is theorized because the lithium goes into the cells rather than stays in the blood. I’m not sure if I understand this, but it seems to cause the lithium to be effective at a lower dose, which also seems to cause less side effects. Lithium can be toxic at blood levels above 1.5 mmol/L, which is also why blood level tests are usually done with lithium carbonate.
In any case, I take 4 pills of Lithium Orotate every day. Each pill is 150mg which contains 4.8 mg of elemental lithium. Some people have found effectiveness with just 1 pill a day. For awhile I was taking 3 a day.
3/20/2015 Update: Doctor's Best brand was discontinued, so I switched to Vitamin Research Brand of Lithium Orotate.
There is one scientific study (Lithium toxicity from an internet dietary supplement) published about a person overdosing on lithium orotate. They took 18 pills and it caused them to have nausea and vomiting but their blood lithium level was only 0.4.
The reason I started taking the lithium orotate was actually my desire to treat myself. It is a risk I take, and not one I advise. But it turned out to a be an affordable solution for me, and an added benefit is no side effect of hand tremor. I took lithium carbonate for awhile, and after about a year, I developed a tremor from it.
I really do like how lithium makes me feel (the mood effects were similar for both lithium carbonate and lithium orotate) because it’s like it just makes me feel normal. When I’m not having to deal with the huge changes in my emotions, then I have more energy to just be myself. I know lithium doesn’t work for everyone, but it’s so good for me that I wish I had found it sooner.
If you want to read anecdotal stories of the lithium orotate, you can read reviews here.
You can read all of the studies availabe (all 7 of them!) at PubMed.gov.
9/7/2012 Update: Results from my lithium blood test.