>Ain't that the truth! I once had to explain to my father that elemental lithium in the water and lithium citrate the anti psychotic medication are not the same thing

Elemental lithium doesn't even naturally occur on Earth at all. Let alone in the water supply.

And I'm not sure why you're saying the lithium salts in water/food are different from those in medications.

The World Health Organization recognizes lithium as a nutritionally essential trace element which can be safely consumed through drinking water, plant-based foods, or very low-dose supplementation.

Naturally occurring lithium in water supplies is associated with low levels of suicide.

If you're referring to intoxication that can happen when there's high concentrations of lithium salts in water supplies and trying to suggest that that doesn't happen with medications then that's it correct either.

Lithium salts are used mainly for acute mania and prophylaxis of recurrent bipolar and unipolar affective disorders. Toxicity may occur either during maintenance therapy or following acute intoxication. Lithium salts may cause hypothyroidism, which may aggravate the ataxia. Acute intoxication may affect the cardiovascular, renal, and/or nervous system. The spectrum of neurological deficits is broad: coma, seizures, coarse tremor, hypokinesia, rigidity, hyperreflexia

Lithium is widely distributed on Earth but does not naturally occur in its elemental form due to its high reactivity. Trace amounts of lithium are found in virtually all rocks.

Nutritional lithium, consumed through drinking water, plant-based foods, or low-dose supplementation, is a well-tolerated naturally occurring nutrient. The World Health Organization recognizes lithium as a nutritionally essential trace element

This synthesis of ecological studies, which are subject to the ecological fallacy/bias, supports the hypothesis that there is a protective (or inverse) association between lithium intakes from public drinking water and suicide mortality at the population level. Naturally occurring lithium in drinking water may have the potential to reduce the risk of suicide and may possibly help in mood stabilisation, particularly in populations with relatively high suicide rates and geographical areas with a greater range of lithium concentration in the drinking water. All the available evidence suggests that randomised community trials of lithium supplementation of the water supply might be a means of testing the hypothesis, particularly in communities (or settings) with demonstrated high prevalence of mental health conditions, violent criminal behaviour, chronic substance misuse and risk of suicide.

Lithium salts are used mainly for acute mania and prophylaxis of recurrent bipolar and unipolar affective disorders. Toxicity may occur either during maintenance therapy or following acute intoxication. The most common side effect of chronic treatment is an enhanced physiological tremor affecting mainly the hands. Lithium salts may cause hypothyroidism, which may aggravate the ataxia (see also Amiodarone). Acute intoxication may affect the cardiovascular, renal, and/or nervous system (Simard et al., 1989). The spectrum of neurological deficits is broad: coma, seizures, coarse tremor, hypokinesia, rigidity, hyperreflexia. High fever is common during intoxication. A neuroleptic malignant syndrome is often suspected since neuroleptics and lithium salts are often administered in combination in psychiatric patients. Although neurological signs are usually reversible after acute intoxication, patients may exhibit a severe cerebellar syndrome with scanning speech, tremor, and ataxic gait (Manto et al., 1996). Intensive care monitoring is recommended to prevent irreversible sequelae