Lithium orotate releases the lithium ion into the plasma and brain just like pharmaceutical lithium carbonate and citrate. This is exactly the same way prescription lithium works, albeit without the toxicity. Symmetry effectively addresses bi-polar volatility by increasing the uptake of two very exciting neurotransmitters (dopamine and norepinephrine) into synaptosomes. Synaptosomes are pinched off nerve endings that cannot release hormones. This helps people to remain calm when they would otherwise not be. A paper published in the January 11th issue of Cell, a Duke Medical Center team has found that lithium interrupts the signaling of one of the D2 dopamine receptors in the brain. Elevated dopamine causes people to act impulsively and erratically. Lithium orotate, citrate, carbonate also inhibits the glycogen synthase kinase 3 (GSK-3) enzyme which is important in the cell’s response to many signaling molecules. By destabilizing the D2 / GSK3 signaling pathway complex mania is reduced.