Lithium Orethate is not carbonate, which need much higher doses to work. We are talking very small dosages in comparison, as well not a prescription drug.
Lithium orotate might also be considered when the mood is unstable, for example in someone who has a lot of irritability, agitation, or frequent mood swings. And also in people who had previously gotten relief from medications, but where they've become less effective over time
https://www.naturalmentalhealth.com/blog/lithium-orotate#:~:text=Lithium orotate might also be,become less effective over time.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413749/