Yuna

is lithium a good anti-manic?

17 posts in this topic

I decided I can't tolerate the Trileptal anymore. Had enough of this bull shit. 

 

Going to ask my doc about lithium. 

 

And another thing- I noticed alot of doctors these days don't seem to like lithium. Why is that? If its this "gold slandered" why do docs not like to use it?

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The therapeutic blood level is very close to toxicity. Blood draws are frequent also.

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1 hour ago, Savannah said:

The therapeutic blood level is very close to toxicity. Blood draws are frequent also.

When you say "toxicity" does this mean lethal? 

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Lithium rocks. Of course there is no way of knowing how you'll react to it until you try it. Don't get scared about the toxicity. Your pdoc will start you out on a low dose and do frequent blood tests to determine whether your in the normal range or not. Personally, lithium keeps me from having really bad manic episodes and also helps with anxiety. The only side effect I got initially was some nausea (but it went away) and increased thirst. And it's dirt cheap compared to a new anti-psychotic. 

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It could be but you would have to take an awe full of lithium to be lethal. Toxic levels have a set of how they effect the body and I don't remember what they were.

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Blood level-

.6 to 1.2 (ish) is therapeutic. Now days people are usually at the lower end. Over 1.5 is toxic 

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I've only been hypo once since I went onto it years ago. I haven't been manic at all. I'm on .8 or .9 depending on the test.

I'm going to move this thread to mood stabilizers.

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Lithium is an amazing med. It was the first discoverd (accidentally) and it works so well. It is a very effective anti-manic. It exists in tiny doses in most peoples blood, but not sure why or what for.

It can have shitty side effects, watch levels. No NSAIDS (unless a dose or two in an emergency, I was given IM Toradol when i broke my ribs, they monitored levels and kidneys, mostly because I could have damaged them) Caffeine, cut back. Stay hydrated, do not adjust salt intake, do not miss blood tests.

It sounds scary. Its not that bad. If your levels are in the good range, you rarely notice side effects (except thirst, but I'm always thirsty) 

Its the only true mood stabilizer, it works so well, unfortunately some side effects are harsh, I had kidney problems (most doctors had never heard of it), had to discontinue, lost 6 years of stability, took years to find a combo half as good. Twice as many meds. (Note: when a med really helps me, it eventually turns on me..)

I was never toxic. It kept me stable, rarely any episodes. 

Note, there is a history of kidney disease in my family. But the problem wasnt permanent. I am great on blood tests, but cant risk it. Again, very rare. Its amazing, it works fast, great med.

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Some people even get away with "sub-therapeutic" treatment levels of like 0.5 and are stable or at least improved. I have a friend who is .5/.6 and it was enough to kill a manic episode 

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It is still the gold standard. You have to keep an eye on your lithium level and kidney function, at first more frequently and then less so. It takes some fiddling to find the right level. Lithium relies on regular dosing, not hit or miss.

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Love lithium, and yes, it can squash a manic episode. Really, there's no big deal, esp after you've hit a stable level. Just drink a lot of preferably water. There's only one note - during a very bad heat wave this past summer, I was having a very hard time staying hydrated (no a/c). With pdoc's blessing, I lowered my dose in half, I was just worried about my fluid intake (I was drinking tons, but sweating tons, and hardly peeing). Anyway, that's past. I'm fine.

Don't get hung up on dosage, everyone's different, blood levels are the only key. I take 600mg, which for some people is ridiculously low, but my levels are consistent at .7-.8. 

Maybe the reason pdocs are more reluctant to prescribe it? No perks from the big pharmacy reps for pushing the latest and greatest (I.e., expensive) meds. 

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I take only 600mg, too, and as I said, at .8 or .9.  But a common starting dose is 900. Everyone's different. After you find a level for a few months, you won't have to do as many tests; I do one ever 6 or 7 months.

You definitely need to watch kidney levels, but I actually have kidney disease, and all my doctors are fine with it. 

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Yes, lithium will slap the bitch out of mania. Total smack down. In my case I think I was on it well after I needed to be, and it flattened me out beyond what was tolerable. 

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Another question for everyone: 

 

My type of bipolar is a continuous manic episode- that is my experience.. I noticed most of you who are taking lithium have bipolar type 1- implying your baseline episodes aren't continuous, as type 1 bipolar has remission periods or depressed periods.

With me I am bipolar NOS and off meds it would always be continuous. Trileptal solves that, however I have read Lithium is only good for bipolar type 1 "classical mania and depressions". Which is not technically me..

 

So would Lithium not work for me then according to this criteria? I know that sounds vague... Thank you everyone for replying to this thread..

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Lithium should treat mania regardless I would think...it's not the fastest but it works very well

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I think it's more of a mania killer than mania from a particular type of BP. This is what it seems like to me, but I am not a pdoc.

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Depakote is a stronger anti-manic and will work on a continuous state.  Blood levels are needed to monitor liver function, but not as many side effects as lithium.

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