Lithium

[Guest Guest_Alissha_*]

So, the brand new p-doc wants to put my on lithium. Keep in mind that I am deathly afraid of gaining weight, am currently bulimic, and have been anorexic in the past. I already have a central tremor and can't take beta blockers for it because of my asthma. I can't work at any of my chosen fields with a tremor (chem lab work, vet clinic, etc). I don't think I can handle this, the side effects I've been reading about are scaring the bejesus out of me. I have a week before my next appointment so that they can get the lab results in. Help! Reassure me that this will probably be okay, or give me some suggestions on how to tell the pdoc that I can't deal with this.

[Velvet Elvis]

Did you tell the pdoc about the ED issues?

Here's the brutal truth: most psych meds suck ass.

Most of the time they don't suck as much ass as what you're taking them for. You've got to ask yourself what you'd be willing to do to feel better. Would you chop of your hand if you knew it meant you'd never have to deal with this MI crap again? What about a finger? Which is worse, losing a finger or gaining ten pounds?

[verti_goat]

I've been on lithium for a little over a month and am not liking it at all. I excercise and am having big problems with the fluid-sweat-salt thing. After working out for 30 minutes in cool weather I start to feel jittery. And that is when I'm consuming fluids and electrolytes just like the doctor ordered. The only thing that makes the jitters go away is to consume huge amounts of salt. My appetite has gone up and I've gained 6-7 lbs since upping my dose to 1200mg/day last week. I have also had a nasty headache behind and above my right ear since coming up to the higher dose. I've been v. depressed the last two days so it sure doesn't seem to be helping. I fucking hate lithium right now and am going to ask my pnurse to switch to Lamictal; we'll see....

[crazynotstupid]

In the two years I spent on lith, the only weight I gained was from all the beer I drank. Lith never stopped my alcohol craving, which was one of the reasons I switched back to topamax. The only probs I had with lith were some zits and occasional tremors, but then those were quite rare. Like maybe every few months.

Sure I was worried about it. But, you never know which side effects you will get till you take the med. Take me and topamax--I got the quite rare effect of greatly reduced sweating. man, you just don't see that! Like, it shocked the hell out of my pdoc! But there ya have it. People bitch about common side effects, but the thing is--no matter how common, they happen only to a percentage of those taking the med--not everyone.

Bring up the ED issues. Certainly, bring up the work issues and tremor problems. Those are all very valid. And all good reasons to be wary of lith. Really, though, it's not the evil scary thing it's made out to be. Worst case, you go on it, it causes problems, you drop it for something else. Most of us have been on the med-go-round. Best case, no probs, it works great. Really all you would lose is time, and OK your stress level would go up, but don't let this overwhelm you.

[faith]

I've got to agree with CNS. You don't know how it will affect you until you try, and you can always try something else if it doesn't work out. Lithium has saved my life, I don't mean that in a drama queen way, but it has stabilized me like nothing else I've tried and I've been on the usual Depakote, Topamax, etc. I gained no weight at all from it and only get shaky if I don't keep my fluids up. I can't tell you it will be like that for you, but it should give you some hope that not everyone gets the same dreaded side effects from it. You won't know unless you give it a shot. Try to look at it as a trial period instead of a lifetime commitment. Just my two cents' worth.

[Alissha]

See, I know that these side effects won't necessarily happen but I'm not sure that I'm in a place to be able to cope with them if they do. The doc knows that I've been actively bulimic lately. Apparently, the restricting between bouts of bingeing isn't worth much since I have no issues with my menstrual cycle (don't agree with him, but didn't want to get too confrontational at the first appointment). He also knows about my tremor issues, job desires, and my asthma complications. I also worry about how the bulimia and its ability to mess with electrolytes will interact with the lithium.

Side effects I can deal with if it makes me better. I can deal with dry mouth, nausea, tingling, some cognitive fuzziness, giving up certain foods, weird hair changes, and some sexual dysfunction. I cannot deal with weight gain right now, period. I'm already in the midst of ED hell and have no hope of getting into a treatment program anytime soon unless I manage to hurt myself to the point of needing hospitalization. Having the doc tell me that I look like a good weight to him is not particularly helpful, because really his opinion is not the one that's going through my head.

I've got a week before my next appointment to weigh (funny, but not) my options. I understand the reasoning behind trying the "gold standard" of treatment, but I just don't know if I'm up to it. I've already gone through so much weight loss/gain/loss/gain between different meds that I've completely messed up any semblance of food related sanity that I had. My mind just keeps coming up with every med I've been on that listed weight gain as a side effect - and yes, I gained weight on all of them. I stuck it out with a good many of them, but I just don't have the strength to do that right now.

[MiaB]

I must also agree with CNS.

Lay out all your fears to your pdoc at your next appointment - including ones that you think he already knows about. Write down a list if necessary.

I'm sure it seems as though you're hearing the same thing over and over again in this regard, but none of us really knows just how a particular psych med is going to treat us until we try. I've been on lithium for some time now (despite having fought tooth and nail about going on it in the first place) and have gained absolutely no weight - this is something I've generally been lucky with, as a longterm high dose of seroquel has had no effect on my weight either.

My biggest problems when I started out lithium were cognitive - the frustration of losing words in the middle of a sentence, or basically having an already dodgy memory run to shit, was difficult to cope with. It's improved somewhat with time, but I basically manage it by carting notebooks around with me and writing everything down, particularly when it's work related.

I have to be honest and say the tremors were difficult to deal with, but they have tended to subside once I've reached a steady dose.

As far as the thirst goes - it can be a pain. I do feel hysterical if I don't have water available 24/7 and easily go through 4 litres a day. Really though, the biggest annoyance with that is needing to run to the toilet several times a night, but - strange as it may sound - it just becomes another part of the meds routine. I've also found that any lithium headaches are reduced if I am keeping up with my water intake.

Your levels will be monitored VERY carefully with regular blood tests in the beginning. If your pdoc knows what he's doing he'll be making absolutely sure that you reach a level that is appropriate for you. I've seen variations on what are considered the "right" levels here, but my pdoc sees that as between 0.6 and 0.8. It won't take long for you to learn the lingo.

Good luck, and once again, don't hold back when telling your pdoc all your fears. It's your right to enter into a dialogue with him and weigh (no pun intended) up the pro's and con's.

PS no weird hair changes here either

[AnneMarie]

Lithium is the most neuroprotective of all the stabilizers. It protects your brain from further deterioration due to BP. There also is a fair amount of emerging research that suggests it also promotes new neuronal growth - new brain cells - which may help repair some of the damage done. (Sorry, no sources now, it's late.)

I have virtually no side effects save a little acne. I can live with that over the illness. As for weight gain... I gained a few pounds initially and a few with increases. I also dropped them just as easily. I'm pretty sure it just was water weight. I read somewhere that the average weight gain on Li is 7-8 lbs, meaning a lot of people didn't gain. That's a lot better than a lot of other meds. This isn't a med that will change your appitite.

I have to be seriously dehydrated to get anything that might pass for a tremor. That's only happened once recently, and my serum level is 1.2 (and needs to get back down!). Lamictal causes me some minor hair loss. Adding Lithium didn't change that. I have not experienced any: "dry mouth, nausea, tingling, some cognitive fuzziness, giving up certain foods, weird hair changes, and some sexual dysfunction."

What Lithium did for me was to shut down a severe hypo in a way nothing else could. It's also augments the antidepressant properties of Lamictal. I'll stop taking these meds when I'm dead, not before. Li is good medicine.

My suggestion is that you talk to your pdoc about titrating up slowly. That way you can see if tremor will be a problem while also giving your body more of a chance to adjust and perhaps avoid side effects. You won't know how it affects you until you try it, and all of these meds are trade offs.

[Velvet Elvis]

Lithium is the most neuroprotective of all the stabilizers. It protects your brain from further deterioration due to BP. There also is a fair amount of emerging research that suggests it also promotes new neuronal growth - new brain cells - which may help repair some of the damage done. (Sorry, no sources now, it's late.)

This guy has lotsa good stuff:

http://richardgpettymd.blogs.com/my_weblog...um_and_bra.html

See all his stuff under the neurogenisis tag.

[Victoria]

See, I know that these side effects won't necessarily happen but I'm not sure that I'm in a place to be able to cope with them if they do. The doc knows that I've been actively bulimic lately. Apparently, the restricting between bouts of bingeing isn't worth much since I have no issues with my menstrual cycle (don't agree with him, but didn't want to get too confrontational at the first appointment). He also knows about my tremor issues, job desires, and my asthma complications. I also worry about how the bulimia and its ability to mess with electrolytes will interact with the lithium.

Side effects I can deal with if it makes me better. I can deal with dry mouth, nausea, tingling, some cognitive fuzziness, giving up certain foods, weird hair changes, and some sexual dysfunction. I cannot deal with weight gain right now, period. I'm already in the midst of ED hell and have no hope of getting into a treatment program anytime soon unless I manage to hurt myself to the point of needing hospitalization. Having the doc tell me that I look like a good weight to him is not particularly helpful, because really his opinion is not the one that's going through my head.

I've got a week before my next appointment to weigh (funny, but not) my options. I understand the reasoning behind trying the "gold standard" of treatment, but I just don't know if I'm up to it. I've already gone through so much weight loss/gain/loss/gain between different meds that I've completely messed up any semblance of food related sanity that I had. My mind just keeps coming up with every med I've been on that listed weight gain as a side effect - and yes, I gained weight on all of them. I stuck it out with a good many of them, but I just don't have the strength to do that right now.

As a recovering bulimic/anorexic, I will tell you, I too was TERRIFIED of psych meds and most of them having a potential for weight gain. In the beginning, although contraindicated for BP, I was on a low dose of Prozac for Bulimia in conjunction with the Lithium and gradually tapered off at some point. I will tell you, I have had DECADES of ED history, so it was very hard cutting ties with my behavior while continuing on a heavy psych med cocktail.

I was, however, honest with everyone on my treatment team (pdoc, gp, tdoc, etc) about my bulimia/anorexia and associated behavior - but indicated that I made sure that I allowed a necessary 2 hour plus window from taking my meds until engaging in any destructive behavior in able to allow the medications to do their job (for example). You end up putting your ED in a "box", so to speak while you work on your MI recovery (which ultimately includes the ED, once you get over the habit of it).

The weight gain is depressing. Drink a lot of water. Don't look at the scale. Don't overindulge. Drink lots of water. Keep only safe foods in the house. Drink lots of water. Keep your meals colorful. Only look at caloric/nutrition panels at the grocery stores, just do portioning at home. Get out of the house. Buy make-up instead of binge food. Drink lots of water. Lithium is your friend. And the important thing, is the weight does come off.

Now, can someone say the same about Lyrica? LOL

[sun_zoom_spark]

Lithium is the most neuroprotective of all the stabilizers. It protects your brain from further deterioration due to BP. There also is a fair amount of emerging research that suggests it also promotes new neuronal growth - new brain cells - which may help repair some of the damage done. (Sorry, no sources now, it's late.)

This guy has lotsa good stuff:

[link=http://richardgpettymd.blogs.com/my_weblog/2007/04/lithium_and_bra.html" target="_blank][link=http://richardgpettymd.blogs.com/my_weblog...um_and_bra.html" target="_blank]http://richardgpettymd.blogs.com/my_weblog...um_and_bra.html[/link][/link]

See all his stuff under the neurogenisis tag.

From the expert - check this out

SZS

[Velvet Elvis]

From the expert - [link=http://www.psycheducation.org/depression/meds/ManjiLithium.htm" target="_blank]check this out[/link]

He really needs to update. I was linking to stuff about the study UCLA put out this past summer.

[zsepthenne]

It really is a good med. Was the only thing I have ever had any result from, after ten or so years with meds. I have currently discontinued it due to weight gain. However, I feel alot of it was my fault. I was always very thin, too thin, 5' 8" and 125 on the average, so I thought i could sit and munch on loads of muffins, potato salad, and whatever else without gaining a pound, like usual. Wrong. I also didn't exercise with it. And I quit smoking after 20 yrs a bit before it. So I could point my finger at my metabolisim changing possibly?

I did drink tons of water, my hair is fine, had no sex side effect, no shaking, only nodded off like a junkie for the first month. Oh yeah, and the peeing 20 times a night really was my only biggie.

I might just pick mine up again in a month or two.

[mj1127]

I stopped Lamictal for side effects before I started Lithium, and I was also very reluctant because of that. However, I've had fewer side effects from Lithium than I have had with almost any other meds. I've gained some water weight, but have been able to get rid of it just by watching my salt intake and drinking cranberry juice. As a med, it has worked very well for me, and I know others have found the same. You do have to discuss all of this with your pdoc, but it may well be that this is one worth taking the chance on.