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Lithium + ED = ok? or really really bad?


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My Pdoc is thining of prescribing lithium to me. I am scared bc I havent told him the extent of my ed behaviours andKNOW I wont follow drinking the water youre supposed to or eating when im supposed to.

Does food and water really affect lithium levels enough that IO will most definately screw myself up on it bc I have and ed? OR are there alot of people who have an ed that take lithium and are ok??

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Hydration does affect lithium levels significantly. Electrolytes can also affect lithium, and vice versa. Depending on the extent of your ED, there's also the possibility of arrhythmias: not a good thing combined with lithium.

I notice you're also on Wellbutrin. That alone would be reason enough to let your psychiatrist know about your eating disorder. Wellbutrin plus lithium would not be better for seizure risk. And I say that as one of the lithium cheerleaders.

I hope this doesn't come off as scolding, because that's truly not the intent. Just answering your questions. I do know people with eating disorders on lithium, but they are forthcoming with their prescriber about their ED, and the necessary monitoring is adjusted appropriately.

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Hydration does affect lithium levels significantly. Electrolytes can also affect lithium, and vice versa. Depending on the extent of your ED, there's also the possibility of arrhythmias: not a good thing combined with lithium.

I notice you're also on Wellbutrin. That alone would be reason enough to let your psychiatrist know about your eating disorder. Wellbutrin plus lithium would not be better for seizure risk. And I say that as one of the lithium cheerleaders.

I hope this doesn't come off as scolding, because that's truly not the intent. Just answering your questions. I do know people with eating disorders on lithium, but they are forthcoming with their prescriber about their ED, and the necessary monitoring is adjusted appropriately.

Hey,

Tx, no scolding taken. What is it about wellbutrin that is so bad with eating disorders? I thought it was just bc it can make you lose weigt, forget to eat?? Since I am not an unhealthy weight right now (just finished gaining 30lbs) I didnt think it would make much dif.

I have been on WB for years! I have told pdoc I have "eating disorderly behaviours" and he said "fair enough". That was the end of that convo, so far. I dont think (pardon the ridiclousness of this next thought) I dont think my ed is bad enough to mention bc i am not signifigantly under or over weight. I am not sickly thin or anything. (I know I know weight doesnt really matter but ... ok theres no but intelligent enough to make that sound ok lol)

I just thought you shouldnt take drugs with warnings about ed's bc you are under or overweight. I guess I shouldve asked the doc why :S

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If a pdoc doesnt totally understand that you don't need to be under or overweight to have an eating disorder then maybe he wouldnt be a good pdoc? I would think he would get this - so maybe you could just tell him?

i think if you didnt drink enough water you'd feel *really* sick on lithium. headaches, nausea. if you are being sick, this is awful too - too much of that = lithium toxicity, if you dont get enough fluid/lose too much fluid.

(i took lithium and had really bad side effects - unbearable nausea, which most people dont seem to get, so the lack of water and being sick had a really massive effect on me).

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[

Tx, no scolding taken. What is it about wellbutrin that is so bad with eating disorders? I thought it was just bc it can make you lose weigt, forget to eat?? Since I am not an unhealthy weight right now (just finished gaining 30lbs) I didnt think it would make much dif.

I have been on WB for years! I have told pdoc I have "eating disorderly behaviours" and he said "fair enough". That was the end of that convo, so far. I dont think (pardon the ridiclousness of this next thought) I dont think my ed is bad enough to mention bc i am not signifigantly under or over weight. I am not sickly thin or anything. (I know I know weight doesnt really matter but ... ok theres no but intelligent enough to make that sound ok lol)

Increased seizure risk with Wellbutrin in bulimic patients who were purging via vomiting, presumably due to the electrolyte imbalance. I don't recall if laxative abuse was included in that group or not, but, since that too can lead to electrolyte problems, I'd assume that would be problematic as well.

It depends on whether you mean "eating disorderly behaviours" or "active purging/excessive restriction." Very different things.

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It depends on whether you mean "eating disorderly behaviours" or "active purging/excessive restriction." Very different things.

I "forget" to eat alot of the time, between binging. I dont drink water. Or juice. I drink coffee (Im cutting back and making it half decaf so far) I smoke. I can make myself eat a granola bar of sorts if nothing else throughout a day. I dont take laxatives, or throw up, not in a long time anyways. But loved starting clomipramine bc it made my mouth water whenever i thought of eating .... and then i wouldnt.

Have gained 30lbs since that affect went away though ;)

To sum it all up, my diet/liquid intake is shit, and i dont have the willpower to change it much. It kinda comes and goes on its own accord. Im scared i will go toxic before i even know it and .... pdoc doesnt seem concerned as i am. Just said well, youll have to drink ## glasses of water a day. I dont think i ican do it. im scared of what will happen if i dont. Very scared. I guess feeling my eating is very much out of my control lately.

I didntrealize that the seizure risk was due to imbalances in electrolytes! Damn lucky i guess, so far. Will be telling tdocthis morning more about diet and see if she can relay it to pdoc better than me.

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Funny how my thoughts automatically went to "they want me/us to stay fat!" when thinking about WHY they dont want to prescribe certain ad's etc to people who have an eating disorder!

Never crossed my mind that it was for my own good duh ... i feel stupid now!

Just thought certain ones made you lose weight so they didnt "want" me to have it in case i lost weight enough to be happy ..... only slightly underweight i swear ......

this feels dumber and dumber the more i type lol

Amazing how eds can twist the mind

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The manufacturers recommendation is to drink 2-3 liters of water a day. I don't force myself to drink water generally. It pretty much takes that much to keep me hydrated. Things that could lead to dehydration and lithium toxicity problems are fever, excessive sweating due to heat or exercise, diahrrea, and vomiting.

The main emphasis on drinking plenty of water is to help flush the lithium from the kidneys in order to prevent damage. Anyone who restricts fluid intake in the long term should be aware of the increased possibility of kidney stones, unrelated to lithium. Silver can comment first hand on lithium/kidney issues.

a.m.

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Heh. At length.

And I've generally been pretty well-hydrated (or at least putting out appropriately dilute urine, before the NDI started up.)

As I go down on the lithium for this little nephrology monitoring session, I am astonished at how much less fluid I'm drinking. Not to mention how much more snarly I've become.

HSRC: killer insight into the thought process of ED there... not dumb at all!

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  • 2 weeks later...

All these psych meds have side effects, it just depends on the individual as to how much of them hits you. Personally, I was on Lithium when I was diagnosed as "crazy" not many side effects. A bit of pimples maybe, but nothing to freak out about, just one or 2 at a time. In the beginning, I swore off alcohol like a good little girl. Then after about 5 months, I started drinking again. Not a good move. Moods went crazy each time I was busy drinking, I would do stupid things and remember NOTHING the next day. Seriously, Many nights of my life are just GONE.

Then I stopped taking it on my own, and went totally manic for months. Attempted suicide, failed, and ended up institutionalised and back on lithium. This time, I took it for over a year, kept drinking, was still crazier on it and still had the blackouts the next morning. I cut back a little on the booze, not really conciously, more so out of circumstances and I tell you now, I have been doing brilliantly for the past 9 months or so. I think rationally. I am not overly emotional at all. My moods are stable and there's been no irrational mania or depression.

BUT...

the side effects have caught up on me. The biggest is the acne. It's been getting worse and worse and am now on treatment for the skin. Sure, you're thirsty, but that gets better. In the beginning I had to have water with me all the time. but after a few weeks, it dwindled down to just being really thirsty during the night after I took my Lithium. During the day I hardly drank anything at all.

As for weight gain, for me, it was maybe 1 or 2 kilograms. But I am a fanatical weight watcher and I just stopped eating more than a biscuit for 2 days and then I was fine again. No more weight gain after the initial gain. As for food, I read about it, even cut out coffee for a long long time, but then I thought, "screw it", living without my little pleasures in life is not living at all. And it had NO effect, I still ended up being "normal" for months and months with no relapses or anything. I ate whatever I wanted and screwed around with my diet for months and months! My life was totally unchanged apart from the side effects that started only many months after first starting.

Honestly, I started weaning off the Lithium a few days ago because I can't stand the acne and partial hair loss. I'd still be on it if it weren't for those factors. It REALLY worked for me. I cried when I took my last full dose of 800mg. It felt like a good-bye. How crazy am I to voluntarily give up sanity because I have acne?!?!?!?

But the way I look at it, I don't want to take one drug for insanity, then another 8 for the side effects it caused me. I figure there has to be something out there that willl give me less or more tolerable side effects. I mean, these drugs are for life. My acne may be treated over a period of 4 months, but the cause is stilil the lithium and I take that every night, what's to say the acne won't come back? Stupid acne, I loved lithium!!!

But all of that is just from personal experience, like I said right in the beginning of my long long long essay, it all depends on the individual.

The only way that you can ever know how it will effect you is if you give it a try yourself. But you have to give it a good chance. These are mind-altering drugs and won't "fix your life" over night. Hang in there, you are definitely not alone

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My Pdoc is thining of prescribing lithium to me. I am scared bc I havent told him the extent of my ed behaviours andKNOW I wont follow drinking the water youre supposed to or eating when im supposed to.

Does food and water really affect lithium levels enough that IO will most definately screw myself up on it bc I have and ed? OR are there alot of people who have an ed that take lithium and are ok??

Oh, you should really tell your pdoc about your disorder. I told mine and she prescribed accordingly. I'm able to tell her straight, don't prescribe anything that will make me fat. And she does her best.

If you for example or likely to stick your finger down your throat alot, the pills will never stay in your system long enough to be effective.

In that case you are just wasting time and money.

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tx guys. I will make sure i fill him in before he writes me a script.

Its so hard to say out loud i find though. Out loud i feel so stupid talking about it. Yes sir i dont eat for days but want to feel better. Yes sir i want to get better but wont take anything that will make me fat. I want topamax sir, even though it DID NOOOT help the raging bitch inside me from jumping down everyones throats

i dont wanna eat, i dont wanna drink. yes i know ill be bitchy and dehydrated, ruin relationships, ruin my body etc ..... but i wont be any fatter.

* i hate hate hate knowing how irrational my thoughts are*

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Hi happy dont know if we have met as yet, i have been off the boards for a bit, actually i have been off life for a few months recovering from surgery, intros aside - i am on Lithium, was on wellbutrin (but went off around march 08 as it seemed to be losing effect and i hoped a short break may help) also have a nasty ass ED that makes me have some very similar thoughts too you.

Firstly - When i started Lithium i drank and had to wee heaps more then normal, dont worry if u dont normally drink water, for me that wasnt an issue cause i was so damn thirsty it felt like i had done a 5hr run with no water. I have been on it a year, i dont drink as much water now but my kidney and liver are in good health. Now i lost 12kg (25lbs) when i went on Lithium cause my mood really stablised and that made my ED symptoms and impulses ease.

Tell your dr u have an eating disorder and what it is. Im sure he will tell u as i do now people drop dead from eating disorder issues not just the super slim - look it up, starvation isnt the only way an ED kills, have a look what binging and purging does to your heart, i was shocked when i realised i had some of the signs to watch!!

I am not a healthy preaching person, im more in the do as i say not as do category. I class psych meds in too categories and my shrink is well aware of this there are 'fat pills' and 'normal pills' i refuse to take fat pills unless he has an alternative to stop the weight gain.

You are not alone in these thoughts as irrational as u are. I think the only way u will get through this though is to be honest with your doc and get the meds u need, u will find when u do it will be much easier to eat and drink what u are supposed. If your doc has a bad reaction to your ED news - get a new one - u pay him/her not the other way around.

U dont deserve to feel like this

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  • 1 month later...

I was prescribed Lithium by a doctor who knew I was eating disordered, then quickly transferred to one who thought that it wasn't "the real issue" so just let it be. The water is a big thing and it was hard for me because I'm usually a caffeine freak so it helped for me to cut that out a little. It ended up with me in a meeting with my pdoc and him giving me three 1lt water bottles, telling me I had to drink all three every day.

For me it didn't work so well as my base mood is depressed, but I lost weight on Lithium (and am now about to go back on the evil mood stabiliser ;) )

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