Discontinuing Lithium

[Bueler]

I feel like I've posted a gazillion threads, so I apologize, but this is still a great resource

As some of you know, based on my postings, I got on Lamictal 200mg (despite the slow and painful titration process).

I've been on Lithium for almost a year, 1200mg per day. But, it's caused really bad acne to come back, which is depressing. But, it's done wonders for my mood and keeping it smooth.

I want to taper the Lithium and go to just Celexa and Lamictal, so I won't have acne, and accutane the acne away.

Does this seem worth a shot? Any suggestions for tapering the Lithium? I feel like I'm juggling way too many meds, but I do have reasoning behind it and really hoping to be stable ya know?

Thanks!

[Anna]

Accutane is known to cause or worsen depression, you might need to be pretty careful with that aspect.

Lithium doesn't really NEED a taper, except that doing so might help you avoid rebound symptoms.

It is possible that the lamictal and AD may be enough for you at this point. Possible. Would you go back on lithium however, if symptoms returned?

Can't they do anything for your acne while you are taking the li? What have you tried?

I sympathize, lithium gave me really horrible body acne, while I was on it. If not for other side effects, however, it probably would have been worth persisting with.

Anna

[nalgas]

Get thee to a dermatologist. They deal with stuff like this (specifically med side effect acne/rashes/etc.) on a daily basis and can help you find something to do with your skin that won't screw with your mood, whether you end up stopping the lithium, having to go back to it, or keeping it.

[Bueler]

I heard that people who taper Lithium do better long-term than stopping abruptly. I have stuck by lithium for a while, because it is really good for moods. However, I tried everything for the acne, and have been to a dermatologist. He says Accutane. I tried oral antibiotics, washing face, benzoyl peroxide, topical retinoids.

I have to admit, having acne is only adding to my depression, because I'm really trying to look my best. Getting into shape, working out, eating healthy, etc.

Last time I quit Lithium, I got a bit hypomanic and went back on. But, I wasn't on lamictal then. So, I guess it seems reasonable to try stopping the lithium, and if symptoms come back, go back on it and treat the acne seperately with a dermatologist.

It's so frustrating when you have to worry about side effects of side effect treatments!

[AirMarshall]

#1 Question: What does your Pdoc say?

-Cold turkey of Lithium is not smart given the well established possibility of rebound mania. A reasonable taper of at least a couple weeks would be well advised.

-Both Lithium and Lamictal can cause acne, and Lamictal is known to exacerbate many skin conditions. I'm not sure that you have established which is causing your problem. Have you had the acne at the same severity ever since starting Lithium? If you are stable mood wise, at trial reduction of your Lithium dose might be reasonable to see if the acne improves.

a.m

[Bueler]

He didn't want me to stop taking Lithium

We came down from 1200mg to 900mg though. But he told me the Lamictal doesn't really do so much to bring me down, so I needed something for that side of things.

I am, however using Accutane, PersaGel, and an exfoliant to take care of the acne, and that seems to be going well.

I'm depressed because it's cold and dark and christmas, but bleh... sometimes I get frustrated with all these meds and I'm still not happy!