Lithium

[snoozzinsuz2]

Ok so I am finally feeling GOOD and the pdoc worries it might get TOO good! I am on a tight leash tdoc appts every week and seeing pdoc every other with promises to call if I start flying too high. This is part of the compromise I made... you see she wants to put me on Lithium and I SOOO don't want it for the following reasons:

1. I am beyond terrified of needles and don't like the idea of blood level checks AT ALL

2. I would rather try to control it -- if possible-- with what I am on right now

3. Hydration-- I HATE drinking water... I drink Gatorade or milk (max 2 sodas a day) so she was worried that the extra calories to stay hydrated would add pounds (which she says I could stand to do but I don't want to)

4. Something in me just doesn't want it... I am afraid of it but I can't explain or don't know why

the pdoc totally understands all my reasons... and she even agreed to do the blood draws herself to try and put me more at ease if we do go that route-- talk about going above and beyond! The compromise was that if I stayed where I am no Lithium.. if I get higher I agreed to TRY it... if I don't like it then she won't make me stay on it.

Anyone that's on it that was afraid to try it in the beginning...

Any horror stories

Any remarkable turnarounds from perceptions to reality...

I'm looking for any kind of feedback here-- and tell me I am irrational if you need-- I get it!

[helenllama]

I'm on lithium and I only drink Juice, milk, tea, coffee etc.

Diluting juice would be one to look into. As you can make it as strong/weak as you wish.

GAtorade you would have to be careful with as it is a rehydration drink and therefore would contain salts.

[Guest]

+1 on the heavily diluted drinks. I'm a fan of Berocca too, Around a quarter to half a tablet to a big drink bottle. Its dilute, but it gives the water a different taste so its not plain water.

Juice wise I generally go for heavily diluted pinapple juice, I don't really drink coke much or anything like that.

Edit: I just thought I would add, I have mizone/gatorade but I generally dilute them to half or a third, Not a huge fan of strong drinks in anycase.

[AnneMarie]

Lithium and Risperdal are my favorite meds. Lithium is a good antimanic but it also helps me noticeably with depression.

It makes me thirsty, so I drink a lot. I have a little acne issue with it so I take doxycycline. Problem solved. No other s/e's. Level checks are every 3-6 months once at a steady state. I have to get full labs every six months for other reasons, too, so it's only like two extra blood tests per year. NBD.

[snoozzinsuz2]

@ helen-- The gatorade salt thing I would have never thought of... hmm.. def something to ask in the event that I am forced to go this route... god knows I don't want anything that might add to the number of blood draws I have to get (and once the pdoc see's how horribly terrified I am she prob won't want to do any more blood checks!)

@Stacia-- I know that Lithium and Risperdal aren't used for the same thing but I know that I tried Risperidal and she yanked me off that FAST-- I was a violent hostile mess. Did you ever try one without the other or have you always had that combo?

[sorrel]

Okay ... first of all once you've been on it a while, blood draws are once a year.

Nothing wrong with consuming salt in whatever form (it is severely restricting salt, after eating more of it habitually, that would cause a problem.)

Don't "like" water, deal with it. You're an adult. Besides, you'll be thirstier taking lithium, and it may not matter because thirst MAKES you "like" water. I take a high dose, but I am so thirsty all the time I think sidewalk puddles look delicious. Seriously. I do not think think it's a good idea to be drinking a lot of juice, milk, or Gatorade. Those things just aren't meant to be consumed all the time. Coffee and tea are fine. Drinking water or coffee or tea isn't so terrible a fate, just deal with it.

[MamaNikkiP]

I took Lithium about a year ago, only for a little over a week. It seemed to calm me instantly (is that possible?) BUT I got so sick from it, I had diarrhea BAD and felt nautious all day, every day. And I do drink lots of water. But that was just my experience, I have heard many great things about Lithium. Good Luck!!!

[SashaSue]

For many people lamictal isn't much of an anti-manic, so it's not exactly unlikely that you'll need to add something. Lithium hasn't been the wonder drug for me that it is for some people, but it's been good. At higher dosages I had some memory issues, but aside from that, I've found it basically side effect free on a day to day basis. The blood tests are kind of a pain, but really not a big deal. And once you get to whatever dosage/level works for you, you don't have to get your level checked all that often.

Maybe sparkling water with a dollop of juice? I do a lot of that.

[AnneMarie]

@Stacia-- I know that Lithium and Risperdal aren't used for the same thing but I know that I tried Risperidal and she yanked me off that FAST-- I was a violent hostile mess. Did you ever try one without the other or have you always had that combo?

About half of my time on Lithium was with Lamictal and a little bit of Seroquel. The other half included Depakote or Tegretol since Lamictal and Lithium alone did not stop the rapid cycling. Risperdal did not enter the picture until years later, and I like what it did a lot.

The cocktail that I want to be one is Lamictal, Lithium and Risperdal. We'll see if I can get my pdoc going in that direction.

[AnneMarie]

As Sasha said, Lamictal is not that great of an antimanic for some people. There's a good chance you will need something if not now, then later. You have options besides Lithium. Depakote, Trileptal and Tegretol are options. Some do great on them. For me, they all include cognitive dully just like a higher dose of Lamictal does. Depakote was very fattening for me, and that's a fairly common s/e. The other options are mid level dose of some antipsychotic. With that comes calories for many. In the universe of antimanics, Lithium is not bad by comparison, IMHO. Sorry. I wish your world didn't come with the need for stabilizers of any sort.

[Moil]

 And hey, drinking more water would probably be good for you.   

[nibblerd]

And hey, drinking more water would probably be good for you.

I don't know how to explain this to my friends that say they do not drink water because they do not like it. How do they survive??

[snoozzinsuz2]

@nibblerd-- I have never really thought about it but I survive. I have never liked water in it's pure form-- I hate the taste -- I have to be well into dehydration to even consider drinking it. I drink tea, coffee, koolaid, soda, but my absolute favorite is milk. In all honesty though I probably only consume maybe 50-60 oz of liquid a day. Maybe that's not healthy but I guess it's what my body is used to-- and being a teacher there are very few opportunities for a bathroom break-- 1 soda, 1 coffee, gatorade and milk.

Thanks for the info guys-- it's good to have an idea of what to expect (good, bad or otherwise) hoping not to have to add another med but only time will tell with this crazy ride!

[netsavy006]

I was very afraid to try Lithium not even for the reasons that you list. (I don't want to make you any more scared so I won't list the reason I was afraid of it).

So every time I went to the psych hospital, I tried to find something else to work as a mood stabilizer:

Depakote made me suicidally depressed,

Tegratol didn't agree with me.

Zyprexa worked but I had to keep going on and off (so in my opinion it's a good emergency drug for bipolar / mood swings)

Abilify works for me, dyscounting the akathisia side effect

Risperdal caused tics 6 weeks into treatment

Invega made me looked stoned and eventually wasn't covered by my insurance.

Seroquel made hallucinations worse so I can't take that one.

Neurontin increased pain and prevented me from sleeping though the night so I couldn't remain on that one.

Geodon I got a rash from

So eventually I had to try something else because other medications weren't helping me so I had to try Lithium and I'm glad I did. I've noticed that since trying it a year and a half ago, I've been able to make the decision to go to my program that I'm still at now, and I have fewer and less intense mood episodes (I still get them though, but I do my best to catch them sooner and squash them quickly).

In regards to your concerns about blood work, yes there is some blood work involved, Once you are on the appropriate dose of Lithium that stabilizes your mood, you will only need blood work once every 3 to 4 months unless there is a problem. I've noticed I've not needed bloodwork myself any more frequently than 4 months at a time.

Hope this helps,

Andy.

[nibblerd]

@nibblerd-- I have never really thought about it but I survive. I have never liked water in it's pure form-- I hate the taste -- I have to be well into dehydration to even consider drinking it. I drink tea, coffee, koolaid, soda, but my absolute favorite is milk. In all honesty though I probably only consume maybe 50-60 oz of liquid a day. Maybe that's not healthy but I guess it's what my body is used to-- and being a teacher there are very few opportunities for a bathroom break-- 1 soda, 1 coffee, gatorade and milk.

Thanks for the info guys-- it's good to have an idea of what to expect (good, bad or otherwise) hoping not to have to add another med but only time will tell with this crazy ride!

Sorry for being so off-topic, but I wonder if the 'taste' of your water is related to where you get it from. The tap water in southeastern Ontario is cold and tasty, in Maryland it is full of iron and nasty, in Texas it has a highly chlorinated taste to it. I usually fill up a brita filter and drink from that, though.

[snoozzinsuz2]

not sure nibble-- I won't drink bottled unless it is like super super cold.. and even that is when I am beyond desperate-- and even more strange than that... I will eat ice cubes all day-- hmmmm can I blame this crazy dichotomy on MI-- nope probably just general crazy!

[nibblerd]

not sure nibble-- I won't drink bottled unless it is like super super cold.. and even that is when I am beyond desperate-- and even more strange than that... I will eat ice cubes all day-- hmmmm can I blame this crazy dichotomy on MI-- nope probably just general crazy!

I'm not sure if you're aware of this or not, but ice cubes are frozen water! Eat it all day if it'll keep you hydrated

P.S.

I like your sleeping dog avatar.

[Laume]

Adding my two cents to the rest.

I cried when told that Lithium was going to be the first drug we were gonna try to calm my kookiness.

Started at 900 mg (300 3x/day). Felt more stable within a few days - not kidding. Obsessive thoughts gone; obsessive repetitive behaviours gone.

I had some wicked thirst for the first 3 weeks. Drank at least 4 litres of water/day. I don't drink soda and always dilute juice 1/2 with water (before Li too).

I keep my caffeine levels a bit lower than pre-Li since it can affect levels.

You are supposed to drink a minimum of 8 classes (2 litres) of water every day for basic health reasons, and that is what I am now consuming 6 months in.

I had some very very bad nausea for about the first 2 weeks, but pushed through it.

Are the needles worth it? Yes when you fully consider that what they are drawing your blood for is not only for your Li levels, but also to ensure that your organs are okay.

Is the crazy water consumption at first worth it? Yes when you consider it is helping you flush your kidneys to keep them healthy.

Was the nausea worth it in retrospect? Yes - I have had a mixed episode that lasted about a week and 2 depressive episodes but I am much calmer, and feel more sane in general. Seeing the pdoc next week and I think some changes have to be made since I am still cycling a bit.

I would try Lithium if I were you. It is a serious med which has some serious side effects and you have to make a concerted effort to drink enough of the right stuff and get periodic blood draws, but the benefits I have experienced have been worth it to me!!!

Take care

[etkearne]

It has brought me back to reality. I was in a severe bipolar depression that nothing took care of. Lithium did/does. It actually has few side-effects compared to some of the other meds I take. I now take 1500mg a day, and still don't have anything other than hand tremors.

[Moil]

 Lithium brought me out of an agitated, suicidal funk...I was actually doing much better after the first week.  It also promoted my self worth significantly above the dirt status it was at.  With that in mind, being a bit shaky and thirstier don't seem like very big issues to me...though when I don't eat enough and over do the caffeine, my shaking can become a bit comical.  I was also kinda shaky before hand, so this may just be me.

[snoozzinsuz2]

Thank you all for the feedback-- I don't have another pdoc appt until next tuesday... who knows what she will think-- I have seemingly come down off my little manic vacation... not a crash thankfully but the light hearted mood and extreme productivity is gone... no more motivation, perfectly happy being a slug... not suicidal-- yet-- and hoping not to get there!

this game sucks, there are no rules and no out of bounds...

[A.J.Overholt]

I've been on it a couple weeks now, and I can already notice a difference. It's like my head finally feels....organized. That's the only way to describe it. I felt like crap the first couple of days, diarrhea and sleepiness not a picnic but after the first week it was like everything started settling down- still wicked thirsty all the time though. I was a bit nervous about taking it at first, but now I'm super glad; it finally feels like I can just be comfortable existing in my own head.

[mj1127]

Lithium has a really bad rep and I think that most people who start it are at least a bit unsettled about the idea. I can say, having been on at least this dose for about three years, that I've had nothing manic or mixed in that time, which has been a huge relief. I can't say it had done what I would like for depression even at levels as high as 1.3 (I felt fine, BTW), but depression is my old nemesis, and you can't expect everything from a humble little salt. Still, to be mania/mixed free and to have my irritability considerably toned down are certainly worth 3 needles a year and some extra fluids. Anyway, don't let it scare you.