Jump to content
CrazyBoards.org




lithium or lamictal for PhD?


Recommended Posts

Just today I was diagnosed with soft bipolar. Kind of shocked still. Anyway; girl, twenties, intrusive thought patterns, anxiety, fatigue, very poor memory for unrelated facts/numbers and coordination and concentration, but also doing a mathy PhD, I am strong analytically. My psychiatrist wanted me to choose between lamictal and lithium. And i dont have a clue. Dont want to get fat, dont want to get more tired, dont want to lose my PhD position, etc. What do you suggest? Please help. Thanks.

Link to comment
Share on other sites

  • Replies 43
  • Created
  • Last Reply

Hm. You'll probably be fine on either. What way do you lean? More depressive or more hypo/manic? Lamictal works very well for depression, but isn't a strong anti-manic. Lithium works pretty well for depression and mania. Lithium is cheaper, but you do have to do the blood tests (not sure how much you'd end up paying with insurance). Lamictal does not cause weight gain, but you may or may not have some word-finding problems. Honestly, I didn't even get this from Lamictal (It's the AAP I take that makes me stupid, heh, but even then, I'm doing grad school just fine). With lithium you might get some water weight gain, but it's usually not a huge deal for people. There are people on the boards that take meds and pursue higher education with little issue from the meds. You'll probably feel a little slower on either of them, but it shouldn't hinder you to the point where you can't function. If Kay Redfield Jameson can take meds and do the work she does, I'm sure you can too.

Link to comment
Share on other sites

Thanks, appreciated. I am not sure if im more manic than depressed. I think I am kind of mixed up ;) but I do get manic regularly (at least once a month) in the sense that I cant control my thought pattern and end up doing stupid things. But no running around feeling awesome or something.

I was thinking of starting with lamictal and then maybe adding super low lithium (15 mg or so) or is that a weird idea? My psychiatrist is pretty open to low doses or whatever.

Link to comment
Share on other sites

I don't think the lithium will do anything if it's not a therapeutic level. There are people who take both lithium and lamictal. I've never taken lithium, but I take lamictal and don't have any cognitive problems

Link to comment
Share on other sites

15mg lithium will do absolutely nothing. You might as well pop pez.

If you're frequently experiencing hypomanic type symptoms, which it sounds like you are, lamictal will do about as much for you as 15mg of lithium.

15mg lithium will do absolutely nothing. You might as well pop pez.

If you're frequently experiencing hypomanic type symptoms, which it sounds like you are, lamictal will do about as much for you as 15mg of lithium.

Link to comment
Share on other sites

15mg lithium will do absolutely nothing. You might as well pop pez.

If you're frequently experiencing hypomanic type symptoms, which it sounds like you are, lamictal will do about as much for you as 15mg of lithium.

15mg lithium will do absolutely nothing. You might as well pop pez.

If you're frequently experiencing hypomanic type symptoms, which it sounds like you are, lamictal will do about as much for you as 15mg of lithium.

Ok I got the message :)

Thanks

so you recommend me to take the lithium? or do I understand incorrectly? what dose would be good then?

Link to comment
Share on other sites

Lithium is dosed by blood level, but 600mg is usually considered the lowest therapeutic dose. You can start lower but you're going to want to titrate to at least a .7 to give it a fair shake.

Lamictal works best as an antidepressant. It also takes a long time to get to a therapeutic dose.

Plenty of people are on meds and do things that require good cognitive functioning. I wouldn't worry about the meds making you stupider as much as I would about your illness disabling you.

Link to comment
Share on other sites

Lithium is dosed by blood level, but 600mg is usually considered the lowest therapeutic dose. You can start lower but you're going to want to titrate to at least a .7 to give it a fair shake.

Lamictal works best as an antidepressant. It also takes a long time to get to a therapeutic dose.

Plenty of people are on meds and do things that require good cognitive functioning. I wouldn't worry about the meds making you stupider as much as I would about your illness disabling you.

Ok I dont know what to worry about yet. I am just very scared.

Thing is I already gained a lot of weight the last 2 years (22lbs), and I really dont want to gain more. But with my low energy (CFS) I cant do a lot of exercise either, so therefore I did not want to do the lithium; If I gain the weight, I cant lose it. I am young, single, want a boyfriend, feel pretty, etc.

Link to comment
Share on other sites

Honestly, the side effects of medications, especially psych medications are so variable that in most cases choosing a medication based on side effect profile isn't the best route to go, with some extreme exceptions. If your major problem is depression, I would try Lamictal, because it's a better antidepressant, but it's not an amazing anti-manic, so if you have a significant mania problem you may want to go with lithium. Side effects can often be managed if they DO occur, and if you try something and the side effects are too severe you can always stop taking it and try something else.

Link to comment
Share on other sites

It true that you won't know until you try them. And as has been written here Lamictal is more of an anti-depressant. Lithium an anti-manic. Personally I love, love Lithium. Some people experience some cognitive issues with words on Lamictal. There is also Depakote which can be good for mixed states. It does take a long time to slowly taper up on Lamical. With Lithium you will probably know much sooner if you like it.

Good luck making a choice, and if it does not work out then you try something else. It is a process more than one big decision. And many people are on more than one med. I didn't get stable until I was on several meds......though if you had told me that 15 years ago I would have been appalled. :) But you definitely can treat your BP and continue in grad school. Lots of people do.

Link to comment
Share on other sites

Thanks so much for all your kind advice. It means a lot. Ive felt alone with this for so long, at least now it has a name.

So id be up for the lithium I guess but is there anything I can do to avoid the weight gain, as I said it is almost impossible for me to get it off. So if it happens it is kind of too late. I already eat very healthy, low carb etc, although I do have an overly good appetite (hungry a lot).

Is there any (safe) med i could try for this?

Link to comment
Share on other sites

Lithium weight gain is mainly water so the best thing to do is stay hydrated, which makes no sense on the surface but seems to work.

FYI: Fat people do find mates. I struggle with weight and ED issues myself, but the truth is that my weight has had much less effect on me than how I've dealt with it.

Low dose Depakote for me has surprisingly so far not been much of a gainer. It's different for everyone.

Finally, people with CFS CAN and DO lose weight... in fact, exercise is one of the things that is found to help with CFS,even if it's just walking.

Link to comment
Share on other sites

If it is the BP, just about every med is going to have the potential for weight gain. Abilify and Geodon aren't as bad, but they're hit and miss weight gain wise and effectiveness wise. Lithium in a lot of ways is the least worse for weight gain.

I also second exercise. Yoga might be doable for you - it makes you strong and lean, and it doesn't take as much energy as a lot of things.

Link to comment
Share on other sites

If it is the BP, just about every med is going to have the potential for weight gain. Abilify and Geodon aren't as bad, but they're hit and miss weight gain wise and effectiveness wise. Lithium in a lot of ways is the least worse for weight gain.

I also second exercise. Yoga might be doable for you - it makes you strong and lean, and it doesn't take as much energy as a lot of things.

what do you mean with "if it is the BP"? what is BP? bipolar?

Link to comment
Share on other sites

BP is bipolar. In the medical world, BP is usually blood pressure, so bipolar is referred to as BPAD. Here, we just use BP for bipolar, which is really fun when blood pressure discussions come up, which they do on occasion.

You're obviously very new to this because you've got kind of a shitty attitude toward meds and the diagnosis in general. You're not a special snowflake because you're in a PhD program. Nor because you don't want to gain weight. Like the rest of us, you need to take meds that are tailored toward your symptoms and see if they work and if you can tolerate them. No side effect is guaranteed. Not everyone who is bipolar is a drooling idiot incapable of thought. You seem to have some really uninformed thoughts about all of this that you should probably examine.

Link to comment
Share on other sites

If it were me in this instance, i'd try lithium first honestly. it didn't cause cognitive dulling in me at all.

Also, i got my MSW on meds and did fine.

I also take depakote which is notorious weight gainer, and it's some of the AAPs that cause me trouble really, the most.

no one likes side effects and no one likes being dx, initially. it will get better if you get over the anxiety and actually try something, honestly. The nice thing about lithium is that it really does kick in fairly fast at therapeutic dose, so you will know fairly soon what happens.

i only gained 5 lbs on lith and it was all water weight. anyone can do five lbs.

Anna

Link to comment
Share on other sites

If it were me in this instance, i'd try lithium first honestly. it didn't cause cognitive dulling in me at all.

Also, i got my MSW on meds and did fine.

I also take depakote which is notorious weight gainer, and it's some of the AAPs that cause me trouble really, the most.

no one likes side effects and no one likes being dx, initially. it will get better if you get over the anxiety and actually try something, honestly. The nice thing about lithium is that it really does kick in fairly fast at therapeutic dose, so you will know fairly soon what happens.

i only gained 5 lbs on lith and it was all water weight. anyone can do five lbs.

Anna

Thanks, yes i am convinced about the lithium now.

I will ask for a second opinion, just because I am not a very clear picture, my friends and family dont believe i am BP and insist I see someone else. I actually think that I am, but a weird form of it.

At the risk of annoying you guys even further: i read some raving reviews of bipolar people taking lithium orotate at Iherb, at lower doses (60 mg elemental lithium) apparently this causes higher blood levels and therefore you can take lower doses with fewer side effects, is that something to look into?

Also: Is it true that the severity of your symptoms determines the dosage, or does everyone has to take the same dose?

Thanks again!

Link to comment
Share on other sites

Since your blood level is what determines the effects, not the dose going down your throat, I would venture to say that that is bunk. If you are going to take lithium, take the lithium that comes from a pharmaceutical company and is prescribed by your doctor.

The number of milligrams of any medication that you take is almost completely irrelevant. There are some psych medications, such as lorazepam, where 1 milligram is a therapeutic dose. For others, like lithium, you don't get therapeutic until after 600 mg or so. Comparing the number of milligrams is like comparing apples to oranges - it just doesn't work. Every drug has its own dosing that depends on a number of factors. Don't get fooled into thinking that if you take less milligrams of something, you are taking less medication.

Generally speaking, comparing doses of a single medication, more of it equals more effects, but this can depend on the individual as well as the severity of the illness. One annoying thing about psych meds is that what works, what exactly it helps with, and what dose works, can very immensely between even individuals with the same condition.

I can tell that you are smart, and I can also tell that you are very anxious about having bipolar and being medicated. It's good that you are smart, because it means that you will be able to advocate for yourself and get the care that you need. The downside here is that it's very easy to go off half cocked and try to avoid prescription medications in any way you can, then google up a bunch of supplements and alternative treatments and really mess yourself up.

Here's the thing - for a drug to be on the market as a prescription medication, it has to go through rigorous safety testing and testing to prove that it works. The pills have to be of a certain quality - they are going to contain the medication they say they do, at the dose they say they have, without any other weird, nasty crap.

That is NOT true with supplements and alternative treatments like lithium orotate. It's like taking lithium without any of the safety and quality control that a pharmaceutical company has to observe. Just because something is "natural" doesn't mean it's safe. There isn't much on lithium orotate on PubMed, but I did find this study saying it's harder on the kidneys than carbonate (what you would likely be prescribed): http://www.ncbi.nlm....ov/pubmed/34690.

For that matter, actually, all lithium is natural - it's just a hunk of metal:

lithium.jpg

The stuff from Big Pharma just happens to be purified and in a less toxic form.

I know that you are in a scary place right now, and the idea of being able to get better "on your own" seems really tempting. But I promise you, things will get easier. You might have to try a few things, but you WILL find something that works for you and you WILL feel better. But the best way to do that is to let your doctor monitor your medication. There are certainly some supplements that can legitimately help people with mood disorders, but honestly, if you want to try that stuff, it's better to get stable on some other medication and add it on for a little boost, because I can tell you almost certainly none of that stuff is going to completely manage your disorder.

I don't know you very well, but from reading your posts, I think your anxiety is getting the better of you. Been there. I was very very scared to be on any medication at all because the side effects seemed terrifying and I didn't want to become dependent and I'd heard all sorts of horror stories. But I'm fine. In fact, I'm more healthy and happy than I've ever been in my life, and it's not all meds, because I've also needed to have therapy and do other stuff, but meds have helped a lot.

Give the medication a try. It might help you a lot, and if it doesn't, you can try something else.

And if you MUST take supplements, make sure you tell your doctor. And if you absolutely HAVE to take lithium orotate (please don't), make damn sure your doctor is testing your lithium levels regularly, because lithium is NOT one of those medications you can mess around with on your own. You get toxic based on the LEVEL, not the milligram dose, and the only way to tell your level is to have a blood test. Here is a case of someone who went toxic because they decided to mess with lithium orotate on their own: http://www.ncbi.nlm....pubmed/18072162.

Therefore, if you start taking orotate at any dose, you will not know your blood level, and you could easily take too much and get toxic. With prescribed lithium, you will be closely monitored, and your doctor will have some general idea of where to start you off to get a lower-end blood level, and you will be very safe.

Link to comment
Share on other sites

On the subject of Bipolar - if you want a second opinion, no harm there. It's one of our rights as patients, and I've asked for one once or twice when I felt that my primary psychiatrist didn't have a great handle on what I needed.

But don't let the relentless hunt for more opinions stop you from getting treatment. The truth is, unless your family contains many psychiatrists who treat tons of bipolar patients, and you are sharing your innermost thoughts with them as you would with your own psychiatrist, they probably don't know jack about what's wrong with you. It's something a lot of us have to deal with.

Me, I've fallen on both sides of the line. Some doctors say I have recurrent depression with a seasonal pattern and antidepressants just happen to make me manic, other doctors say I'm actually bipolar. The truth is, I don't particularly care what it says in my records, as long as I get treatment that works.

You've talked a lot about all the things you are afraid of. And there are a lot of things to fear, it's true. Going on meds is scary. Being diagnosed with a mental illness is scary. I felt like my life was over, at first. But it wasn't. I'm starting medical school in September, totally medicated (with Lamictal and an antipsychotic), and I don't have any doubts that I will be able to dive right in there and perform academically. If anything, I perform better now, because I'm not nutso all the time.

There must have been a reason that you tried to get help in the first place. Can you think about that too? There must have been something about these symptoms that was bothering you. You say you've felt alone with this for so long, so there's got to be something unpleasant going on there, something that's been happening for a long time. You're not JUST getting a chance at a bunch of shitty side effects, you're also getting a chance to feel better. Try to also remember that.

As a sidenote, are you in psychotherapy? With any of the mental stuff, it's something to look into.

I hope that you will stick around here and I hope you don't feel that people are coming down hard on you. We have a lot of members who go through very similar struggles accepting that they need medication, or that they have some sort of illness. We're here to help you get through this.

Link to comment
Share on other sites

Thanks for your thoughtful reply.

I have been feeling ill for quite some time, knowing something was very amiss, since no doctor could figure it out Ive lost my trust in the medical system on my way, and have turned into a kind of supplement queen. So yeah, it is hard to let go. But letting go, does seem to me like a relief, so it is something I look forward too. I wanted a box to fit in to for so long now, if it is bipolar that is fine with me.

Of course I would let the lithium orotate levels be monitored. My psychiatrist is pretty open minded and subscribes lower than regular levels herself. However i agree with you that it is not a good idea to go with medications that are not well researched for their safety profile. So I wont pursue this.

I will ask my doc for a trial of the lithium and tell her I am going to watch my weight very closely :D

I looked a bit into medicines with a better safety profile and saw studies with some good results with calcium channel blockers such as verapamil and ditrazem. Also trileptal shows some effectiveness. Ill ask her about this too, to see what the alternatives are.

ETA ha yes, i am scared as shit for a lot of things lately, I even had a butterfly freak me out a while back :) For myself I'd actually like to start the meds and see what happens, but my mum is not in favor of this at all. Yes you are right that there is the possibility to improve, I am well aware. But change is scary, be it good or bad. Ha I just got diagnosed yesterday, so I feel entitled to my state of shock :P but i will pick myself up soon, promised.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...