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Lithium to augment Prozac in MDD


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So I haven't posted in a really long time.  I basically fell into a deep depression and went off my meds (without permission), which I know is wrong and bad, and I felt terrible about it.  I finally went back to my pdoc and he put me back on my regular 40mg Prozac dose. 

 

Six weeks after going back on my meds, I still felt like absolute crap.  It was as if the Prozac wasn't doing anything anymore.  I just went to see him again today and he tried to prescribe me Abilify.  I don't have insurance but he gave me this savings card given out by the Abilify people but I ended up not being able to use it (because I don't have insurance... what's the effing point then?).  It turns out the Abilify would cost about $800 for a 30 day supply.  I literally had a breakdown in the middle of the pharmacy.  I am already suffering and I thought I would never be able to get better.  The pharmacist calms me down and says my doc might be able to prescribe something else.

 

Luckily, I was only half a block down from my pdoc so I went straight back and told him the situation.  He was ultra apologetic and said he had no idea it was THAT much per month.  He then said he was going to put me on a low dose (450mg) of Lithium (which is really cheap) and it should have the same effect of augmenting my Prozac and make me feel better.

 

So I ask, has anyone taken Lithium to augment their SSRI for major depression? What is it like?  I tried to do some forum searches but didn't come up with much.

 

Thanks in advance for your help.

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Hello Kaiserin. I am not a doctor, but I´ll give you my opinión based on my experience with meds.

 

I don´t understand why your doctor is not giving you another antidepressant (if the Prozac is not working). From what I understand you suffer from Major Depressive Disorder.

If he replaces prozac with another antidepressant then you will be paying one medication instead of 2 (prozac + abilify).

 

The other thing is that Abilify didn´t work for me as an augment to my antidepressant to treat depression. Maybe it won´t be the case for you.

Abilify is an antipsychotic, and from what you write you don´t suffer from psychosis.

 

The same with lithium, you don´t mention being bipolar, and lithium is a mood stabilizer.

Edited by CookieN
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Kaiserin,    Well it is very common to take a 'cocktail' of meds to combat the sort of Major Depressive Disorder that you describe.

 

An anti depressant is usually tried first and there are many meds in several chemical classes.

 

Lithium is often prescribed as a mood stabilizer and can be incredibly effective ...  it is classed as an anti-convulsant but that is only because historically it was first used to control epilepsy.   And yes it can be used as an add on med for depression.

 

The third leg of the cocktail is usually an anti -psychotic such as Quetiapine ... the anti-psychotics were first named because they were used to treat psychosis but they can be effective in treating insomnia,migraine, anxiety, bipolar disorder and ... depression!

 

You have not even scratched the surface in trying drugs to help you feel more normal and find some joy in life.   Reasearch more and in the meantime try the Lithium  ...  it just might be the magic bullet.

Edited by glasssss999
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Some people that live in my house are using Li to augment their antidepressant. It is not unheard of. Li is also dirt cheap. It's certainly worth trying. 

 

I wish you the best of luck.

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About 50% of those who take Lithium do not have significant side effects and find it effective. It doesn't work for about 25%. Another 25% find it effective, but that it has side effects. (Edited to add that these stats are for treating bipolar, but give a fair idea about frequency of significant side effects.)

 

I did not have side effects on Lithium.

 

Adding Lithium to an antidepressant to treat MDD (not bipolar) is a standard practice after attempts with other antidepressants fail. More docs go to the newer antipsychotics these days, but Lithium as an adjunct used to be the standard and is still considered a standard practice.

 

If other ADs haven't worked, I definitely give it a go. There are all kinds of studies on how Lithium helps with depression. Suicide rates in areas where it naturally occurs in the water are even lower than elsewhere. It's good stuff when it works.

Edited by AnneMarie
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I am glad I tried lithium, and can see ow if you are really severely mentally dysfunctional that it may be of benefit, but for the majority of depressive disorders it seriously is too dangerous (don't get me started on the liver function tests!)..

 

You have a lot of opinions for someone who doesn't even know what organ Lithium is hard on.

 

Lithium causing psychosis is really, really hard to believe. Maybe it did, anything is possible, but you'd be in some sort of super, super miniscule minority.

 

When properly managed, Lithium is very safe to take. It is a naturally occurring element. The OP's doc is prescribing the standard low dose for use as an AD adjunct. Don't go fear mongering. And, it generally is a better life practice to not assume that everyone's experiences are the same as yours.

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I take lithium for BP but at 1000mg a day I don't have any side-effects. I had some initially but they were pretty tame and they went away with time. Using lithium to augment antidepressants may not be so common anymore, what with Abilify and Seroquel, but it used to be standard practice for treatment-resistant depression. And at the doses used for this purpose, I imagine it would be much safer than using AAPs, and cheaper of course.

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Go for it! My cousin has MDD. She had tried many anti-depressants over the years. At one point during a particularly bad spell her pdoc decided to augment her anti-depressant which was Efexor 300mg at that time. After about 3 weeks on lithium 600mg she turned the corner and 2 years later she remains very well, with only minor dips in mood. She has no side effects except for increased thirst and urination which don't really bother her too much. She is very happy with her medication combination

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Doctors do not prescribe what is best, simply what is most profitable (sertraline being one of the cheapest SSRIs) - do your homework, experiment (much of psy medicine is trial and error) and don't give up. Just because the man telling you what you should do has been to medical school does not make him right. In my experience most doctors are pretty clueless. Take control and ask for what you want. 

 

 

I realize you are in the UK, but I have been to a ton of doctors for both MI issues and other illnesses, and I strongly disagree with your statement that doctors prescribe what is most profitable, not what is best.  I'm sorry your experiences have led you to believe that, because I have found that not to be true at all.  Also, most of the doctors I have seen are knowledgeable.  Some are great, and some are mediocre, but I haven't seen many that are clueless. 

 

For the OP, my pdoc has chosen lithium as the next med for me if and when I get into another depressive episode.  I haven't needed it yet.  It would be an add-on to the Wellbutrin and Lamictal that I already take (generic versions).

 

Lamictal is also a mood stabilizer like lithium, but has anti-depressant properties also, and is generic so not too expensive.  There are lots of meds to try.  It's worth the trouble to get on a good combo for you.

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Catnapper, when we thought we had lost our COBRA, we priced lamotrogine, and it was crazy expensive. His neurologist didn't believe it until he showed her the site. I am willing to bet that the price of lamotrogine varies from company to company, though.

 

Lithium was a breakthrough in treating mental illness. People litteraly lived in patient for years.

 

That doesn't mean it can't have bad side effects, but aspirin can have bad side effects. And Pregablin and lithium share some of the same side effects.

 

Unless you quit it yesterday, I sincerely doubt you have lingering side effects, except possibly kidney issues, As someone pointed out, Lithium is famously hard on kidneys. Not livers. I actually have kidney damage from earlier illnesses, and haven't had problems.

 

I use it as an add-on to my Wellbutrin, and I take Lamictal as well. The only side effect for me is the gross tremor. But the side effects of the med to treat my side effects were awful, I'll take the gross tremor, please.

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OP here. One more question. I started taking the Lithium with my Prozac both at the same time in the morning but realized it made me tired as hell and I slept all day. I am switching to taking the Prozac only in the morning and then the Lithium at night. Maybe this is a dumb question, but this is OK to do, right? The Lithium I take is controlled release btw.

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I take all my lithium at night. The only issue I've run into with taking it at night is when you get your level checked. You need to be certain that you take lithium 12 hours before them drawing blood. 

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  • 2 months later...

Kaiserin,    Well it is very common to take a 'cocktail' of meds to combat the sort of Major Depressive Disorder that you describe.

 

An anti depressant is usually tried first and there are many meds in several chemical classes.

 

Lithium is often prescribed as a mood stabilizer and can be incredibly effective ...  it is classed as an anti-convulsant but that is only because historically it was first used to control epilepsy.   And yes it can be used as an add on med for depression.

 

Lithium is not classed as an anti-convulsant, and has never been used to control epilepsy. It is a class unto itself. It is classified as a mood stabilizer.

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If your pdoc is prescribing lithium, he i definitely NOT trying to squeeze money out of you. Lithium is dirt cheap.

 

How did Lithium interfere with your liver function, since you insist it did? It would be extra nice if you provided a peer reviewed paper supporting your claim.

 

And listing your alleged degrees as a trump card doesn't impress us. You will find people on CBs with greater qualifications than you. Please remember, that on CBs, you are a peer, not an alleged health professional.

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ffs - not trying to 'impress' anyone. Just telling my experience, not preaching, judging nor trying to influence others. A peer reviewed paper? wtf??? what reason would I have to lie about it?  Thanks for your support and understanding.

GFY

Edited by Krishnaboy
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