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Lithium and memory loss - again


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I got to speak to a doctor at some length on the phone who has a cognitive and memory clinic. At first when I described how my short term memory is so bad that my famly is concerned, she said for me to get a CT scan because I might have had a mini stroke. But when I told her that with a lower lithium dose (like 600 instead of 900, which my doc wants me to take), I can actually think pretty well and rememeber stuff, she said to work with my doctor on finding the lowest possible dose.

Now, at last, I have some ammunition to get my doc to take my memory problems seriously! I can manage on 600 mg lithium as long as I sleep.

She also said that med-induced memory problems usually only happen to patients who have taken the meds "for a long time", however I was on Depakote for 10 years and clonezepam for many years. Benzos harm memory, too.

Just FYI. 

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I went through a battery of tests at a memory center and they decided that my memory loss was within the "normal" range and that I could compensate for it.

That was a lot of help.  ;)

It's the worst when I talk and can't think of the right word, remember what I am talking about, etc.  It's making me damn anti-social.

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  • 2 weeks later...

I don't know if this helps or hurts, but I think our illness might screw with our perception of our cognitive capabilities, in addition to our actual brain capabilities. Many, many times I have felt like I am in a complete fog, almost like being under anesthesia, but when I mention this, people say I'm fine. And sometimes the opposite happens: I think I have a few good ideas, but realize later that they weren't all that new or creative or even right.  So the tricky part will be figuring out some way to test our brain, to give us some clue as to whether the cognitive processes are working well that hour or not.  I've tried doing math problems but think some other "working memory" test that can be done on the fly might be helpful. 

I hope this makes some sense. I'm not sure myself.... Suggestions welcome. The only cognitive tests that I know have been tested for accuracy and predictability are on-line, but accessible only to professionals who charge a fee.

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Woth reading...

OBJECTIVE: Growing evidence suggests that abrupt lithium discontinuation increases the risk of recurrence for patients with bipolar disorder. To assess the effect of abrupt change in lithium dose, the authors reanalyzed data from a previously reported, randomized, double-blind trial of standard- versus low-dose lithium for maintenance therapy in bipolar disorder. METHOD: In the original study, serum lithium levels were obtained during a 2-month open stabilization period for 94 patients with bipolar disorder who were then randomly assigned to be maintained on a low (serum level=0.4-0.6 meq/liter) or a standard (0.8-1.0 meq/liter) level of lithium therapy. Patients were then followed for up to 182 weeks. This reanalysis examined the potential confounding influence of prerandomization lithium level and change in lithium level on the outcome of subjects assigned to a standard or low maintenance dose of lithium. RESULTS: In a Cox proportional hazards model incorporating pre- and postrandomization lithium levels and the interaction of these factors, only the interaction term remained significantly associated with time to recurrence. CONCLUSIONS: The findings indicate that change in serum lithium level may be a more powerful predictor of recurrence of bipolar disorder than the absolute assignment to a low or a standard dose of lithium and suggest that an abrupt decrease in lithium level should be avoided. This reanalysis did not directly address optimal maintenance lithium levels but raises questions about the original study's finding of superiority for lithium levels > or =0.8 meq/liter. The results underscore the importance of accounting for the possible confounding effects of changes in the intensity of pharmacotherapy in studies of maintenance therapies for bipolar disorder.

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