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Lithium For Depression?


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I've always thought Lithium was more of an anti-manic medication, but I've been reading it's used for depression too.  PDoc wants to add this to my Effexor to see if it'll give it a boost in the right direction...

Wondering the usual, has anyone tried it, side effects, and did it help or not?  Be Honest.

Thanks a lot in advance.

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@looking for answers is not bipolar, maybe, but has MDD..also maybe. His blood levels are under the generally accepted therapeutic levels but he's said it's been a total game changer for him.

There's this

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC193982/

there's also this. as someone stuck in unspecified mood disorder land, this guy's site is something i reference often but might not apply to true unipolar without complications or other associated MDD with spicy features.

https://psycheducation.org/treatment/mood-stabilizers/the-big-three-for-bipolar-depression/lithium/

key point in there is that the therapeutic range of .6-1.2 was a range developed for acute bipolar 1 treatment of mania. Something that is less acute could in theory see a benefit at a lower range.

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I started lithium initially years ago because of depression. I have trouble with AD’s, and pdoc wanted to see how it would do. It’s not perfect, but I do think it’s helped control the depths of it. 

But unless you have very steady types of low cycles, I do also think it’s also kinda like saying “zinc will shorten a cold”... since you don’t know how long the cold’s going to be otherwise, you don’t *really* know that it’s shortened it. Anti-depressive effects might be more subtle. 

Lithium has the fewest s/e’s of any med I’ve ever tried. And the lovely part is that if a dose is skipped, there’s no withdrawal symptoms. Not that I’ve skipped very much, but some meds are a bitch on wheels. 

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2 hours ago, BrianOCD said:

I've always thought Lithium was more of an anti-manic medication, but I've been reading it's used for depression too.  PDoc wants to add this to my Effexor to see if it'll give it a boost in the right direction...

Wondering the usual, has anyone tried it, side effects, and did it help or not?  Be Honest.

Thanks a lot in advance.

I’ve heard of it being very effective for resistant suicidal ideation 

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I have tried it, and personally it had no effect on me other than to make me more of a numb zombie like the vast majority of psych meds do. It is worth adding that I was put on it for suicidality and not MDD as a whole. It did nothing for my suicidality, and besides the above, it did nothing and was more like a sugar pill. I took it both as an adjunct and as monotherapy, same statement applies to both. 

 

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On 7/15/2019 at 9:10 PM, argh said:

@looking for answers is not bipolar, maybe, but has MDD..also maybe. His blood levels are under the generally accepted therapeutic levels but he's said it's been a total game changer for him.

There's this

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC193982/

there's also this. as someone stuck in unspecified mood disorder land, this guy's site is something i reference often but might not apply to true unipolar without complications or other associated MDD with spicy features.

https://psycheducation.org/treatment/mood-stabilizers/the-big-three-for-bipolar-depression/lithium/

key point in there is that the therapeutic range of .6-1.2 was a range developed for acute bipolar 1 treatment of mania. Something that is less acute could in theory see a benefit at a lower range.

I guess my bipolar is debatable. One doc who saw me for 15 min said I had it. Then I went to an iop and they took his diagnosis. New doc said he doesn’t think I am, but “maybe”, but uses the diagnsis code to fit the meds.

 Using the “spectrum” my anxiety is my mania? 

Ive never been manic or close to it.

 

so whatever I dunno

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16 hours ago, looking for answers said:

I thought the same bud. And until mynlevels hit .5 ish it didn’t do much but then it was like a

lightbulb, so it took a few weeks to build up.

Well that's good to hear, when you say lightbulb what do you mean exactly?

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.5 is the minimum therapeutic level, so makes sense that’s when it felt like it kicked in. 

You'll need a few blood draws initially, to ensure you’re at a proper blood level. Everyone reacts differently to dosage. I’ve seen people here on 1500mg... I’d be dead if I took that much. I take 600mg, and I’m consistently at .7, which is a sweet spot for me. I’m *very* sensitive to meds. 

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7 hours ago, BrianOCD said:

Well that's good to hear, when you say lightbulb what do you mean exactly?

 

7 hours ago, BrianOCD said:

Well that's good to hear, when you say lightbulb what do you mean exactly?

I was in an IOP at that point, and really had no desire for anything. Was in a dark place. It pulled me out of that, gave me hope. Didn’t fix it all, but sure prolly saved my life  

3 hours ago, Rabbit37 said:

.5 is the minimum therapeutic level, so makes sense that’s when it felt like it kicked in. 

You'll need a few blood draws initially, to ensure you’re at a proper blood level. Everyone reacts differently to dosage. I’ve seen people here on 1500mg... I’d be dead if I took that much. I take 600mg, and I’m consistently at .7, which is a sweet spot for me. I’m *very* sensitive to meds. 

Yep I’m on 900 and stick around under that 0.6 mark. Heck in the hospital pst week I drew 0.31. I have been on 1200 and still not been over 0.6

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@looking for answers @Rabbit37 How would you compare Lithium to Lamictal? I gave a super short trial to Lithium YEARS ago..but I struggle mainly with (apathetic) depression & it didn't seem to really help that. I always thought it was better for mania, slowing things down (a bit too much), but I didn't go up too high I think I was scared of sedation & weight gain. I also got scared about possible liver/kidney issues.

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5 minutes ago, Blahblah said:

@looking for answers @Rabbit37 How would you compare Lithium to Lamictal? I gave a super short trial to Lithium YEARS ago..but I struggle mainly with (apathetic) depression & it didn't seem to really help that. I always thought it was better for mania, slowing things down (a bit too much), but I didn't go up too high I think I was scared of sedation & weight gain. I also got scared about possible liver/kidney issues.

lamictal didnt work for me. I had high hopes for it. BUt i was in a dark place, and wasn

I have had really no side effects on both lithium and lamictal.

But the lithium like i said pulled me from the deepest darkest depression, got me to a point where i can live and function, and get the help i need.

 

im still on it, my biggest beef now is the "flat", whether its that or seroquel. I never realy feel super sad, and never feel "happy", but im on a ton of meds.

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33 minutes ago, Blahblah said:

@looking for answers @Rabbit37 How would you compare Lithium to Lamictal? I gave a super short trial to Lithium YEARS ago..but I struggle mainly with (apathetic) depression & it didn't seem to really help that. I always thought it was better for mania, slowing things down (a bit too much), but I didn't go up too high I think I was scared of sedation & weight gain. I also got scared about possible liver/kidney issues.

I tried lamictal a long time ago, don’t remember it helping much, and then whatever it did do completely crapped out on me. I tried it again recently, and couldn’t handle the intense headaches. 

I LOVE lithium, provided it’s at a good level. I’ve been too high before, around .9, and I did feel flat, and I had problems with hand tremors. They weren’t bad, but I do delicate work, so that was unacceptable. Pdoc brought it down, and I’ve been happy. 

It is more reputable with mania, but that’s seldom a problem for me. My hypomanias can get intense, but overall I struggle with depression more. Basically at the dose I’m on, it keeps everything within a certain range. I’ve still gone high and low, but not to an extreme. 

Pdoc is adamant about treating the symptoms, not about maintaining a certain number. .7 is good for me. 

I don’t have s/e’s now, just have to always make sure I stay hydrated, which isn’t a problem. And have to be careful if I’m outside doing sweaty work, have to drink tons of water. I don’t think the liver is an issue, it’s processed through the kidneys. I’ve had thyroid issues earlier in life, but weirdly they disappeared, and a recent lab showed they’re normal. 

Oh, and I’ve had no sedation from it. Lack of sleep is my issue :( 

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Lithium personally wasn't for me. It made me feel kind of ill. No other way to really describe it. Only made it 10 days and to about 600mg. Ultimately valproate was better for me than lithium. Each person responds to them differently though.

What I can say is that I personally asked for lithium when I was in a deep dark spot. It did help improve my depression and some suicidal thoughts I had been having went away completely. However, the side effects just weren't worth it to me.

I urge you, however, to try it yourself with an open mind. For many, lithium is LIFE-CHANGING. It certainly was effective. It's just whether or not your body "rejects it". In the end I ultimately don't know why I had the experience I did, and I never did get a blood level done. So I'm not sure if it was that I was experiencing toxicity because my body couldn't clear it for some reason? Idk who knows?

But like @argh pointed out, there's a ton of evidence in favor of LOW-DOSE lithium as an augment to an antidepressant for treatment-resistant unipolar depression. By low-dose, I mean a dose that gives you a blood level of 0.4 - 0.6. Higher doses of lithium up to levels of 1.2 are only necessary for mood stabilization and anti-manic effect, but they aren't as effective for depression in the long-term.

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Thanks for all your responses guys, it helps me a lot to put things into perspective.

Btw, does it matter when you take Lithium or with food?  I forgot to ask my PDoc these questions, mainly cause I can't remember anything anymore lol

Edited by BrianOCD
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2 minutes ago, looking for answers said:

If u don’t mind me asking, you think ur gonna try it

Ya, I'm just waiting for the delivery.

If this one doesn't work I found an old PDoc that was great years ago that I had thought retired but found his office... I'm going to switch over to....

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1 minute ago, looking for answers said:

Good I think it’s worth a try. Do u have a titration schedule?

Just told me to start taking 300 daily, if I don't see anything positive I probably won't be going up or staying on it long, but from what I gather, the lower doses are for depression anyways?

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That works I did my titration during an iop stay. Just FYI . And this was for me. I had really weird like dissociative feelings the first 3 days with each dose increase and when starting then leveled off and was fine. Again like always ymmv just trying to say I’m an advocate for it, that things passed for me

quuickly 

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25 minutes ago, BrianOCD said:

Btw, does it matter when you take Lithium or with food?  I forgot to ask my PDoc these questions, mainly cause I can't remember anything anymore lol

Depending on the amount, probably most people split it am and pm. I only take 600mg, so all at night. I find it makes me slightly tired. Not enough to help with sleep, but enough I don’t want it during the day. 

Food’s never been an issue.

and when you get the blood draw, it’s best to have it done 12 hours after a dose, for an accurate level.

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21 minutes ago, BrianOCD said:

Just told me to start taking 300 daily, if I don't see anything positive I probably won't be going up or staying on it long, but from what I gather, the lower doses are for depression anyways?

Why would u not go up or stay on it?

 

different strokes for different folks on dosing times. I don’t believe any special instructions. Just try and stay even with water consumption big changes up or down can change ur levels. Same with salt. 

 

Ii take 900 all at once at night.

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You said a light bulb came on which sounded good...

I say this cause I've literally felt half-asleep now every day for a while, is it normal to feel half-asleep/half-conscious in depression?  I sometimes wrestle with is this depression, or do i have brain damage...

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5 minutes ago, BrianOCD said:

You said a light bulb came on which sounded good...

I say this cause I've literally felt half-asleep now every day for a while, is it normal to feel half-asleep/half-conscious in depression?  I sometimes wrestle with is this depression, or do i have brain damage...

Yeah man, that def can be depression : I struggled with that a while back and at times still do. Tbh it’s how I ended up on vyvanse. Which has been my semi miracle.  But like I said I attribute lithium to pulling me out of that black hole. 

Didnt fix the depression but got me out of the hole, enough to work half heartedly, and dive into therapy and meds with a string family support system. But I struggled and fought. And I still do. I still haven’t found my answer totally.

but if your that down. Absolutely try it, and give it a fair shake. 

This is by no means directed at you, or anyone. But something I learned. To give any meds a fair shake, even if ur afraid of it or it’s side effects. Like seroquel , it lets me sleep and I thankfully haven’t gained weight on it. I won’t do zyprexa though lol 

anyways good luck I hope it works for you. If u have questions ask, enough of us have experience with it.

also message me if u just need to talk.

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  • 2 weeks later...
8 hours ago, browri said:

@BrianOCD did you ever start the lithium?

Not just yet, I'm getting a second opinion with an older Psych doc tomorrow so I'm putting it off.

The doctor I saw who prescribed lithium, has so far been very wrong on meds.

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On 7/30/2019 at 6:00 PM, BrianOCD said:

Not just yet, I'm getting a second opinion with an older Psych doc tomorrow so I'm putting it off.

The doctor I saw who prescribed lithium, has so far been very wrong on meds.

How'd the appointment with the other pdoc go?

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55 minutes ago, browri said:

How'd the appointment with the other pdoc go?

Good he was my IP PDoc so I trust his opinion more, I didn't realize he had been doing outpatients.

His inclination was to switch to Pristiq so I started Pristiq yesterday and then he was to add Wellbutrin but I've had issues with that drug in the past so no go.  He also had mentioned Vibrid or something?

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Will do, I can't believe 18 months of my life are gone though, that's what is really gonna disturb me if I find something that finally works and begin to climb up.

Edited by BrianOCD
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On 8/1/2019 at 6:35 PM, BrianOCD said:

Will do, I can't believe 18 months of my life are gone though, that's what is really gonna disturb me if I find something that finally works and begin to climb up.

So it looks from your signature like your pdoc hard cut you over from 300mg venlafaxine ER to 100mg of desvenlafaxine ER. How do you feel the past few days?

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7 hours ago, browri said:

So it looks from your signature like your pdoc hard cut you over from 300mg venlafaxine ER to 100mg of desvenlafaxine ER. How do you feel the past few days?

Pretty spaced out, weird, exhausted, nausea, dizzyness, confusion

So pretty much like every other day 🥴

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12 hours ago, BrianOCD said:

Pretty spaced out, weird, exhausted, nausea, dizzyness, confusion

So pretty much like every other day 🥴

Yeah give it a few days. I've only ever taken 50mg of desvenlafaxine but that was back before they realized that 100mg was a useful dose. Like I don't think the 100mg tablet was even available when I was taking it.

The only thing I ever had a problem with on desvenlafaxine was occasional constipation that I can recall. I don't recall any nausea though.

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