Taking Lithium

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• Have you taken Lithium?
• Fish oil a natural form of lithium?
• Prescribed Lithium for bipolar disorder - does it help?
• More advice about Bipolar Disorder

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Have you taken Lithium?

Nov 2006

Hi all: PLease excuse the anonymous post, but as you may all appreciate mental health issues are a bit delicate. I have been taking an anti-depressant for some 4 years (Remeron - -mirtazapine generic), but I am increasingly irritable, angry and anxious. The psychiatrist I saw at Kaiser (my analyst cannot prescribe meds) says I have dysthymia and is recommending that after my blood tests come back to show whether I can take lithium, I should add lithium, rather than any sedative or Xanax- type anti anxiety drugs. He thinks lithium will have ''synergistic effects'' with the Remeron, unlike the other drugs. I am aware of some of the toxicity side effects from the literature, but I would like to know if others have used lithium, for what type of situations and to what effect, so I can make a more informed decision before I start pumping this stuff into my system.
Thanks so much,
Person

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My understanding is that Lithium is a mood stabilizer and is often used in the treatment of Bipolar Disorder. Bipolar has many different levels, from severe mania to more mild ''hypomanic'' or soft symptoms that can include irritability and anxiety. Often people who have been misdiagnosed and are taking anti-depressants are ''pushed'' into a more hypomanic or manic state just because of the drug itself. I would ask your health care providers if this could be a factor in your situation and/or the reasoning behind the prescription for Lithium. If this is accurate, Lithium is the gold standard for treatment and anti-depressants can be taken in addition. A great resource for Bipolar II or Soft Bipolar is http://www.psycheducation.org/. Dr. Phelps is amazing. Hope this helps. http://www.redwoodpsychotherapy.com
Alexandra

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I HIGHLY recommend that you see a psychiatrist about this. While it may be expensive, particularly at first, it is well worth it. For example, there are many newer drugs out there that are similar to lithium but with less side effects. Anon

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Just a few thoughts and a bit of info from my experience as someone who has been working with a mood disorder for many years and has been through many drug trials.

It does sound like you would do well to add a mood stabilizer. I take both an anti-depressant and a mood stabilizer- with just an anti-depressant I also eventually swing into an anxious, edgy, confused, irritable, and angry state, but with both I do well. I've used xanax along the way, I think it's a great med, and it can offer some valuable short term relief. But if you've got a real mood disorder, it's a bandaid, not a long term solution.

Lithium was the first mood stabilizer, it works great for many people, and it's safe when properly prescribed and monitored. In the years since lithium, other good ones have been found, all of them anti-convulsants that were originally developed for epilepsy. The one that's worked best for me is Lamictal, and it's being widely used because it does help many people, and often helps where other drugs have failed.

Lamictal is a patent drug, it's grossly expensive, and some health plans may resist paying for it right off. But I'm at Kaiser too, and my docs have been able to prescribe whatever they've thought best, patent or not, formulary or not.

When I say ''safe'', I'm not being cavalier, it's always risk v. benefit in taking a med or in driving a car or in getting up on a ladder to change a light bulb. No med is without potential side effects, no med is right for everybody, any med has to be monitored and carefully dosed. If you read the manufacturer's insert on ANY med without having more info you'll scare yourself half to death.

Organize all your questions and concerns and talk openly with your doc about them. Remember to be proactive (I know this is easier said than done when your mental state is bad, but do your best). Maybe there's a particular reason he's recommending lithium for you, maybe not. Maybe a change of anti-dep in combination with a mood stabilizer would be worth trying.

If your doctor doesn't like questions, consider meeting another one (but ask for an appointment quickly, don't let them make you wait for weeks, you need some help now) anon

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I've been on several antidepressants over the last 10 years, and about 6 months ago had Lithium added to my Paxil regimen. So far, so good--much better, in fact, than I had been for a long time.

Early on, I struggled a bit with excessive thirst and hand tremors, but those eased up within about 4-6 weeks. Now I only experience tremors when I overexert myself. I make a point to keep myself hydrated (dehydration increases blood levels of lithium, which can lead to the tremors and taxes the kidneys).

I have my lithium level, kidney function, and thyroid function checked every 6 months. All levels have been good so far. Lithium has been around a long time, so the side effects (mainly kidney & thyroid problems) are well known, unlike some of the other, newer mood stabilizers.

I am so grateful to the doctor who suggested that maybe my depression needed more than antidepressants. There is a good deal of literature about how lithium augmentation can be very helpful for some people. I hope it works well for you!
***liking Lithium so far***

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Get evaluated for Bipolar, NOS which means you may not meet the strict criteria for Bipolar disorder but you may have some depressive and some hypomanic symptoms which can manifest as decreasing response to antidepressants, anxiety and panic, irritability, decreased sleep and other symptoms. Both mirtazapine and lithium can cause weight gain and could increase your chances of getting diabetes. They have no synergistic effects compared to other medications for mood instability. Mirtazapine can also raise your cholesterol so this should be monitered. Both mirtazapine and lithium are generic medications and less costly than other medications that could be used. Any antidepressant could cause increased mood instability over time if you have Bipolar, NOS anon

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Fish oil a natural form of lithium?

April 2006

Re: Therapist for 11 year old boy
If you don't want to medicate (after you find a therapist) - consider giving him 1 1/2 teaspoons of fish oil a day (mix with juice). It is a natural form of Lithium - a highly effective anti- depressant.
zacmeg

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Lithium is NOT an antidepressant. It is a ''mood stabilizer'' and is used most often in the treatment of bipolar (manic-depressive) illness. Robert A. Fink, M. D.

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I HAVE to add a quick response to someone's recent posting about using fish oil as a source of lithium for depression. When I google this connection, I don't get any support for it (kelp, though, apparently is a fair source). If you want to need lithium, make sure you are really getting it, because it does make a difference -- my brother-in-law uses it and it literally saves his life.
anon

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As a psychiatrist I would like to add that fish oil is not a form of lithium. There are no controlled studies that show that fish oil helps with emotional problems. There are a some individual reports suggesting that fish oil may help people with a variety of health problems. Lithium, a naturally occuring salt, has years of controlled clinical trials (studies that have a placebo group) demonstrating efffectiveness for treatment of bipolar disorder and depression. There are many newer medications that also treat bipolar disorder with fewer side effects than lithium.
Judy

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Prescribed Lithium for bipolar disorder - does it help?

May 2006

I recently started seeing a psychiatrist for my bipolar disorder and was prescribed Lithium. He explained the medication and side affects to me, but I was a little surprised at the time and had many questions after I left his office and took in the severity of my condition. I have not filled the prescription yet.

I do not know anyone who is/has taken Lithium before and would like to get some comments on the medicine from someone who has taken it. Did this medication really help you? Why do you have to take the blood tests? Is this something I will have to take for the rest of my life? What will I feel like when I do take it? What will happen if I miss a dose, or a few days? My doctor told me not to drink any alcohol when I am on this medication. What will happen if I do? Do you get a stomach ache or headache? Or make a public idiot out of yourself? I do not want ANYONE (except my husband) to know I am taking this medication....is it normal to feel embarrassed about taking psychiatric meds???

Any advise on any or all of my questions is appreciated! Anon

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Hi, I have taken Lithium before and would be happy to talk you about it. I had a very positive experience with Lithium but I understand your concerns and, yes, it's not unusual to be very private about this. A few years ago I doubt I would have posted this message (which requires identifying myself)! I'm NO expert on lithium and only have my own experience to share, but I am happy to share and to listen. Whatever you decide, good for you for seeing a psychiatrist and getting support. You don't have to suffer and you are NOT alone. Best wishes, E

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My son takes lithium for his bipolar disorder and it has literally been lifesaving. As with treating any serious disorder it is a question of risk v benefits. Lithium has been around forever--it is a naturally occurring mineral often found in hot springs (which explains why depressed people who went to spas to take ''the cure'' 100 years ago actually got some results). It is toxic if taken in too great a quantity, but this is monitored simply by blood tests which can be infrequent, once a reliable dose is established. The primary side effect is thirst but even at pretty high doses (like my son's) the thirst is not extreme and easy enough to deal with. I do not know what happens when it is combined with alcohol. People with bipolar disorder should be wary of alcohol anyway.

The bottom line is if you are truly bipolar and your symptoms are affecting your life, you need a mood stabilizer. Try the lithium--give it a month or two--and see if you feel better. If you don't like it, ask for a different mood stablizer--or if you are new to this diagnosis and not sure about it, question the diagnosis.

There are more modern mood stabilizers which have different side effects but lithium is still the ''gold standard'' for certain symptoms, as I understand it. Mom of bipolar kid

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I took lithium several years ago with antidepressants. I was diagnosed with ''cyclical depression'' which meant my depression would occassionally spiral. Lithium helped with this. I'd do it all over again. The meds gave me enough stablility to work out the issues causing my depression and in that I am/was lucky. I got to a point where I could stop taking meds with doctor's blessing. However, I believe you should never stop meds suddenly or without advice. Sometimes that has a pretty negative effect on your health. Check with your doc on what to do if you miss a day or two.

Whether you'd take it your entire life I can't say. As I understand bipolar disease, it can be a lifetime illness and I hear that medications for its treatment are so good that you can start to think you don't have it anymore once you've been on your meds a while. However, it might be the case you would have to take it for your lifetime to keep those benefits of seeming illness free. The blood tests how they monitor your dose and they are important.

The combination of my antridepressants and lithium had side effects I could not trace to one med or the other. I gained weight and was thirsty all the time. You ask your doctor what side effects you should watch for so you can inform her because some indicate a dosage problem.

There is no reason any side effects would ever indicate to others your medical condition. However, you might be feeling sort of stimatized, already, perhaps even by your own feelings of your diagnosis. If this is the case, it is a sad statement that our society still produces that in us. Try not to worry that you are not really ''mainstream'' anymore because you seek to treat illness. You are seeking to live a happy and productive and fulfilling life and might be able to do that much better with medication. If you had high blood pressure or diabetes, you'd take a daily medicine to do just this. ''Mental illnesses'' (lets call them illness of the nervous system instead ok?) are chemical imbalances and you deserve treatment and a quality life if medical science can help you with it.

Good luck! Former Lithium Queen

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Hi, I am also bipolar. I was diagnosed at age 13. I am now 32. I was only on lithium for a week many years ago. I was having a particularly bad episode and the doctor wanted to use lithium for a very short period to stabilize me. But lithium is a much older drug and is much more finicky with more side effects than more recent drugs such as Prozac, Zoloft, etc. You may want to ask your doctor why he/she wants you on lithium rather than newer drug. Sometimes, depending on your condition, lithium is truly the best choice. While other times, your doctor may not keep up on the latest research.

I also highly recommend that you seek therapy, too. You do not have to have any deep-seeded issue to need therapy. It is often beneficial to be able to talk about having this illness. In fact, a mixture of therapy and medication is almost always the best treatment for bipolar. All too often, patients that only seek one or the other, have much more difficulty and confusion dealing with it.

And it is not uncommon to feel shame or embarrassment about taking medication. In fact, there is a scientist at Cal Berkeley that is dedicating his talents towards the social effect of bipolar. He is the first to really do this. (Sorry, I don't remember his name.) But, he has been finding that mental illness, most commonly, bipolar is the leading ''handicap'' in the workplace (he used a better word for it). It is also one of the leading illnesses in the US. However, due to the shame surrounding it, most companies, families, etc are unaware of the social impact it is making.

I have gone back and forth in my life, of acceptance and embarrassment. It is an ongoing challenge. But you are so much better off seeking treatment.

Best to you! Cathy

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I don't take lithium so can't answer your detailed questions, but my sister has been on lithium for bipolar disorder for 20 years now, and has expressed nothing but relief from it. The way she describes it, it just helps to moderate her tremendous mood swings. When she first got on it, she noticed her husband's behavior was actually similar, and since she understands the frustration associated with being in an uncontrollable rage, she suggested it to him also. They have both been on it since. She stayed off for a couple of years to get pregnant and nurse, and I got the impression that it was difficult for her, and she cut off nursing at a year or somethign because she felt like she needed her lithium. As her sister, I can't honestly distinguish her personality from her disorder, since I grew up with her, and she's a difficult person regardless of any mental health issues, although as years go by I'm learning more. But I can definitely say she's been easier to be around, and less likely to fly into a blind rage over some irrelevant detail, and more self-aware, since being on the lithium. At least initially the prescription was also accompanied by mandatory therapy, which I think also helped. My sister has never been embarassed about the meds, but I think that is an individual thing (my sister isn't embarrassed about much). I think you should be discreet if it is your preference, but it may be easier for you to at least be straightforward with your trusted friends if/when the issue comes up. Maybe don't share the info for people who you don't know well or who would insensitively use it to stigmatize you.

Although this is easier for me to say since I am not on meds, I wish more people would be straightforward about it, so there wouldn't be so much stigma. The only thing average people hear about bipolar disorder is from the few people with very serious illnesses who manage to commit violence when off their meds. My sister is not like that at all, though she has a challenging personality. Others that I know with the disorder would probably rather not let people know about it, but I do think our society generally could be better educated

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Dear ''Lithium'',
It great you're asking questions these important questions. I'm an experienced LCSW who has treated a number of clients diagnosed bipolar and prescribed lithium. I highly recommend that you talk with your psychiatrist about your concerns. And I wonder if s/he also does psychotherapy with you or focuses solely on medication management? It's really important that you have psychotherapy along with the medications. The two modalities together are well known to be more effective than either one individually. Since, I'm not a doctor I can't offer advice or guidance about medication. What I've heard from some clients and from my own independent research, I've learned that lithium is a standard and often very effective medication for treating bipolar. For greatest efficacy, you do need to take your medication regularly as prescribed. And you need blood tests to monitor the levels of the medication in your blood. Again, your doctor can answer all of your questions. Do go back and discuss your concerns. Sincerely, Deena

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Hi - I had a similar diagnosis about 25 years ago and was prescribed Lithium. I recall feeling calmer than usual but that's about it. Not feeling heavily drugged or anything. After about a month, I decided to discontinue it. I stopped suddenly. This brought on a huge panic attack, or something that felt like one. When my doctor was contacted they said it was brought on by suddenly stopping the medicine, and that you should never do that with Lithium. So this is just a warning should you start taking it and then decide to stop - don't do it suddenly.

Of course I don't know what the dosage was or if you are taking the same amount, etc. Since you are so unsure about taking this drug, maybe you should get another opinion? After I stopped taking it I never started it again, and have been pretty much fine ever since. Or at least I think I am!? Anon

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Please check out this website (http://cchr.org/) before you decide to take any drugs that your psychiatrist prescribes! Educate yourself before assuming that taking drugs is the answer. Joke

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Hi, I wanted to respond to the posting that referred you to http://cchr.org/. S/he raises valid concerns. The pharmaceutical industry is often greedy and unethical. However, if you do suffer from bipolar, DO NOT dismiss prescription drug use. Because of the pharmaceutical industry's greed, it has put made people very weary of taking drugs. However, there are those that really need them.

This site claims that there is no proof of a chemical imbalance. And it is correct. But any ethical doctor will tell you this. The reality is that if you truly suffer from a mental illness, there is no real clear-cut answer. This is why it is so important to seek a therapist, as well as a psychiatrist. I have been dealing with my depression for almost 20 years. (I am doing very well these days.) The key has been in finding a therapist and/or a doctor I can truly trust. Doctors and therapists should always be seeking out various forms of treatment for you, not just drugs. They should also always be very open and honest about treatments and willing to answer all your questions. What responsible doctors know is that they cannot locate the area of the brain that causes the theoretical ''chemical imbalances''. But they have found other activity in the brain that responds positively to drugs.

The body and mind are interlinked. So it makes sense that one affects the other. And as others have already stated, everyone's experience is different. Not everyone suffering from a mental illness needs drugs. They are surely over prescribed. But it doesn't mean that all prescriptions are wrong either.

As if the illnesses themselves are difficult enough to deal with! I hope that this helps. Cathy

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I'm bi-polar II, my niece is BP I, & I have a friend who is BP I. The thing about psychiatric disorders is that one size doesn't fit all when it comes to meds.

My own ''case'' was ''treatment resistant'', which meant that I had to go through years of trying different meds before getting well stabilized.

At first, I was terrified of meds & ashamed that I needed them, but I had been living in hell & so hung in through those years. I had good doctors who gave me time & information, & I also did my own research. Eventually I got used to the trial & error nature of the process, calmed down, began to learn to distinguish a side effect from other body sensations, & learned to trust my intuition about whether or not a particular med was a good choice for me.

Lithium didn't happen to be a good choice for me- it threw my sense of balance off- & my niece got mental confusion from it. My friend has done great on Lithium for 20 years (except for a few months when she decided she didn't need it any more, stopped taking it, & cycled into mania).

I take a combo of meds, but my primary mood stabilizer (and my niece's also) is Lamictal, a newer one that's now widely used. It's a very expensive drug, & some health plans may not offer it unless cheaper meds have failed, but I recommend inquiring about it. It has changed life for me, & for my niece.

Bi-polar disorder is permanent, it's a genetic disorder, it doesn't go away. If your diagnosis of BP is correct, you will need to take meds for the rest of your life. It's a pain in the butt, but I'm just grateful that these drugs exist.

I am very selective who I tell about my disorder- even in this psychologically sophisticated part of the world, there is still a lot of subconscious fear & judgement about mental illness. Trust your instincts and keep your own counsel as you need. You are who you are, you are not your illness, & even though it is a defining part of the life experience for those of us who have it you don't have to explain yourself to anyone!

Best of luck to you, hang in there- with good professional help you can find the stability you need anon