Posted by bleauberry on July 4, 2009, at 19:36:14
In reply to Going back to old-school - lithium., posted by SLS on July 3, 2009, at 6:42:30
I know my comments sometimes go against the grain of academia. But I believe shooting for a predetermined target dose of anything, including lithium, based on a general consensus of what happens in the general population, is bogus. I think it causes more failure than success. I think more success is attainable by slowing increasing doses, after starting at very low doses, so as to find "the" place and not shoot past it. If the mind numbing stuff of lithium is already kicking in, the dose in my opinion is already too high. It perhaps needs a lower dose and longer time, versus higher dose and shorter time. Lithium should feel invisible at the right dose.
Totally different drug, but an example. My LLMD claims to have never had a failure at fixing anyone's depression. His arsenal consists mostly of just lexapro or zoloft. The trick is not the drugs, but the doses. He has patients in complete remission from treatment resistant drug sensitive depression on things like: 1 drop of liquid lexapro up to 5mg of lexapro. 1 drop is 1/10th of 1mg. Psychiatrists and pharmicists would scoff at the idea and probably laugh hysterically. The only problem is, it works over and over in very difficult populations.
We accept dosing targets as if they came out of a bible. They didn't. They are just as flawed as the clinical studies they came from.
I see no problem with lithium except in two areas:
1)When it is combined with a serotonin med, which in your case doesn't apply, so that's cool. I think it works best in norepinephrine or multi-neurotransmitter meds, but not pure serotonin meds.
2)When a preconceived dose target is set, as if anyone on the planet could have the slightest clue how much lithium you need. Example, I know someone who had the lithium numbing at 300mg, totally zombied at 600mg, but pleasantly energized and feeling good at 75mg.
I think the version of lithium you take is also important. They are not the same. If one bombs, try the other. I don't know if you have the citrate version or what, but they are different.
poster:bleauberry
thread:904699
URL: http://www.dr-bob.org/babble/20090630/msgs/904965.html