Posted by dragonblack on May 17, 2011, at 18:59:30
In reply to Re: Regular Lithium: better than ER... » dragonblack, posted by SLS on May 17, 2011, at 15:30:54
> > It's pretty complicated, and I could expound at length on my theories regarding alcohol use and abuse and my newfound lithium effect. I'll spare you that... : )
>
> Please don't. I would be very interested to know about your theories.
>
>
> - ScottHmm. Well, when it comes to neurochemistry and psychopharmacology, I know just enough to appear knowledgeable to the clueless and a fool to the clued-in (read: SLS and assorted PB friends). You are right regarding genetics; the incidence of substance abuse in the general population is 7%; among bipolar it is >61%. According to Fredrick Goodwin, coauthor of the physicians desk reference on bipolar, alcoholism and bipolar are almost certainly genetically linked.
It seems to me, however, that in rough terms alcohol essentially causes an increase in serotonin and gaba levels, the latter being the source of its cns depressant status. For a long term drinker, this specific serotonin/gaba cocktail is a biochemical signature that one seeks, psychologically and maybe even physically. Now, it may just be, as you say, that this seeking is garden variety self-medicating, and that by treating the mood disorder and/or depression with lithium, one neednt continue to self-medicate in the old way. I must say, though, it feels far more specific to me. Ive been on other mood stabilizers, and Ive managed to stop cycling before, yet nothing mirrored this effect. Ive also successfully treated my depression in the past, yet never with any effect on my desire to drink. I wonder if lithiums effects on serotonin and glutamate somehow displace or mimic or blunt the effect of that serotonin/gaba cocktail that the drinker seeks out.
This idea that lithium treats alcoholism isnt new orotate is touted for this specifically, but the medical literature refutes it (though its been studied repeatedly, so someone thought it worth testing). I came across an anecdotal account of a woman on askapatient.com that was very similar she said that on lithium she all of a sudden found alcohol repulsive and stopped drinking. I dont find it repulsive so much as I feel completely indifferent to it, and the idea of drinking seems very weird to me, almost like I cant imagine doing it. Maybe its just the case that a subset of people have this response. That the makers or orotate actually market it for this purpose makes me wonder if there isnt a substantial fraction of mood disorder sufferers who will experience this effect on lithium, though not large enough to be vindicated in clinical trials with a verdict that lithium treats alcoholism.
I also wonder if theres anything to the idea that we might be experiencing a certain visceral repulsion to a diuretic with lithiums effects on thirst and electrolytes, and the dehydrated hangover awakening state that the long term drinker knows so well, I wonder if there isnt an (almost) immunological push to avoid that which severely dehydrates. (Then why didnt you give up coffee, you ask? For long-term caffeine users, typical daily doses cease to be diuretic to a meaningful extent (beyond water). Only for novices is caffeine a true diuretic.)
I could go on, but at this point my thoughts become all about how Ive responded to various things in the past, and then its just me, me, me. Ill keep this part of the dialogue internal.
poster:dragonblack
thread:985426
URL: http://www.dr-bob.org/babble/20110515/msgs/985574.html