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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Christina on May 15, 2001, at 12:56:08
Hi. I've rambled here for a while about my med history (mainly SSRIs, Tri-cylics, mood stabilizers) for the past 6 years.
Recently I quit taking Celexa (drug free for about 3 weeks). Withdrawal was bad, and the depression seems to be returning along with sporadic anger and irritability. I want to stay off Celexa, but I had some leftover lithobid (300mgs), so I started taking them until I can see my new PDOC for some relief.
I actually feel a little better.
Does anyone take mood stabilizers alone for depression?
Have you had success?
I'd love some discussion about this.
Thanks
Posted by SalArmy4me on May 15, 2001, at 13:25:24
In reply to Lithium Alone for Depression, posted by Christina on May 15, 2001, at 12:56:08
I thought you might find this interesting:
From: Schou, Mogens MD, DRMed, DrHCMult. Forty Years of Lithium Treatment. JAMA Archives of General Psychiatry. 54(1):9-13, January 1997:
LITHIUM PROPHYLAXIS IN UNIPOLAR AFFECTIVE ILLNESS
...Trials by Baastrup et al and myself [2,3] have demonstrated that lithium is also prophylactically effective in recurrent unipolar depression (recurrent major affective disorder), and, in most parts of the world, lithium has been used successfully for this indication. In a recent comprehensive analysis of the literature Souza and Goodwin concluded: "There is no reason to doubt the efficacy of lithium in the prophylaxis of unipolar depressive illness."...However, the British study reveals nothing about the value of lithium alone, and it is difficult to see how a single American study (based on pooling of patients from many clinics with consequent risk for "loose" diagnoses) can outweigh the evidence of more than 15 studies carried out over the last 25 years that show the prophylactic, recurrence-preventive action of lithium to be as effective in unipolar as in bipolar affective disorder.
...In recent years American research has proved that long-term treatment with antidepressants is prophylactically effective in recurrent depressions. Although these are fine studies, lithium prophylaxis was not mentioned. I believe that patients who suffer from recurrent depressions without obvious psychosocial precipitating factors, have symptom-free intervals, and are without deviating character features, might benefit from first-line or second-line lithium maintenance treatment. The final choice of prophylactic agent must depend on how individual patients respond to and tolerate treatment with antidepressants and with lithium.
...For patients with unipolar illness, the new antidepressants may, for the reasons given above, be preferable as first-choice agents, but lithium should not be forgotten as an effective alternative of proven efficacy.
Posted by loosmrbls on May 15, 2001, at 14:20:30
In reply to Lithium Alone for Depression, posted by Christina on May 15, 2001, at 12:56:08
This is a very complicated topic. For bipolar patients, lithium and anticonvulsant mood stabilizers act as "antidepressants" by stopping cycling, and some seem to have better AD properties than others. Lithium seems the most proven as an antidepressant.
I am on Depakote and Lithium for bipolar DO (with the lithium acting as stabilizer and AD with "OK" results).
I'm assuming some diagnosis of bipolar disorder was entertained at some point with you, since you had lithobid lying around.
However, if you are rapid-cycling or having mixed states, lithium is a poor choice and usually does poorly.
Now, for unipolar depression, it is usually used to augment another "classical" AD like an SSRI -- but outside of the united states it is used first-line with mixed results.
When I first started lithium (on two occasions) the side effects felt SSRI-like, except stronger. It is definately pro-serotonergic. But it has other properties as well.
So, to answer your question: for bipolar illness -- yes. For unipolar depression -- probably yes.
Posted by Christina on May 15, 2001, at 17:29:52
In reply to Lithium Alone for Depression, posted by Christina on May 15, 2001, at 12:56:08
Thanks for the input.. I feel a little better about my decision to try the Lithium by itself. My old PDOC suggested I might have some bi-polar tendencies (and bp runs in my family), which is why he gave me the Lithobid. Unfortunately I was also swtiched to Effexor at the same time with bad results, so stopped both and went back on Celexa.
I didn't feel I was getting the relief I needed from Celexa (nor any of the other meds I've tried like Paxil, Zoloft, Pamelor, Wellbutrin, Prozac and Depakote.) His next move was to try me on Neurontin before he retired, but I decided against anymore med trials till i found a new doc.
Incidentally, I've never had the rapid-cycling that can go with BP, so I was probably more unipolar.
In any event, I feel a little calmer today and I seem to be able to focus a little better than normal (could be placebo effect).
So I'll see what happens in the next few weeks till I see the new doc.
But if any one has any other comments, I would love to hear them..
Thanks!
Posted by Alex J on May 15, 2001, at 19:00:55
In reply to Lithium Alone for Depression, posted by Christina on May 15, 2001, at 12:56:08
Christina,
My mother has been on Lithium for the last 15 years to successfully treat unipolar depression. It appears to be the only med that works for her.
AJ
Posted by Christina on May 15, 2001, at 19:32:01
In reply to Re: Lithium Alone for Depression » Christina, posted by Alex J on May 15, 2001, at 19:00:55
I glad she found something that works for her... it really is a struggle. If you don't mind me asking, has she gained weight from Lithium? I gained about 40 lbs on ADs, and I'm hoping I might lose some (or at least not gain) on Lithium alone.
> Christina,
>
> My mother has been on Lithium for the last 15 years to successfully treat unipolar depression. It appears to be the only med that works for her.
>
> AJ
Posted by Alex J on May 15, 2001, at 20:04:18
In reply to Re: Lithium Alone for Depression, posted by Christina on May 15, 2001, at 19:32:01
I'm happy to report that my mother has not experienced any weight gain while on Lithium. Probably not as happy as she is though :)
Posted by Mitch on May 16, 2001, at 0:48:16
In reply to Lithium Alone for Depression, posted by Christina on May 15, 2001, at 12:56:08
I am bpII and just restarted lithium *yesterday* at 300mg a day (after a 2 year absence). I am also taking Neurontin and Klonopin. I take a *little* Celexa too. My long-term goal is to stay off all AD's without being plagued by anxiety/panic/depression. I have found that only Li/Neurontin works for major depression of the mood stabilizers I have tried (The only ones I haven't tried is Lamictal and Zonegran). I too, can feel a benefit already frm the Lithium. I am a little dulled, but my thoughts are quieter, and I am more in touch with *perceptual* stimulii rather than just the usual barrage of *conceptual* "trash". Also getting sleepy at bedtime when I should be!
> Hi. I've rambled here for a while about my med history (mainly SSRIs, Tri-cylics, mood stabilizers) for the past 6 years.
> Recently I quit taking Celexa (drug free for about 3 weeks). Withdrawal was bad, and the depression seems to be returning along with sporadic anger and irritability. I want to stay off Celexa, but I had some leftover lithobid (300mgs), so I started taking them until I can see my new PDOC for some relief.
> I actually feel a little better.
> Does anyone take mood stabilizers alone for depression?
> Have you had success?
> I'd love some discussion about this.
> Thanks
Posted by loosmrbls on May 16, 2001, at 8:24:38
In reply to Lithium Alone for Depression, posted by Christina on May 15, 2001, at 12:56:08
I actually remember now, my pdoc saying he had a patient that he was convinced was unipolar depression who only responded to lithium.
I am on lithium 900mg and depakote 1250mg and it's been the best combo so far, but there is definately room for improvement.
I would also mention that people that had a "bad response" to a mood stabilizer, like depakote -- do not count it if you were on an AD at the same time. Especially if you have BP I or II.
Posted by Mitch on May 16, 2001, at 12:10:19
In reply to Re: Lithium Alone for Depression, posted by loosmrbls on May 16, 2001, at 8:24:38
The "mood stabilizers only" meds for unipolar depression being successful for some doesn't surprise me. Depakote was helpful (it was calming), but Lithium/Neurontin helps me better for depression/ADHD. I had to stop Depakote due to tremor, otherwise I would probably be taking it.
> I actually remember now, my pdoc saying he had a patient that he was convinced was unipolar depression who only responded to lithium.
>
> I am on lithium 900mg and depakote 1250mg and it's been the best combo so far, but there is definately room for improvement.
>
> I would also mention that people that had a "bad response" to a mood stabilizer, like depakote -- do not count it if you were on an AD at the same time. Especially if you have BP I or II.
This is the end of the thread.
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