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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by cubic_me on November 12, 2004, at 17:41:34
I've been on Effexor XR for 18 months now, and many other drugs besides, but none of them have really worked for me, and I'm currently trying thyroxine with litte success in lifting my depression. My pdoc said that the next stage would probably be to try Lithium. I've always thought of this as a 'hard-core' mood stabiliser with lots of unpleasant side-effects that could be longlasting. I've read quie alot about it, but I'm still confused about whether I'd really want to go down that line of treatment.
Another thing that bothers me is that I've been diagnosed with mild/moderate depression (although my pdoc doesn't know half of what I think etc) and he is still suggesting this line of treatment - is that usual for seemingly so mild symtoms?
Posted by jack smith on November 12, 2004, at 18:26:58
In reply to Lithium - is it really that big a step?, posted by cubic_me on November 12, 2004, at 17:41:34
It really is not. I would recommend starting at a low dose, maybe 300 for a week, then 600 for a week, and then you might have to go higher. Lithium finally killed a nasty depression that was lingering (i.e., not that bad anymore but still not fully gone) for many months on 300 mg of Effexor. Added 300 mg of Lithium, and within a week I was feeling much much better. One of the mildest meds I have ever been on by far. I'd give it a go.
I take 300 mg of Effexor and 300 mg of Lith and have been on that combo for over a year with good results. Lithium also supposedly has a good track record at prolonging remissions from unipolar depression, which is what I think I suffer from. . . . .
JACK
Posted by Slinky on November 12, 2004, at 18:46:11
In reply to Lithium - is it really that big a step?, posted by cubic_me on November 12, 2004, at 17:41:34
I'm starting lithium next week..I've been scared of taking it..but my depression won't lift
As someone said here-you can just try and if it doesn't help go off it...simple why worry.
Posted by Dan Perkins on November 12, 2004, at 19:21:54
In reply to Lithium - is it really that big a step?, posted by cubic_me on November 12, 2004, at 17:41:34
I had the same reaction when my pdoc brought up Lithium. I had always thought of it as pretty hard core end of the line kind of thing, but my pdoc seemed to have no idea where I would have gotten the notion that lithium was any kind of big deal at all.
So, I went on lithium (to augment Parnate and later Nortriptyline) and he was right, it was no big deal AT ALL! It had a stabalizing effect on my mood (even though I am unipolar) but even that effect wasn't that dramatic. I have been on a whole lot of meds and Lithium does not stand out at all as having had a lot of side effects or as being that serious.
I don't know the history of lithium and why it seems to have the stigma that it has, but in my book it is completely unfounded. Maybe it's thought of as serious because it is used to treat bipolar which people may have stereotyped as hardcore and serious and that some of that image rubbed off on the drug.
I'm not endorsing lithium (ultimately wasn't right for me) but I am telling you that there is nothing to fear about taking it.
Posted by prodgirl on November 12, 2004, at 22:08:31
In reply to Re: Lithium - is it really that big a step?, posted by Dan Perkins on November 12, 2004, at 19:21:54
I was terrified at first, as well. I didn't want to go near Lithium, so I tried other mood stabilizers for 1.5 years after my BP dx. I started taking Li about 6 weeks ago, and it's not that big of a deal.
I think that there IS a nasty stereotype.
Although some people have taken it with ease, you never know how your body will react. Make sure that when you sit down with your pdoc and get the rx, you talk about scenarios. The most common side effect I have read about are GI problems, which I also suffered from. I take fiber about an hour before my morning dose, which my pdoc and I chose (timing can effect your absorbtion levels). Talk about hydration (electrolytes), diet (don't cut out your sodium, watch caffiene), pain killer (tylenol vs advil). Everyone is different, just make sure that you talk about these things with your pdoc before you go to pick up your rx.
Posted by jlbl2l on November 13, 2004, at 3:52:40
In reply to Lithium - is it really that big a step?, posted by cubic_me on November 12, 2004, at 17:41:34
Lithium depletes brain inositol which is a crucial intermediate of the phosphatidyl-inositol cycle. This is a second-messenger system used by several noradrenergic, serotonergic and cholinergic receptors. Many people use high dose inositol for depression.
jlb
Posted by jclint on November 13, 2004, at 6:09:49
In reply to Re: Lithium - is it really that big a step?, posted by jlbl2l on November 13, 2004, at 3:52:40
What are your guys' experiences with weight gain? Anything significant?
Posted by cubic_me on November 13, 2004, at 6:59:26
In reply to Re: Lithium - is it really that big a step?, posted by jlbl2l on November 13, 2004, at 3:52:40
Thanks so much of all your reassurance everyone. I suppose the most worrying possible side effects for me would be long term memory/brain funtioning trouble and weight gain. I never thought that weight gain would affect me until I went on Remeron and coudn't stop the gain no matter how little I ate or how many times I went to the gym - so frustrating!
jlb121 - are you saying that lithium shouldn't be used in depression as it reduces the absorption and reuptake of mood enhancing compounds? I understood what you were saying but wondered what your conclusions were. Thanks.
Posted by Keith Talent on November 13, 2004, at 23:25:33
In reply to Re: Lithium - is it really that big a step?, posted by cubic_me on November 13, 2004, at 6:59:26
All over my back, had to be controlled with isotretinoin. I didn't have the weight gain or gastrointestinal or cognitive side effects of the other posters.
Posted by cubic_me on November 14, 2004, at 13:12:08
In reply to Acne only problem, posted by Keith Talent on November 13, 2004, at 23:25:33
Thanks Keith, I had acne from when I was nine years old and went on Roaccutane which helped tremendously but had very irritating side effects, so acne is definately something to watch out for with me.
Thanks
Posted by B2Chica on November 14, 2004, at 17:33:45
In reply to Lithium - is it really that big a step?, posted by cubic_me on November 12, 2004, at 17:41:34
Hey Sweetie, haven't talked for a while.
i'm so glad you asked this question...my pdoc is possibly suspecting rapid cycling with me and i've read that lithium is used quite often and i DEFINATELY have the same concerns. Li just seems like the MOTHER of all mood stabilizers, but also comes the stereotypes and concerns of side effects.if you go to it let us know how it's going for you. Please be good to yourself...
(smile! cubic)
B2c.
Posted by Barbaracat on November 16, 2004, at 2:22:39
In reply to Re: Lithium - is it really that big a step?, posted by cubic_me on November 13, 2004, at 6:59:26
Lithium saved my life and was no big deal at all. I was horrified at first at what it 'meant' and what if people found out, but laugh at this now (although I still don't broadcast it). It really made all the difference in a medication journey that went on for over 30 years without much success.
I've been on a low sub-therapeutic dose (600mg) for over 2 years. I'm bipolar and didn't realize it except that SSRIs weren't working any longer and destabilizing me terrible into mixed states. As soon as I began lithium it was like a nice fuzzy blanket came to protect me from that wild electric static so common to bipolars.
Yes, make sure you get the other info - electrolytes, water intake, take extra salt (sea salt, no Morton's). You'll also gain weight unless you make a very concerted effort not to, so commit to getting alot of exercise. You may also notice your hair quality feels different at first, kind of coated, but this went away.
As far as mind problems, lithium has been shown to actually grow new dendrites and increase BDNF, a very good thing for brain health. Anti-aging proponents are taking small amounts for just these brain regeneration properties. Go slow and you may find that you don't need the 'therapeutic window' amounts dictated by blood tests which are likely to cause annoying side effects, at least at first (tremors and dopeyness were the most annoying for me until I reduced the dose). Even though I'm not even in the low end of the window, my pdoc eventually said 'it seems to be working, the blood tests aren't telling us anything new, so let's just skip them'. Fine with me. But you need to find what works for you.
BTW, I also was on Remeron and have never glutted myself like a fattened hog like I did on that med. I was insatiable, lurking by the fridge at 2am and I've never been this way. Lithium is NOTHING like Remeron. You don't feel like a constant food lust-bucket, it just takes forever to lose anything you put into your mouth, Atkins diet, anything, and you absolutely need to exercise those calories off.
> Thanks so much of all your reassurance everyone. I suppose the most worrying possible side effects for me would be long term memory/brain funtioning trouble and weight gain. I never thought that weight gain would affect me until I went on Remeron and coudn't stop the gain no matter how little I ate or how many times I went to the gym - so frustrating!
>
> jlb121 - are you saying that lithium shouldn't be used in depression as it reduces the absorption and reuptake of mood enhancing compounds? I understood what you were saying but wondered what your conclusions were. Thanks.
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