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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by Toph on October 30, 2005, at 17:06:56
In reply to lithium- initial effect then apathy, posted by linkadge on October 30, 2005, at 16:51:11
Sorry to hear that link. Lithium takes the very dangerous extremes off of my BPI, but not my ability to enjoy life. I can laugh my *ss off and feel like sh*t just like most people. It causes no detectable alteration of cognition or mood for me. One thing I have noticed is, I don't get really stupid drunk, by that I mean I don't get that euphoria when initially high (though my central nervous system is undeniably impaired). It's a life saver for me but may not be the medication of choice for you or for BPIIs. I tried Lamictal and it didn't help lift my mood at all. I hope you find something to your liking.
Toph
Posted by linkadge on October 30, 2005, at 17:17:17
In reply to Re: lithium- initial effect then apathy » linkadge, posted by Toph on October 30, 2005, at 17:06:56
Well I've been taking it. I notice it helps some symptoms such as insomnia, and anxiety, but beyond that I just can't figure out what to do with myself.
I can't seem to find anything that will bring any satisfaction or pleasure. And my goodness it makes the world around me seem so grey. It's like the color just drained right out.
Glad you're having more sucess.
Linkadge
Posted by TomG on October 30, 2005, at 18:05:59
In reply to Re: lithium- initial effect then apathy, posted by linkadge on October 30, 2005, at 17:17:17
I took 600mgs of lithium for 2 weeks then raised to 900mgs. I had a drastic reduction of my symptoms immediately following but for only five days. Attempts to raise the dose caused nothing but this extreme agitating feeling gritting my teeth and it was like I was straining and causing blood to rush to my face.
That was the first drug to quit on me and Geodon was the second. I have not had a third response.
Tom
Posted by linkadge on October 30, 2005, at 18:39:16
In reply to Re: lithium- initial effect then apathy » linkadge, posted by TomG on October 30, 2005, at 18:05:59
It is disheartening.
Linkadge
Posted by SLS on October 30, 2005, at 19:19:00
In reply to lithium- initial effect then apathy, posted by linkadge on October 30, 2005, at 16:51:11
Try treating the apathy separately.
Ritalin, Adderall, Wellbutrin...
If you haven't already tried Parnate + lithium, you might want to place it high on your list of things to try.
- Scott
Posted by linkadge on October 30, 2005, at 19:25:19
In reply to Re: lithium- initial effect then apathy, posted by SLS on October 30, 2005, at 19:19:00
I would like to try lithium + nortryptaline
at some point.Linkadge
Posted by Phillipa on October 30, 2005, at 20:33:21
In reply to Re: lithium- initial effect then apathy, posted by linkadge on October 30, 2005, at 19:25:19
Nortriptalline put me to sleep and I couldn't wakeup the next day till two pm. I felt like I was part of the bed. Fondly, Phillipa
Posted by SLS on October 31, 2005, at 1:46:56
In reply to Re: lithium- initial effect then apathy, posted by Phillipa on October 30, 2005, at 20:33:21
> Nortriptalline put me to sleep and I couldn't wakeup the next day till two pm. I felt like I was part of the bed. Fondly, Phillipa
Nortriptyline affected me the same way the first time I tried it. It took a few days for the somnolence to disappear, as it appears this was a startup side effect. If you never gave nortriptyline more than a day or two, I would consider retaining it on your list of things to try.
Most people respond best to 75mg. However, nortriptyline is the best-studied antidepressant drug for blood-levels versus response, so it is easier to determine dosages. I take 100mg. If you take too much, you can actually lose the antidepressant response, so dosage determination is more critical with nortriptyline than it is for the other TCAs. As a guideline, blood levels should range between 50-150 ng/ml. Of course, some people will need to be higher and some people lower. Clinical titration is still necessary.
Of course, there are other TCAs.
- Scott
Posted by linkadge on October 31, 2005, at 11:51:54
In reply to Re: lithium- initial effect then apathy » Phillipa, posted by SLS on October 31, 2005, at 1:46:56
For post ECT replase prevention, there is a lot of research done on the combination of lithium and nortryptaline.
The combination prevented relapse more markedly than either agent alone.
Linkadge
Posted by linkadge on October 31, 2005, at 11:54:13
In reply to Re: lithium- initial effect then apathy, posted by linkadge on October 31, 2005, at 11:51:54
The main problem is that if I ad an SSRI to lithium I get significant additive serotonergic side effects.
Linkadge
Posted by ed_uk on October 31, 2005, at 15:01:35
In reply to lithium- initial effect then apathy, posted by linkadge on October 30, 2005, at 16:51:11
Hi Link,
What dose of Li are you taking? Have you had your blood level measured?
Ed
Posted by linkadge on October 31, 2005, at 15:27:22
In reply to Re: lithium- initial effect then apathy » linkadge, posted by ed_uk on October 31, 2005, at 15:01:35
600mg. No bloodwork. Doctor went on vaccation.
Don't really want theraputic level. I'd much rather take an insufficiant dose and then complain about how it doesn't work.
Seriously speaking though, a theraputic level makes me too dumb to attend university. I was on 1500mg at one point two years back, if you can believe. I started to fail tests, quizzes, and exams left and right.
Linkadge
Posted by ed_uk on October 31, 2005, at 15:36:15
In reply to Re: lithium- initial effect then apathy, posted by linkadge on October 31, 2005, at 15:27:22
Hi Link
>600mg
of lithium carbonate?
Perhaps you should try a lower dose - say 450mg.
Kind regards
Ed
Posted by Phillipa on October 31, 2005, at 17:51:10
In reply to Re: lithium- initial effect then apathy » Phillipa, posted by SLS on October 31, 2005, at 1:46:56
Scott if you can believe it it was only 5mg. And the pdoc still had me take the l5mg of valium. When I asked about blood levels she said"You want blood levels you can if you want them". So you see how critical it is for me to find the right pdoc in Charlotte. PJ/Phillipa
Posted by Phillipa on October 31, 2005, at 17:58:22
In reply to Re: lithium- initial effect then apathy » Phillipa, posted by SLS on October 31, 2005, at 1:46:56
Scott, I forgot to mention that she ordered it as Pamelor. Does it make a difference? And it was so expensive. Almost $l00 for l0mg pills which the parmacy CVS had to special order. I thought the older meds were much cheaper. PJ/Phillipa
Posted by SLS on October 31, 2005, at 18:50:00
In reply to Re: lithium- initial effect then apathy » SLS, posted by Phillipa on October 31, 2005, at 17:58:22
> Scott, I forgot to mention that she ordered it as Pamelor. Does it make a difference?
I use the generic.
In theory, the generics should be equivalent to the original brand name medications. In practice, this is not always the case. Although the active ingredients are the same, the inactive excipient recipes and manufacturing can be quite different. This can lead to differences in bioavailability as the drug preparation proceeds through the gastrointestinal tract. Larry Hoover can better describe the details.
So far, I haven't had a problem with the generic. As you've said, the TCAs and their generic preparations have been around for a long time. Relatively speaking, they are cheap. Still, you are paying a premium for the Pamelor. It would be consistent, if nothing else. If you are still reluctant to use a generic for fear of lack of consistency, you could always ask your pharmacist to use the same generic supplier.
If the money is coming out of your pocket, I would recommend the generic.
- Scott
Posted by Optimist on October 31, 2005, at 20:43:10
In reply to Re: lithium- initial effect then apathy » Phillipa, posted by SLS on October 31, 2005, at 18:50:00
I notice no flattening of mood what so ever. Actually the reverse if anything. I am more animated and am able to enjoy life much more fully than I have pre-Lithium.
I'm taking 600mg Lithium Carbonate, with 300mg Wellbutrin SR, and Selegiline 5mg.
Brian
Posted by Emily Elizabeth on October 31, 2005, at 21:28:45
In reply to lithium- initial effect then apathy, posted by linkadge on October 30, 2005, at 16:51:11
Sorry, I didn't read what others wrote to you, but I saw your question and something occured to me (perhaps someone has said this). Li can supress thyroid functioning, so it is impt to have bloodwork done to check thyroid hormones after taking Li for a while. Thyroid probs would cause apathy, etc.
My pdoc and I just had this discussion today, and so it was on my mind.
Best,
EE
Posted by Phillipa on October 31, 2005, at 21:39:29
In reply to Re: lithium- initial effect then apathy » Phillipa, posted by SLS on October 31, 2005, at 1:46:56
Scott maybe the generic would be better. And it does come out of my pocket. Medicare. No drug insurance for psych meds. And if there is a a 20% difference up or lower than the original. They maybe if it were lower do you think nortriptalline is lower it just might be worth another try. Now if only your pdoc in Charlotte would be taking new patients and I can locate him. Would he be willing to try it. The names my pdoc were Linda Mundle and Pamela Wright-Etter. Saw a picture of the first one on the internet and yes she is old and the other one I couldn't find. How fast can you find out information on them tonight? Tomorrow is supposed to be moving day and Greg was up all night packing up his junk and I mean junk and he's already said he will do the same tonight as he has no consept of time. Took more valium last night because someone has to sleep. But the computer is off tomorrow for who knows how long. Please Scott tell me which one yours or hers. Fondly Phillipa
Posted by 4wd on October 31, 2005, at 23:13:15
In reply to Re: lithium- initial effect then apathy, posted by Phillipa on October 30, 2005, at 20:33:21
> Nortriptalline put me to sleep and I couldn't wakeup the next day till two pm. I felt like I was part of the bed. Fondly, Phillipa
Wow, it had the opposite effect on me. At 25mg per day, after about a week, I was bouncing off te walls with super anxiety and jitteryness. Not to mention that I couldn't speak because my mouth was so dry.
Marsha
Posted by linkadge on November 1, 2005, at 17:31:11
In reply to Re: lithium- initial effect then apathy » Phillipa, posted by 4wd on October 31, 2005, at 23:13:15
No, my thyroid function is ok, it was checked recently.
It is fairly dose dependant. The more I take, the more I ask myself "what's the point ?"
Linkadge
Posted by katekite1 on November 1, 2005, at 21:32:31
In reply to lithium- initial effect then apathy, posted by linkadge on October 30, 2005, at 16:51:11
Hey there, I haven't been on this board in a couple years so its nice to recognize a name.
What was the symptom you were trying to alleviate with the lithium?
My guess is its too high a dose or too quick a rise. People change, maybe you just don't tolerate as high a dose as you did before, or maybe other drugs you are on are different this time.
Or... you know you do seem to care a lot that it is making you apathetic (though your words are pretty sparse already), perhaps if you took more you would be so apathetic you wouldn't mind! (not suggesting you do that). If you are thinking of it, wait and check your levels first. :)
Katekite1
Posted by linkadge on November 1, 2005, at 21:40:27
In reply to Re: lithium- initial effect then apathy » linkadge, posted by katekite1 on November 1, 2005, at 21:32:31
I am basically taking it for unipolar depression.
Other treatments have stopped working so we decided to try lithium again.
I had a few good days, and then ended up back where I was originally, and stayed there ever since.
Linkadge
Posted by Dr. Bob on November 2, 2005, at 0:02:54
In reply to Re: lithium- initial effect then apathy » linkadge, posted by katekite1 on November 1, 2005, at 21:32:31
> I haven't been on this board in a couple years
How about going back to your original name? Do you need your old password?
Bob
Posted by katekite1 on November 2, 2005, at 16:19:32
In reply to Re: haven't been on this board » katekite1, posted by Dr. Bob on November 2, 2005, at 0:02:54
Hi Dr. Bob,
Sure that would be a-okay... when I tried to renew using my old name katekite it didn't seem to work, not sure why.
Katekite
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