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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by UgottaHaveHope on May 21, 2006, at 2:06:26
Does anyone take Lithium on this board? You never hear about it? My pdoc mentioned trying me on Lithium and Depakote ... is that combo any good? What is the pdoc aiming for with that combo? Thanks, Michael
Posted by yxibow on May 21, 2006, at 3:08:09
In reply to Why doesnt anyone talk about Lithium?, posted by UgottaHaveHope on May 21, 2006, at 2:06:26
> Does anyone take Lithium on this board? You never hear about it? My pdoc mentioned trying me on Lithium and Depakote ... is that combo any good? What is the pdoc aiming for with that combo? Thanks, Michael
Your doctor may be testing whether you have BPI/II -- Lithium doesn't really have a huge value outside of Bipolar disorder although it is used. Both medications are primary medications for Bipolar. Lithium preparations are not without their side effects, they require some monitoring and they do produce more thirst.
Posted by Jost on May 21, 2006, at 14:48:30
In reply to Re: Why doesnt anyone talk about Lithium? » UgottaHaveHope, posted by yxibow on May 21, 2006, at 3:08:09
My Pdoctor recommended it to enhance the action of some ADs also-- although from this board, lamictal seems to be more the drug of choice for that now.
Jost
Posted by bipolarspectrum on May 21, 2006, at 15:05:44
In reply to Why doesnt anyone talk about Lithium?, posted by UgottaHaveHope on May 21, 2006, at 2:06:26
Hi,
Ironically, enough, I am on the lithium/depakote combo! Lithium, in itself, can be a wonder drug.. many bipolars respond amazingly to lithium, same with depakote... lithuim seems to be a booster for ADs as well... the combination of the two often allows one to minimize adverse effects they may experience while maintaining the therapeutic effect.. anywayz, good luck, dont fear either drug!
bps
Posted by linkadge on May 21, 2006, at 15:28:13
In reply to Re: Why doesnt anyone talk about Lithium?, posted by bipolarspectrum on May 21, 2006, at 15:05:44
I have been on lithium multiple times. It is good for certain things, but it is not good for my anhedonia. It also seems to make movement a little stiff for me. It affects my sleep, it seems to block my ability to really sink into the matress.
People do respond to it, generally better than I do.
Linkadge
Posted by blueberry on May 21, 2006, at 15:38:07
In reply to Why doesnt anyone talk about Lithium?, posted by UgottaHaveHope on May 21, 2006, at 2:06:26
I agree with what bipolarspectrum had to say in a previous post. Don't fear either lithium or depakote. Both have been around and widely used for many decades for all sorts of things. I would though only start one at a time. Probably depakote because it is fast.
Your doctor is probably on the track that you are having a certain type of mania, a very uncomfortable anxiety fear type and going way too fast inside. Even if it isn't mania, depakote can slow it all down pretty fast.
Posted by Phillipa on May 21, 2006, at 21:23:40
In reply to Re: Why doesnt anyone talk about Lithium? » UgottaHaveHope, posted by yxibow on May 21, 2006, at 3:08:09
And wt gain. My ex Father - in-law is and has been on it for years. A mood stabalizer the oldest. Did you know people in Europe bathed in baths full of lithium to absorb the salt. Wonder if they were bipolar? Love Phillipa non med expert
Posted by yxibow on May 21, 2006, at 21:59:08
In reply to Re: Why doesnt anyone talk about Lithium? » yxibow, posted by Phillipa on May 21, 2006, at 21:23:40
> And wt gain. My ex Father - in-law is and has been on it for years. A mood stabalizer the oldest. Did you know people in Europe bathed in baths full of lithium to absorb the salt. Wonder if they were bipolar? Love Phillipa non med expert
They used to use lithium chloride as a salt substitute until they discovered it was toxic (in enough quantities). Since then they've used potassium chloride.
Posted by Squiggles on May 22, 2006, at 6:52:44
In reply to Why doesnt anyone talk about Lithium?, posted by UgottaHaveHope on May 21, 2006, at 2:06:26
> Does anyone take Lithium on this board? You never hear about it? My pdoc mentioned trying me on Lithium and Depakote ... is that combo any good? What is the pdoc aiming for with that combo? Thanks, Michael
I think lithium is making a come-back for bipolar disorder. It went out favour slightly for a while but the medical literature is now reviving it. I can understand why a dr. may want to use a combo of lithium and Valproate because that way the side effects and toxicity of lithium are avoided. I think drs. may find the regular blood tests required for lithium "cost-ineffective", but i have a hunch that the need for them is historically exaggerated. Other drugs can become toxic too, e.g. the tricyclics and they never do blood tests for them or rarely.
Squiggles
Posted by linkadge on May 24, 2006, at 18:46:48
In reply to Re: Why doesnt anyone talk about Lithium? » UgottaHaveHope, posted by Squiggles on May 22, 2006, at 6:52:44
Oo, I don't know. I think the blood tests are pretty serious stuff. My mother accidentally took double her dose of lithium and I think she got lithium toxicity. Her cognition has never been the same since. Within theraputic dose lithium seems to be neuroprotective, but above theraputic and it can quickly become highly neurotoxic. (at least thats what I've heard)
Linkadge
Posted by Squiggles on May 24, 2006, at 18:56:45
In reply to Re: Why doesnt anyone talk about Lithium?, posted by linkadge on May 24, 2006, at 18:46:48
Sounds like marketeer talk; if they're
really concerned about lithium toxicity
they wouldn't come up with THE LITHIUM PATCH
(thanks to Dr. Nemeroff). A li-detector
would be nice; alternatively, a blood check
every year as I have been getting for the past 20 years. I am still cognitively competitive.Anyone interested in some spectroscopic research for a portable lithium detector?
Squiggles
Posted by Larry Hoover on May 24, 2006, at 19:16:58
In reply to Re: Why doesnt anyone talk about Lithium? » UgottaHaveHope, posted by Squiggles on May 22, 2006, at 6:52:44
> I think drs. may find the regular blood tests required for lithium "cost-ineffective", but i have a hunch that the need for them is historically exaggerated.
The toxicity of lithium is not all exaggerated. It is precisely the problem.
Lithium is one of the "drugs" with one of the smallest therapeutic indexes of all drugs. I put 'drugs' in quotes because it's not a drug at all, except in how it's used. It's an ion, found in low concentration in the environment. It's a salt, in its natural form.
Therapeutic index is technically the ratio of LD50 to ED50, which, in layman's terms, is the ratio of toxic dose to therapeutic dose.
Lithium is considered to be an NTI (narrow therapeutic index) drug, and its use requires very close monitoring. Every health authority in the world, (FDA, Health Canada, etc.) publishes annual lists of NTI drugs, and lithium will always appear on that list.
Every person's kidneys handle lithium a little differently than everyone else's. The therapeutic dose is that dose that maintains a stable blood concentration, balanced by intake and excretion in urine. Although the blood concentration that is effective is similar for all people, the dose that maintains that concentration can vary from 300 to 2700 mg/day. Moreover, chronic lithium use changes how the body manages lithium. Over time, the intake dose generally needs to be reduced.
But all of this data that is required to manage lithium can *only* be obtained by sampling blood.
That's what makes lithium a "high management" drug, from a doctor's perspective.
Lar
Posted by Squiggles on May 24, 2006, at 19:31:36
In reply to Re: Why doesnt anyone talk about Lithium? » Squiggles, posted by Larry Hoover on May 24, 2006, at 19:16:58
I know all that Larry. And I expect that
my doctor knows all that too. I've been
taking lithium for 25 years - i must be the
Energizer Bunny's grandmother :-)Squiggles
Posted by Larry Hoover on May 24, 2006, at 19:53:27
In reply to Re: Why doesnt anyone talk about Lithium? » Larry Hoover, posted by Squiggles on May 24, 2006, at 19:31:36
> I know all that Larry.
"i have a hunch that the need for them is historically exaggerated. "
It is not exaggerated. I cannot reconcile these statements you have made.
Lar
This is the end of the thread.
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