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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 rjlockhart37 on December 17, 2015, at 20:02:06
my doctor was going to use lithium for depression but i said no, and went to prozac 80mg because i don't want to get blood tests every month, cannot stand a needle being stuck in me
but jsut out of curosity what does lithium do for you? does it just stablize, clear thoughts up? lamotragine stabilzes me at 200-400mg but sometimes it makes me feel boring and emotionally blunted, everythings seems too stablized
what effects does it have?
Posted by SLS on December 17, 2015, at 23:47:33
In reply to lithium experiences, posted by rjlockhart37 on December 17, 2015, at 20:02:06
> my doctor was going to use lithium for depression but i said no, and went to prozac 80mg because i don't want to get blood tests every month, cannot stand a needle being stuck in me
For unipolar depression, lithium is used as an augmenter to antidepressants rather than an anti-manic mood-stabilizer. I feel better at 300 mg/day. At 300 mg/day, blood tests are not necessary. I have no complaints regarding cognitive side effects.
You shouldn't have to constantly adjust your dosage of Lamictal up and down. Perhaps a steady dosage of 300 mg/day would suit you best. Try giving any one dosage time to settle in.
- Scott
Posted by rjlockhart37 on December 18, 2015, at 12:50:43
In reply to Re: lithium experiences » rjlockhart37, posted by SLS on December 17, 2015, at 23:47:33
like when i take lamotragine, if im depressed or in a unstable mood, it stablizes and i feel more content, but does lithium do the same thing?
it can't really "enhance" the mood, but i think it's more a stablizer with some enhancements with nuerotrasmitter transmission
what does it do? does it stablize depression?
Posted by SLS on December 18, 2015, at 13:15:57
In reply to Re: lithium experiences, posted by rjlockhart37 on December 18, 2015, at 12:50:43
> like when i take lamotragine, if im depressed or in a unstable mood, it stablizes and i feel more content, but does lithium do the same thing?
>
> it can't really "enhance" the mood, but i think it's more a stablizer with some enhancements with nuerotrasmitter transmission
>
> what does it do? does it stablize depression?I am taking a combination of Parnate and desipramine for depression. Adding 300 mg/day of lithium makes the antidepressants work better. I can feel an immediate improvement when I add it - 48 hours. At such a low dosage, I would not expect lithium to stabilize bipolar mood oscillations. That usually takes 900 - 1500 mg/day. You don't appear to need these higher dosages. So, yes, lithium can help with depression when combined with an antidepressant. Maybe it would enhance the positive effects of other drugs, too. I don't know. I would say that if you don't experience any positive effects by 10 - 14 days, it probably won't work (unless your other drugs need to be optimized). The negative effects on thyroid and kidneys are dose-dependent, so I wouldn't worry about toxicity. Although lithium doesn't bring me to remission, every little bit of an improvement helps. Besides, there is evidence that low dosages of lithium (150 mg/day) can help to prevent Alzheimer's Dementia - something that I am at high risk for.
Don't forget to stay at one dosage of Lamictal! You might have to finesse the dosage to find the one that improves depression but doesn't affect cognition too much. As far as feeling "flat" is concerned, give 300 mg/day a few weeks to see if it wears off. It did with me.
- Scott
Posted by Lamdage22 on December 20, 2015, at 4:00:45
In reply to Re: lithium experiences » rjlockhart37, posted by SLS on December 18, 2015, at 13:15:57
Hey Scott,
which specific symptoms does your 300mg Lithium treat??
Posted by SLS on December 20, 2015, at 6:20:20
In reply to @Scott. Re: lithium experiences, posted by Lamdage22 on December 20, 2015, at 4:00:45
Hi Lamdage.
> which specific symptoms does your 300mg Lithium treat??You know, it has been so long since I added lithium, I am having a hard time trying to characterize the improvements it gave me. It did give me more mental energy and cleared up my thinking a little. I suppose it also brightened my mood and helped with anhedonia a bit. All I can say is that the effect was significant and showed up within 48 hours of taking my first dose. I found that 450 mg/day flattened my affect and made me feel less well. 150 mg/day didn't really help. 300 mg/day works best for me.
Obviously, lithium has not provided the robust response that I am looking for, but that it helped at all with depression was a pleasant surprise for me.
I don't know if I mentioned this in a previous post, but lithium is now being studied for use in schizophrenia. Who knows? Perhaps it would be an ideal adjunct drug for treating schizoaffective disorder. I don't know whether or not you have schizoaffective disorder, but, either way, it couldn't hurt to add lithium at low dosages (300 - 600 mg/day). I wouldn't give it any more than two weeks to work. You could start at 300 mg/day for 5 days; 450 mg/day for 5 days; and 600 mg/day for 5 days. A study performed by Harvard 15 years ago indicated that the average dosage of lithium that produced a response when added to Prozac was 450 mg/day. I'll see if I can dig it up.
- Scott
Posted by SLS on December 20, 2015, at 6:33:26
In reply to Re: @Scott. Re: lithium experiences » Lamdage22, posted by SLS on December 20, 2015, at 6:20:20
This wasn't the exact study I was thinking of, but it was conducted by the same investigators.
http://www.ncbi.nlm.nih.gov/pubmed/12172337
Their findings here were that low-dosage lithium (300-600 mg/day) added to low-dosage fluoxetine (20 mg/day) helped, but that raising the dose of fluoxetine to 40-60 mg/day without adding lithium helped somewhat more. Unfortunately, there was no arm in the study looking at adding lithium to high-dosage fluoxetine. It makes sense to try, though.
- Scott
Posted by Lamdage22 on December 20, 2015, at 11:02:03
In reply to Re: @Scott. Re: lithium experiences, posted by SLS on December 20, 2015, at 6:33:26
Scott,
i would ideally take a bit less because a) this dosage wouldnt induce any weight gain and b) i think i had palpitations even on 600 mg.
I would try 200mg. Added to the lithium orotate i already take.
Hmm.
You know i am more particular with side effects than you.
My psychiatrist doesnt want me to try new things. But i have a tough time complaining about bad mood.
Posted by SLS on December 20, 2015, at 11:39:36
In reply to Re: @Scott. Re: lithium experiences, posted by Lamdage22 on December 20, 2015, at 11:02:03
> Scott,
>
> i would ideally take a bit less because a) this dosage wouldnt induce any weight gain and b) i think i had palpitations even on 600 mg.I don't gain weight at all on lithium - high or low dose. Some people gain a lot. I don't know if there is any way to predict. The palpitations are interesting.
> I would try 200mg. Added to the lithium orotate i already take.
That makes sense.
Good luck.
- Scott
Posted by Lamdage22 on December 21, 2015, at 11:27:00
In reply to Re: @Scott. Re: lithium experiences, posted by SLS on December 20, 2015, at 11:39:36
Today i am going down to 10mg Zyprexa. Everybody is pressuring me to go off the APs.... I want to do it at MY SPEED.
> > Scott,
> >
> > i would ideally take a bit less because a) this dosage wouldnt induce any weight gain and b) i think i had palpitations even on 600 mg.
>
> I don't gain weight at all on lithium - high or low dose. Some people gain a lot. I don't know if there is any way to predict. The palpitations are interesting.
>
> > I would try 200mg. Added to the lithium orotate i already take.
>
> That makes sense.
>
> Good luck.
>
>
> - Scott
Posted by SLS on December 21, 2015, at 16:17:30
In reply to Re: @Scott. Re: lithium experiences, posted by Lamdage22 on December 21, 2015, at 11:27:00
> Today i am going down to 10mg Zyprexa. Everybody is pressuring me to go off the APs.... I want to do it at MY SPEED.
It is likely that you have more information to work with than the people around you. They might be worried about horror stories regarding side effects or simply the stigma involved in taking a drug with the word "psychotic" in it. It sounds too heavy-duty. Both concerns are understandable. Zyprexa is arguably the drug that has the best combination of antipsychotic and antidepressant properties. Of course, the best drug for any individual is the one that works. If Zyprexa didn't have such strong metabolic side effects, it would probably be used more often.
I have probably already asked this question, but I am curious if you have tried Luvox (fluvoxamine) yet. It has a reputation for being effective in treating psychotic depression.
- Scott
Posted by Lamdage22 on December 22, 2015, at 2:00:45
In reply to Re: @Scott. Re: lithium experiences, posted by SLS on December 21, 2015, at 16:17:30
Zyprexa makes me lazy. Very lazy.
This is the end of the thread.
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