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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Emily Elizabeth on July 12, 2005, at 20:13:51
I asked about this a few months ago, but the issue has come up again, so I thought I'd ask again.
I have unipolar depression and I have tried a lot of different things, all with incomplete results. My pdoc mentioned that lithium might be the next thing to try. Anyone here tried this before? Was it helpful? What were your side effects like?
Any thoughts would be appreciated!
EE
Posted by med_empowered on July 13, 2005, at 3:07:26
In reply to Lithium antidepressant augmentation?, posted by Emily Elizabeth on July 12, 2005, at 20:13:51
hey! I have bipolar, so I havent taken a mood-stabilizer for unipolar depression. Some relatives and friends of mine have taken mood-stabilizers and/or antipsychotics as add-ons for severe depression, with mixed results. Sometimes the depression goes away and everything is awesome. Sometimes you feel better, but the lithium makes you feel kind of stupid. Sometimes nothing happens. And...worst case scenario...sometimes the add-on drug actually deepens the depression. Have you tried Lamictal? The reseearch on it for unipolar depression is scant, but it seems to pack a punch against depression. Lithium, depakote, etc. all pretty much function as anti-manic agents; although there may be fewer depressive episodes and the rate of successful suicide attempts is decreased by the use of mood-stabilizers, they arent really mood brighteners in the conventional sense. Plus, speaking from experience, they can cause some bad side effects--cognitive dulling, emotional numbness, lethargy, over-sedation, weight gain, hormonal problems, skin problems, hair loss, so on and so forth. This isnt to say they dont work for some people--they do, and the side-effects dont hit everyone and they can usually be managed--but please realize that Lithium is a pretty hardcore medication. Lamictal can cause weird rashes and what not, but it seems to have a mood-lifting effect, almost like an antidepressant or stimulant. Its more expensive than lithium, but there arent any blood tests and, assuming you dont get "the rash," the side-effect profile is a lot more user-friendly than that of lithium. Other options would be...stimulants (desoxyn, dexedrine, adderall, ritalin, provigil--maybe cylert, but I'd avoid it b/c of the liver problems), buspar (anti-anxiety and some anti-depressant effects at higher doses), antipsychotics (with old ones, low dose perphenazine used to be a standby; zyprexa is the most popular antipsychotic for this use, but abilify is gaining popularity since it has a nicer side-effect profile), amoxapine (weird tricylic/antipsychotic in one: good for treatment resistant depression, psychotic depression, "moody schizophrenia"/schizoaffective, etc...chemically related to loxapine), and some others. Then, there are some creative, VERY "off-label" uses of meds for antidepressant effects. Painkillers seem to have some antidepressant effects; Ultram, for instance, seems to help some people (if you read old medical documents, you find that opium used to be the antidepressant/anxiolytic/sedative/antipsychotic of choice). Marinol, the THC pill, is sometimes used for depression, bipolar, ADD, etc., but few docs are willing to try it (for some reason, its OK to RX amphetamines, but not pot. Go figure). Drugs used in Parkinsons and Alzheimers are also sometimes used, usually in addition to more standard treatment. Good luck!
Posted by linkadge on July 13, 2005, at 6:22:14
In reply to Re: Lithium antidepressant augmentation?, posted by med_empowered on July 13, 2005, at 3:07:26
"the rate of successful suicide attempts is decreased by the use of mood-stabilizers"
I belive the only mood stabalizer shown to reduce suicide is lithium. The same anti-suicide effect has not been found with tegretol or carbamazapine.
I could be wrong, but I've read that in a few places.
Linkadge
Posted by Ilene on July 13, 2005, at 15:09:07
In reply to Lithium antidepressant augmentation?, posted by Emily Elizabeth on July 12, 2005, at 20:13:51
> I asked about this a few months ago, but the issue has come up again, so I thought I'd ask again.
>
> I have unipolar depression and I have tried a lot of different things, all with incomplete results. My pdoc mentioned that lithium might be the next thing to try. Anyone here tried this before? Was it helpful? What were your side effects like?
>
> Any thoughts would be appreciated!
>
> EEI have unipolar depression and got lithium when I was in the hospital. It made my ankles swell, which is a symptom of allergy, so I was taken off it. I don't think I was on it for long enough for it to have any beneficial effect.
I.
Posted by yesac on July 14, 2005, at 18:53:39
In reply to Lithium antidepressant augmentation?, posted by Emily Elizabeth on July 12, 2005, at 20:13:51
Well, I'll tell you a bit about my personal experience.... I have tried about a billion drugs over the past 5 years or so: antidepressants, mood stabilizers, benzos, antipsychotics, stimulants. FOr the most part, nothing really helped me much. I don't know if I'm bipolar-- technically I guess not, but I have a very agitated depression with a lot of mood lability. Call it what you want.
So anyways, a couple of months ago, I finally started to feel better. I am taking lithium and Seroquel. A lot of the improvement is due to improvement in my more bipolar symptoms, such as agitation, irritability, rage, mood lability. But there is some improvement in depression too. I would say that I feel better than I have in years. Not great, certainly not perfect, but I feel like I can handle things a little better, I'm not suicidal every single day, I'm not totally flipping out half the time.
So in my opinion, lithium is definitely worth a try. And in terms of augmentation, I do think that it augments the Seroquel, which is not an antidepressant, but the two seem to work better together than either one alone.
Good luck!
Posted by wraith on July 17, 2005, at 5:41:12
In reply to Lithium antidepressant augmentation?, posted by Emily Elizabeth on July 12, 2005, at 20:13:51
For what its worth I was placed on Lithium augmented with Amitryptyline after being diagnosed with Treatment Resistant unipolar Depression.
At first the 'lithium' thirst was a problem and I would spend the entire day with a dry mouth but this was alleviated by ensuring I had sufficient water to hand. On occassions I would get a severe tremour but this cleared up by itself after 3 or 4 weeks. Having the blood work done is also a pain due to a fear of needles but certainly tolerable.
On the plus side - I have never felt better, this was the only drug to pull me back from insanity and start to restore and heal all the symptoms of depression. In fact even now it just seems to get better day by day.
I started this treatment over a year ago. Because of my progress I have now been discharged from my Pyschs care with the provisio that I continue on the meds.
If you do make it onto Lithium I hope your experiences are as positive as mine.
The best of luck.
Wraith
> I asked about this a few months ago, but the issue has come up again, so I thought I'd ask again.
>
> I have unipolar depression and I have tried a lot of different things, all with incomplete results. My pdoc mentioned that lithium might be the next thing to try. Anyone here tried this before? Was it helpful? What were your side effects like?
>
> Any thoughts would be appreciated!
>
> EE
Posted by Emily Elizabeth on July 17, 2005, at 13:01:52
In reply to Re: Lithium antidepressant augmentation? » Emily Elizabeth, posted by wraith on July 17, 2005, at 5:41:12
Thanks for your reply. That is helpful info. If memory serves me correctly, Amitruptyline is a TCA, right? I take Desipramine (also a TCA) so in some ways it is a similar situation. I'm sick of all the meds, hoping that they will fix it, but then being disappointed when they don't. But I'm also soooo sick of this long and unrelenting depression. Your experience does make me think that litium might be worth a try.
Thanks,
EE
> For what its worth I was placed on Lithium augmented with Amitryptyline after being diagnosed with Treatment Resistant unipolar Depression.
>
> At first the 'lithium' thirst was a problem and I would spend the entire day with a dry mouth but this was alleviated by ensuring I had sufficient water to hand. On occassions I would get a severe tremour but this cleared up by itself after 3 or 4 weeks. Having the blood work done is also a pain due to a fear of needles but certainly tolerable.
>
> On the plus side - I have never felt better, this was the only drug to pull me back from insanity and start to restore and heal all the symptoms of depression. In fact even now it just seems to get better day by day.
>
> I started this treatment over a year ago. Because of my progress I have now been discharged from my Pyschs care with the provisio that I continue on the meds.
>
> If you do make it onto Lithium I hope your experiences are as positive as mine.
>
> The best of luck.
>
> Wraith
>
>
> > I asked about this a few months ago, but the issue has come up again, so I thought I'd ask again.
> >
> > I have unipolar depression and I have tried a lot of different things, all with incomplete results. My pdoc mentioned that lithium might be the next thing to try. Anyone here tried this before? Was it helpful? What were your side effects like?
> >
> > Any thoughts would be appreciated!
> >
> > EE
>
>
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