![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Jimmyboy on February 5, 2007, at 10:44:02
I started Lithium about 5 weeks ago , and the change has been nothing short of miraculous. I was in the depths of depression that had lasted over 8 months and it has gradually slipped away since beginning Lithium. ( Also taking Tianeptine , but I am only a week into that)
It has had amazing antidepressant effects, and yes, there are side effects, but not near as bad as with SSRI's. I just don't understand why when someone is possibly bipolar and depressed they always rush to Lamictal. Its expensive and it takes forever to titrate up to the right dose. My Lithium cost me $4 a month at Wal-mart and I felt somewhat better in under 2 weeks.
JB
Posted by Phillipa on February 5, 2007, at 11:18:11
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
Can't take it with thyroid problems. Love Phillipa
Posted by polarbear206 on February 5, 2007, at 11:59:14
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
> I started Lithium about 5 weeks ago , and the change has been nothing short of miraculous. I was in the depths of depression that had lasted over 8 months and it has gradually slipped away since beginning Lithium. ( Also taking Tianeptine , but I am only a week into that)
>
> It has had amazing antidepressant effects, and yes, there are side effects, but not near as bad as with SSRI's. I just don't understand why when someone is possibly bipolar and depressed they always rush to Lamictal. Its expensive and it takes forever to titrate up to the right dose. My Lithium cost me $4 a month at Wal-mart and I felt somewhat better in under 2 weeks.
>
> JB
Many people cannot tolerate the long term side effects of Lithium when it reaches therapeutic drug levels. There is new evidence that combining Lamictal and low dose of Lithium can enable those to reduce their AD's. This combinbation has a good AD response. I plan to persue this avenue.
Posted by willyee on February 5, 2007, at 12:09:52
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
> I started Lithium about 5 weeks ago , and the change has been nothing short of miraculous. I was in the depths of depression that had lasted over 8 months and it has gradually slipped away since beginning Lithium. ( Also taking Tianeptine , but I am only a week into that)
>
> It has had amazing antidepressant effects, and yes, there are side effects, but not near as bad as with SSRI's. I just don't understand why when someone is possibly bipolar and depressed they always rush to Lamictal. Its expensive and it takes forever to titrate up to the right dose. My Lithium cost me $4 a month at Wal-mart and I felt somewhat better in under 2 weeks.
>
> JBGlad youre doing well,...you speak of why people arent trying it as much,and in the same post of the price escalation....my friend i think you answered your on question.
Many people dont like to question there doc,might even do it once,perhaps im guessing here but maybe sample cards of lamictal,and the drug itself just ......might be recomended more so for reasons of profit,this could some far fetched theory (coughs) of course.
Glad your doing well again,that is always of most importance above anything written here.
Posted by Bill LL on February 5, 2007, at 12:58:57
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
If Lithium were a patented drug and Lamictal were the generic; you would see just the opposite trend. Money rules.
Posted by Squiggles on February 5, 2007, at 16:06:06
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
I'm so glad it has worked. I am sorry but
I forget what your diagnosis was?Squiggles
Posted by ed_uk on February 6, 2007, at 15:03:55
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
Hi JB
What dose of lithium are you on and what is your blood level?
Ed
Posted by notfred on February 6, 2007, at 18:48:26
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
The problem with Lithium is the therapeutic and toxic levels are really really close to each other.
Thus the requirement for regular testing, which makes it less popular as a first line med for depression.
Posted by Squiggles on February 6, 2007, at 19:35:58
In reply to Re: Lithium is underused as an antidepressant, posted by notfred on February 6, 2007, at 18:48:26
> The problem with Lithium is the therapeutic and toxic levels are really really close to each other.
> Thus the requirement for regular testing, which makes it less popular as a first line med for depression.That *is* the received wisdom and yes lithium
is one of the drugs which becomes toxic once physical circumstances allow the drug to increase without elimination; however, it is not the only drug that has cerebral consequences such as malignant serotonin syndrome, and neuroleptic syndrome, and coma, etc.-- many ADs have this power to reach dangerous levels. I think there is some pharmacological folk wisdom with the lithium which has stayed with us. One good thing about the lithium toxicity, is that it is more gradual than defined in this "narrow therapeutic index" label, and you *can* feel it going toxic-- at least if you are an experienced and educated lithium taker (from the brochures and dr.'s advice).Squiggles
Posted by Maximus on February 7, 2007, at 12:20:49
In reply to Re: Lithium is underused as an antidepressant, posted by polarbear206 on February 5, 2007, at 11:59:14
> Many people cannot tolerate the long term side effects of Lithium when it reaches therapeutic drug levels. There is new evidence that combining Lamictal and low dose of Lithium can enable those to reduce their AD's. This combinbation has a good AD response. I plan to persue this avenue.
>Hi Polarbear,
This is what i take: Lamictal + Lithium + Effexor. It works fantastic and i'm highly functional. I've been taking this combo for years now. I'm bp II, mainly depressed. Here, in Quebéc, Canada, it is know as the "premium" combo.
- Lamictal 150 mg
- Lithium 600 mg (0.4 level) Doesn't need to be high when used with Lamictal
- Effexor 150 mgGood day,
Eric
Posted by Squiggles on February 7, 2007, at 12:28:18
In reply to Re: Lithium is underused as an antidepressant » polarbear206, posted by Maximus on February 7, 2007, at 12:20:49
I've always thought that was a good idea for
*any* AD that has a tendency to toxicity; it
would certainly eliminate the need for sounding
the alarm in drugs causing dyskinesia, NMS, etc.
But, I guess it takes too much skill and trials to
get it right with every individual.Squiggles
Posted by Maximus on February 7, 2007, at 12:59:38
In reply to Re: Lithium is underused as an antidepressant, posted by Squiggles on February 7, 2007, at 12:28:18
> But, I guess it takes too much skill and trials to
> get it right with every individual.
>
> SquigglesNo. A competent "psychiatrist" can do it "easily", fingers in the nose. Of course i wouldn't trust generals pratictionners for that :-))
Posted by Squiggles on February 7, 2007, at 13:15:14
In reply to Re: Lithium is underused as an antidepressant » Squiggles, posted by Maximus on February 7, 2007, at 12:59:38
> > But, I guess it takes too much skill and trials to
> > get it right with every individual.
> >
> > Squiggles
>
> No. A competent "psychiatrist" can do it "easily", fingers in the nose. Of course i wouldn't trust generals pratictionners for that :-))
You're a troublemaker. :-)Squiggles
Posted by polarbear206 on February 7, 2007, at 14:12:19
In reply to Re: Lithium is underused as an antidepressant » polarbear206, posted by Maximus on February 7, 2007, at 12:20:49
> > Many people cannot tolerate the long term side effects of Lithium when it reaches therapeutic drug levels. There is new evidence that combining Lamictal and low dose of Lithium can enable those to reduce their AD's. This combinbation has a good AD response. I plan to persue this avenue.
> >
>
> Hi Polarbear,
>
> This is what i take: Lamictal + Lithium + Effexor. It works fantastic and i'm highly functional. I've been taking this combo for years now. I'm bp II, mainly depressed. Here, in Quebéc, Canada, it is know as the "premium" combo.
>
> - Lamictal 150 mg
> - Lithium 600 mg (0.4 level) Doesn't need to be high when used with Lamictal
> - Effexor 150 mg
>
> Good day,
>
> Eric
Wow!! So glad to hear from you!! Right now I'm on 200mg Lamictal, 300mg Effexor. My plan is to lower Effexor to 150mg, and start low dose Lithium. My main reason is from the sexual side effects from effexor. That's the only complaint I have. I've been great otherwise on this combibation. Any side effects with lithium as far as weight gain? I would think it shouldn't be a problem on a lower dose.
Polarbear
Posted by Maximus on February 7, 2007, at 14:39:43
In reply to Re: Lithium is underused as an antidepressant » Maximus, posted by polarbear206 on February 7, 2007, at 14:12:19
> Wow!! So glad to hear from you!! Right now I'm on 200mg Lamictal, 300mg Effexor. My plan is to lower Effexor to 150mg, and start low dose Lithium. My main reason is from the sexual side effects from effexor. That's the only complaint I have. I've been great otherwise on this combibation. Any side effects with lithium as far as weight gain? I would think it shouldn't be a problem on a lower dose.
>
>
> Polarbear
>
>Hi,
Ahhh! Sexual side effects... (long sighhh). I hear you. Sure at a lower dose you'll get less problems.
I get no side effect from Lithium, at least at that dose. May be a bit of edema at first. Take a lithium sustained release form like Duralith and you'll be okay. You're not going to regret the amazing synergy of this combo.
Bye.
Posted by polarbear206 on February 8, 2007, at 5:51:14
In reply to Re: Lithium is underused as an antidepressant » polarbear206, posted by Maximus on February 7, 2007, at 14:39:43
> > Wow!! So glad to hear from you!! Right now I'm on 200mg Lamictal, 300mg Effexor. My plan is to lower Effexor to 150mg, and start low dose Lithium. My main reason is from the sexual side effects from effexor. That's the only complaint I have. I've been great otherwise on this combibation. Any side effects with lithium as far as weight gain? I would think it shouldn't be a problem on a lower dose.
> >
> >
> > Polarbear
> >
> >
>
> Hi,
>
> Ahhh! Sexual side effects... (long sighhh). I hear you. Sure at a lower dose you'll get less problems.
>
> I get no side effect from Lithium, at least at that dose. May be a bit of edema at first. Take a lithium sustained release form like Duralith and you'll be okay. You're not going to regret the amazing synergy of this combo.
>
> Bye.
>
>
Thanks alot!! I'm confident I will have the same success as you. I'm also BP II depression dominated.Thanks,
Laura
Posted by Netch on February 8, 2007, at 8:19:00
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
Jimmyboy, glad to here you getting better!
How much lithium are you taking?
What are the side effects?
Is there a big difference in effect between different dose levels?
How often do you monitor lithium levels?
Posted by yxibow on February 9, 2007, at 2:32:03
In reply to Lithium is underused as an antidepressant, posted by Jimmyboy on February 5, 2007, at 10:44:02
> I started Lithium about 5 weeks ago , and the change has been nothing short of miraculous. I was in the depths of depression that had lasted over 8 months and it has gradually slipped away since beginning Lithium. ( Also taking Tianeptine , but I am only a week into that)
>
> It has had amazing antidepressant effects, and yes, there are side effects, but not near as bad as with SSRI's. I just don't understand why when someone is possibly bipolar and depressed they always rush to Lamictal. Its expensive and it takes forever to titrate up to the right dose. My Lithium cost me $4 a month at Wal-mart and I felt somewhat better in under 2 weeks.
>
> JB
Actually Lithium is one of the first line agents to prevent suicide, at least in short term use, such as psychiatric holds. After that would probably come an atypical or typical antipsychotic.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.