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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by qbsbrown on November 9, 2008, at 12:19:10
I'm BPII, and don't tolerate anticonvulsants or antipsychotics very well.
At 600mg of lithium, it helps a little bit, and I feel fine. But there is only a trace of it in my blood. Doc wants to get up to therapeutic level. When I raise to 900mgs, I feel very depersonalized and stoned. Does this go away? I have this reaction (derealization), to many or most meds, must be a defense mechanism.
a)might this go away
b) is lithium effective for BP II and racing thoughts?
c) is it ok to take lexapro with LithiumThank you all.
Brian
Posted by Phillipa on November 9, 2008, at 12:36:46
In reply to Lithium make you feel stoned/depersonalized?, posted by qbsbrown on November 9, 2008, at 12:19:10
Brian you say you feel fine so why would the pdoc want to change your dose? Love Phillipa
Posted by qbsbrown on November 9, 2008, at 12:41:40
In reply to Re: Lithium make you feel stoned/depersonalized? » qbsbrown, posted by Phillipa on November 9, 2008, at 12:36:46
600mgs helps, but not enough. I can tell that going higher would help. Same as with Depakote. I felt better on 1000mgs, but needed to get to 2000mgs to reach a therapeutic level. Once I reached it, I could tell, but I was severely mentally impared.
I'm trying to augment it with Trileptal, but as most AED do, it gives me depression and makes me emotionally flat.
Posted by polarbear206 on November 9, 2008, at 13:12:45
In reply to Lithium make you feel stoned/depersonalized?, posted by qbsbrown on November 9, 2008, at 12:19:10
> I'm BPII, and don't tolerate anticonvulsants or antipsychotics very well.
>
> At 600mg of lithium, it helps a little bit, and I feel fine. But there is only a trace of it in my blood. Doc wants to get up to therapeutic level. When I raise to 900mgs, I feel very depersonalized and stoned. Does this go away? I have this reaction (derealization), to many or most meds, must be a defense mechanism.
>
> a)might this go away
> b) is lithium effective for BP II and racing thoughts?
> c) is it ok to take lexapro with Lithium
>
> Thank you all.
>
> BrianBrian,
Alot of people with Bipoar II require a low dose of an antidepresssant and tolerate them quite well with a mood stablizer on board. You could try combining Lithium with Lamictal. Lamictal has some antidepressant properties. I saw a power- point presentation video from a psychiatric conference about this very subject. Using Lamictal with depakote or Lithium with good success rates reported.
Posted by Ricker on November 9, 2008, at 14:27:14
In reply to Re: Lithium make you feel stoned/depersonalized?, posted by qbsbrown on November 9, 2008, at 12:41:40
> 600mgs helps, but not enough. I can tell that going higher would help. Same as with Depakote. I felt better on 1000mgs, but needed to get to 2000mgs to reach a therapeutic level. Once I reached it, I could tell, but I was severely mentally impared.
>
> I'm trying to augment it with Trileptal, but as most AED do, it gives me depression and makes me emotionally flat.Hi Brian, I think the anwser is yes to all 3 of your question.
What is your Trileptal dose? I am asking because I will probably be trying that next..apointment tomorrow. I am taking a low dose of zoloft and a LOW dose of lithium. If your trileptal is a therapeutic dose, you could keep the lithium at 600 and get a good result. Low dose lexapro may help with the depressive end as well.
It could take 6-8 weeks before you stop pinballing up and down and when depression is the predominant symptom, that can be a challenge. Hang in there bud, hope it works out.Regards, Rick
Posted by Maxime on November 9, 2008, at 16:46:20
In reply to Lithium make you feel stoned/depersonalized?, posted by qbsbrown on November 9, 2008, at 12:19:10
I was never able to go past 600 mg myself and there wasn't enough in my system. I felt very stoned and nauseous on more than 600 mg.
Which mood stabilisers have you tried already?
Posted by qbsbrown on November 9, 2008, at 16:49:02
In reply to Re: Lithium make you feel stoned/depersonalized? » qbsbrown, posted by Maxime on November 9, 2008, at 16:46:20
Wow, I guess I can't mix these two. either a minor serotonin syndrome, or raising my lithium levels. Waiting at home for my PDOC to call me back.
Totally threw me into a mania, confusion, delerious, body hot, sweating but cold at same time.
Hope this wears off soon.
Brian
Posted by azalea on November 9, 2008, at 18:08:27
In reply to Lithium SSRI interaction, posted by qbsbrown on November 9, 2008, at 16:49:02
Lithium is commonly used to augment SSRIs such as Lexapro. Theoretically, that shouldn't cause a problem. What are your current meds and dosages?
> Wow, I guess I can't mix these two. either a minor serotonin syndrome, or raising my lithium levels. Waiting at home for my PDOC to call me back.
>
> Totally threw me into a mania, confusion, delerious, body hot, sweating but cold at same time.
>
> Hope this wears off soon.
>
> Brian
Posted by qbsbrown on November 9, 2008, at 19:03:30
In reply to Re: Lithium SSRI interaction » qbsbrown, posted by azalea on November 9, 2008, at 18:08:27
Lamictal alone gave me quite bad anxiety and hypomania. Plus it't not fun waking up at the crack of dawn with a ton of energy. Does nothing for racing thoughts.
I wonder if Lithium would take care of all that.
Regards,
Brian
Posted by sam K on November 9, 2008, at 22:44:51
In reply to Lamictal+Lithium, posted by qbsbrown on November 9, 2008, at 19:03:30
brian I find this funny, but I was exactly where you were a few weeks ago or something. I combined lithium and lexapro and I went into mania" type stuff, extremely racing thoughts. Ive tried lamictal and lithium, didnt work. I say go on an antidepressant if your depressed!! Ive been hurt so badly by anti depressants by side effects I never wanted to go back to those bas***ds, but then Ive been taking paxil for a while and I feel releif. But who knows!! good luck Brian!!!!
Posted by psyclist on November 10, 2008, at 9:17:27
In reply to Lithium make you feel stoned/depersonalized?, posted by qbsbrown on November 9, 2008, at 12:19:10
> I'm BPII, and don't tolerate anticonvulsants or antipsychotics very well.
>
> At 600mg of lithium, it helps a little bit, and I feel fine. But there is only a trace of it in my blood. Doc wants to get up to therapeutic level. When I raise to 900mgs, I feel very depersonalized and stoned. Does this go away? I have this reaction (derealization), to many or most meds, must be a defense mechanism.
>
> a)might this go away
> b) is lithium effective for BP II and racing thoughts?
> c) is it ok to take lexapro with Lithium
>
> Thank you all.
>
> BrianYep I am bipolar too but I've never bothered about the numeral. The obvious answer/comment is what happens with 800mg of Lithium? I take 900mg and can readily associate with your feelings of being stoned. Maybe I have been stoned for the past 30 years. Shudder!!! But maybe 800mg will be the happy medium between getting onto a therapeutic blood serum level and avoiding the feeling of being stoned. I always associated the feeling with anhedonism but on reflection I think your 'stoned' fits the feeling better.
So my answers to your questions are as follows:
a) Avoid too much Lithium. I myself feel stoned on 900mg but only moderately stoned.
b) Subdivisions of Bipolar Disorder are not my speciality. Lithium does help for racing thoughts. The secret I believe is not taking too much of the stuff. If your pills don't equate to a lesser dose get hold of a pill-cutter and cut the bastards down to size. It seems to me that your pills are 300mg each. Great. Take two and cut one in half making a total of 750mg. Thats a happy medium between keeping the racing thoughts at bay and avoiding the feeling of being stoned.
c) Sorry I don't know about lexapro. Does it have another name? Like you I do not tolerate anti-psychotics. They make my brain feel numb.
Good luck Brian. I hope someone else fills in the bits that I have left out.
Posted by qbsbrown on November 10, 2008, at 11:14:02
In reply to Re: Lithium make you feel stoned/depersonalized?, posted by psyclist on November 10, 2008, at 9:17:27
Can you cute the Lithobid ER pills?
Brian
Posted by psyclist on November 11, 2008, at 9:50:22
In reply to Re: Lithium make you feel stoned/depersonalized?, posted by qbsbrown on November 10, 2008, at 11:14:02
> Can you cute the Lithobid ER pills?
>
> BrianI am not familiar with this brand but I'm guessing that they dissolve in water. If so dissolve one pill in a glass of water, stir it, and then drink half of it. You have just taken half a tablet! Sorry if this is not water-soluble.
Alan.
Posted by psyclist on November 11, 2008, at 10:09:52
In reply to Re: Lithium make you feel stoned/depersonalized? » qbsbrown, posted by psyclist on November 11, 2008, at 9:50:22
You can buy a pill cutter from your local pharmacy. Basically it is an oblong shaped plastic box with a hinge at one end and a blade that slices the pill in half. The pill is held loosely in V-shaped jaws. You can cut any shaped pill but round ones are the easiest. If the pill is scored try to cut it along the score mark. Sorry if you already know all of this. A pill cutter should only cost you a few dollars. Of course it is not extremely accurate but good enough. I see the Lithobid 300 tablet looks like a hard round tablet without scoring.
Alan
Posted by qbsbrown on November 11, 2008, at 11:40:10
In reply to Pill-cutter » psyclist, posted by psyclist on November 11, 2008, at 10:09:52
I do have a pill cutter, but it's been my understanding that extended release pills loose their effectiveness if they are cut.
brian
Posted by qbsbrown on November 11, 2008, at 13:30:09
In reply to Re: Lithium make you feel stoned/depersonalized?, posted by Ricker on November 9, 2008, at 14:27:14
> What is your Trileptal dose? I am asking because I will probably be trying that next..apointment tomorrow. I am taking a low dose of zoloft and a LOW dose of lithium. If your trileptal is a therapeutic dose, you could keep the lithium at 600 and get a good result. Low dose lexapro may help with the depressive end as well.
> It could take 6-8 weeks before you stop pinballing up and down and when depression is the predominant symptom, that can be a challenge. Hang in there bud, hope it works out.
>
> Regards, Rick
How did your appointment go? Did you get the Trileptal? After only one dose of trileptal, depression lifted, calling all my friends, visiting them, and went on a date. things I haven't done in a year.Although the low dose of 600mgs so far is inducing a little happy hypomania, doc said this should settle as we go up. I might try 900 of lithium, as long as the stoned depersonalzation feeilng doesn't come back.
Good luck, and lets us know.
Regards,
Brian
Posted by psyclist on November 11, 2008, at 14:28:56
In reply to Re: Pill-cutter, posted by qbsbrown on November 11, 2008, at 11:40:10
> I do have a pill cutter, but it's been my understanding that extended release pills loose their effectiveness if they are cut.
>
> brianYep sorry you're correct. I don't use ER lithium. Maybe its worthwhile converting to the normal release, or else take a chance and see what happens. It may damage the ER or it may not.
You may be able to live with the damage or you may not.Alan
Posted by qbsbrown on November 11, 2008, at 14:30:58
In reply to Re: Pill-cutter » qbsbrown, posted by psyclist on November 11, 2008, at 14:28:56
Just spoke with the pharmacist and said i can't cut.
Perhaps I will try the 900, but spread em out in 3 doses and perhaps avoid those side effects.
Regards,
Brian
Posted by psyclist on November 11, 2008, at 15:08:09
In reply to Re: Pill-cutter, posted by qbsbrown on November 11, 2008, at 14:30:58
> Just spoke with the pharmacist and said i can't cut.
>
> Perhaps I will try the 900, but spread em out in 3 doses and perhaps avoid those side effects.
>
> Regards,
>
> BrianHi Brian
The pharmacist should know but I had a look in Wikepedia and they say this:
"Sustained-release tablets are formulated so that the active ingredient is embedded in a matrix of insoluble substance (various: some acrylics, even chitin, these are often patented) so that the dissolving drug has to find its way out through the holes in the matrix. In some SR formulations the matrix physically swells up to form a gel, so that the drug has first to dissolve in matrix, then exit through the outer surface."
I guess it all depends on the scale of the matrix. If it is molecular then there should be no harm in cutting. But if it is bigger, i.e. visible to the naked eye, then I guess you can't cut. I suspect pharmacists as a breed are inherently against cutting tablets. They would prefer that you buy the custom size. They make more money that way. Maybe he is getting confused with Controlled Release where I believe the active ingredient is coated with something that only breaks down when the active ingredient has been delivered to the site where it will act. It may be worthwhile asking some of the more knowledgeable bods on the board.
Regards
Alan
Posted by psyclist on November 12, 2008, at 10:51:44
In reply to Re: Pill-cutter » qbsbrown, posted by psyclist on November 11, 2008, at 15:08:09
Been taking this at 900mg nocte for years, cutting the 200mg tablet in half, with the knowledge of my pdoc. 400 + 400 + 1/2 of 200 Never noticed any problems which is not to say its the right way to do things. The tablets look homogenous so I reckon it is OK to do it. Just spoke to my pharmacist and she reckons Yes it is OK to cut Priadel 200mg (lithium carbonate) in half. The tablet is described as 'prolonged release' which I guess is virtually the same as ER.
This is the end of the thread.
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