Comments on: Bipolar Medication Spotlight: Lithium

By: Rachel

Rachel — Sun, 04 Sep 2011 03:53:51 +0000

My mother has been on lithium for over 20 years. Lithium has worked so well for her, but…. Lithium gave her diabetes insepidus, hypothyrodism, high blood pressure, and now her para-thyroid is messed up. She had lithium toxicity about 2 years ago and almost died. She just recently was diagnosed with cancer. While at the hospital we discovered a couple of these issues and they took her off lithium. It is so sad because all the other medicines they are trying her on is not working.

By: Joe Kraynak

Joe Kraynak — Sat, 26 Mar 2011 10:04:18 +0000

Hi, Anne–

You may find a previous post on Bipolar Beat of interest: “Bipolar Disorder QA: SSRI Induced or True Bipolar?” Although I believe that SSRI antidepressants contributed to the onset of my wife’s bipolar, I no longer think that simply stopping the antidepressant will make it go away. Believe me, we tried.

Having said that, I tend to agree with you generally about antidepressants, including the SSRI variety. It almost becomes a predictable pattern: Patient sees doctor for depression, doctor prescribes antidepressant, patient becomes manic, doctor diagnoses bipolar disorder and prescribes a lifetime regimen of a mood stabilizer + antidepressant. I have heard the story again and again.

This is why it is so important for doctors to 1) Carefully screen for a family history of bipolar (something my wife had in her family history) and for any symptoms of past mania or hypomania and 2) Rule out the possibility of medication-induced mania if the first signs of mania or hypomania occur directly after a medication change, especially related to an antidepressant, or to some incident or history of substance abuse.

While I share your distrust of Big Pharama, I think demonizing them or doctors isn’t helpful. We did a post awhile back entitled “Big Pharma: Generous Freebies or Underhanded Bribes?” which you may also find of interest, and Dr. Fink has posted repeatedly on her concerns about the overdiagnosis of bipolar in children. She is not afraid to take stands against popular thinking or medical practices, but she is a consummate scientist, basing her views and recommendations on what she deems the most reliable scientific research currently available. Because of this, I trust and respect her opinion more than most p-docs.

A huge dilemma is that depression is very painful and that all antidepressants, as I understand it, can “trigger” mania. Unfortunately, we don’t have a perfect drug for depression that treats it very effectively in all people without the risk of potential negative side effects. Personally, I think SSRI’s are the worst of the bunch in this respect, although Dr. Fink informs me that the current research shows less of connection than some may believe based on other studies and anecdotal evidence.

I think we need to take a fair and balanced approach, rely on the best treatments available at this time, and hope that research uncovers better treatments in the future — both for bipolar and depression. Doctors also need to be more careful, as explained earlier, to screen for potential bipolar before prescribing antidepressants and to rule out medication-induced mania when the first signs of mania appear while taking an antidepressant.

By: Anne

Anne — Sat, 26 Mar 2011 06:02:49 +0000

Joe (his wife)& anyone else who was DX BP after being on anti-depressants. Are you sure BP is the right Dx? Anti-depressants often cause mania, so do many other kinds of drugs, but one is only atomaticly given a DX of BP if it happens with anti-depressants. However if you become manic after taking any of the other medications, the drug is stoped, and you are not told or given a DX of BP. If someone labels you BP after a anti-depresant I would not trust it. I was and then stepped onto a merry-go-round of appalling medication over prescribed and often counter indicated, my quality of life was zero. I refused to take any more anti-depresants and never had an episode of mania. I’ve been off all drugs for a bit over 4 years and remain fine except for my PTSD. I beleive BIG PHARM has created a false positive stating that if you become manic on a anti-depressant you are BP. I don’t beleive that. It’s just a gimmic to keep people on dangerous drugs, and greed at the cost of human quality of life and sometimes human death. But does that matter to BIG PHARM, nope. They need to stay out of Dr’s offices and hospitals and not be allowed to sponcer conventions for Dr’s.

By: Here

Here — Fri, 18 Mar 2011 23:36:02 +0000

Ideally – I also am an ultra rapid cycler and my moods are mixed when I have episodes. Oh how they suck…Right now I am at 1200mg a day for lithium carbonate XR. This is probably the best I have felt in 6 months. Weight gain? Yes… 10lbs. in one month…But I’ll deal with that rather than cycling rapidly every day for months on end. EXHAUSTING AND SCARY. I had some thirst when first starting lithium, but that went away. No hand tremors. Weight gain is my only complaint so far.

By: ideally...

ideally... — Sat, 12 Mar 2011 03:55:24 +0000

I have bipolar disorder and ADD. I guess. I still struggle with trying to understand the nature of this low and overwhelmingly intense quality of life that has haunted me for the last 12 years.What is in my control? Biological/Psychological(I can work through it? Will it?)Nutritional/Cognitive/Spiritual…etc I know it is(and we/humans in general are)complicated and multi-leveled. Also there are Pharmaceutical companies preying on people, and over diagnosis etc… I am well aware. All the BUT’s stopped me from taking medication for around a decade. But at this point I’m tired. Trying to keep up with bipolar disorder is exhausting. My cognitive resources are constantly exhausted themselves.My relationships are stained. And worst of all I don’t trust myself anymore. Especially my emotions. I can’t predict or plan anything, because it is hit or miss with me.I’m 28yrs now and have just in the last three years agreed to try medications. It has been a mess. You want to talk side-effects!!!!! I have a sensitive system and I cycle rapidly with mixed episodes. I have tried Lamictal, Klonopin, Zoloft,Risperidone, Seroquel, Abilify, Geodone, Zyprexa, Wellbutrin, and Depakote is the latest(I’m sure I’ve missed at least one). It worked wonders for 6 months,and no noticeable side-effects except for good old bipolar symptoms reemergence. Now I am weening off the Depakote and finally agreed to try Lithium. It is too soon to tell, but… Despite the fact that I am still a skeptic of medication and diagnosis, I have reached my limit. With the frantic spinning(that’s the only way I can describe it) I experience in my thoughts, mood and body and the damage it does to me on a personal and interpersonal level it was time. I can take an hour out of my day to get blood work done. Compared with the years of life this chaotic companion has stolen, what’s an hour now and then to give me a life…I can hardly imagine, but I am completely open to what’s out there… Medication included. If that is what will/could work for now…down the road…who knows…I’m always keeping my options open.

By: Nicole

Nicole — Fri, 11 Feb 2011 05:26:10 +0000

I am 35 years old. Diagnosed with BP at 23. For the last 12 years, I have played a dangerous game of med non-compliance. I have been on every BP med known to man – and as soon as I felt stable I went off. The “reason” I went off almost every time was the weight gain issue

The positives – I stayed on long enough to get myself through law school and buy a house and more or less be there for my kids.

The negatives of being unmedicated – lost a marriage, ruined credit, gambled away all of my money, developed cocaine addiction, ended up in psych ward four times and ended up in rehab twice.

Currently, I am clean, on meds, and my life has never looked brighter. Going on 10 months now – on Depakote and Lithium. I gained 60 pounds BUT I am a sane member of society.

Please learn from my mistakes and stay on your meds if you are bi-polar,

By: jerry

jerry — Thu, 25 Nov 2010 03:08:03 +0000

I am a lithium toxicity survivor.

From around Dec. 15, 2008-Jan.30, 2009…I was in the Nashville VA Hospital with toxicity/Feb. 1 2009-Feb. 28, 2009 at Centennial Hospital with damaged trachea, and blood clots.

death—three times some heart related and some respiratory related,
dyalisis—5 days,
delirium—every waking moment,
neuroleptic malignant syndrome—5 days,
restrained—almost the whole time,
intibated—5 times,
self-extubated, w/out deflation—3 times,
damage to trachea—removal of three rings worth of damaged trachea scar on neck is priceless,
self-removal of picc line right arm—2 times resulting in blood clots in right arm, pulminary artery, and p/e in right lung, currently still on blood thinner,
respiratory failure—so often that i was seconds away from getting a tracheostomy
weight loss—<50lbs
sanity—still not sure
death experiences—3 still remember them as if they just happened no lighted tunnel i had to earn my life each time,
years my parents aged during ordeal—unfathomable
how i know "death" is near—the hairs on the back of my neck tingle,
what "death" looks like to me: as oft i saw it, it appeared as the road does while your driving in the heat…that illusion of water flowing, or when you see petrol evaporate, the way it distorts the image behind it…whenever i saw it, that is what it looked and felt like.

This is the first time writing about my experience…kind of feels odd. Very good though, getting it out. I am happy to be alive, but very very humble to the point of similarity to being afraid. Would like to make and wear t-shirt that reads "I SURVIVED LITHIUM TOXCICITY", but not sure what decorum calls for. Thank you for taking the time to read my note…therapy69_1999@yahoo.com

By: Lisa

Lisa — Fri, 30 Jul 2010 10:19:39 +0000

I have been on lithium since 2006. I take 900 mg. at bedtime. Long story why, but I have been off my meds (and I take a lot of psych meds) since February and since I’m on Medicare it’s been hell getting a dr. At a family clinic I did see a psych nurse practitioner and she made me, my husband, and my mom choose which two meds I should start back on first. While we differed in some areas, we all said I should start taking lithium asap. The few psych drs. or nurse practitioners I have talked to have all said they would never prescribe lithium unless they had to, although one admitted it was because he was lazy about the regular blood tests.
Lithium has helped more than anything else, and the only side effect I have is some trembling in my hands. I make sure to carry electrolytes when it’s hot. The hand-trembling doesn’t even matter anymore because when I get back on Abilify, I expect trembling to increase considerably. Small price to pay, though, to be stable. We all picked lithium over my antidepressants because it helps mood swings–which make you feel out of control–and some of the anxiety and depression as well. I’m lucky my dr. at the psych unit when I was diagnosed started me on lithium. It’s great.

By: Candida FInk MD

Candida FInk MD — Thu, 29 Jul 2010 20:14:31 +0000

Hi Tina – I am sorry to hear about your grandmother. When people are going through grief reactions as you are, it looks and feels and smells just like major depression. The difference is that it will resolve – with some time – it is a normal human brain process. However, in people with mood disorders, grief can trigger a full blown mood episode – more often depression but sometime mania as well. It is important that you be in touch with your doctor and therapist to discuss your grief reaction and determine if you need to be adjusting your meds in anyway during this time – and you may want to start or increase therapy sessions for some time while you are grieving.
Take good care -

By: Tina

Tina — Thu, 29 Jul 2010 15:44:36 +0000

I’ve been on 900 mg of lithium for about a year now. I have bi polar 1 and it has worked wonderfully. My grandmother passed away about 6 weeks ago and i can’t get out of this funk. I feel down and sad all the time and am afraid it’s going to get worse. Does lithium stop working or do I need a higher does?