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Old Aug 02, 2020, 03:37 PM
fern46 fern46 is offline
Grand Magnate
 
Member Since: Mar 2019
Location: USA
Posts: 3,021
Quote:
Originally Posted by Soupe du jour View Post
Hello bpcyclist. I'm a big fan of Dr. James Phelps and his website. Though he has a focus on bipolar type 2, he writes a lot about his research and observations that pertain to bipolar type 1, and other bipolar spectrum disorders, as well. What he wrote on the following page of his website may or may not be new news to you, but it is on the topic you bring up.

Lithium and seizure threshold - PsychEducation

On Neurology.com I found the following article Impact of Psychotropic drugs on Seizure threshold (P6.311) | Neurology that states that a study found "Bupropion, Imipramine, Clozapine, Olanzapine and Haldol" as the medications with the most propensity to lower seizure threshold. Some others, but to a lesser degree.

It's a coincidence that you bring up the topic of possibly having seizures, as a person with bipolar disorder. I had a discussion with someone recently on this. If ever you are interested in comparing notes, I'd be happy to do so. In any case, my possible seizure activity occurred primarily during the most severe period of my bipolar illness (my 30s and early 40s), but not prior to that, to my knowledge. A neurologist did give me a diagnosis of Simple Partial Seizures (a type of focal seizure or Temporal Lobe Epilepsy). An epileptologist later said it was not definitive. I chose not to follow his recommendation to have a 6-day inpatient EEG. I suppose I should have. The fear was that by lowering my anticonvulsant that my bipolar itself would worsen again. That scared the heck out of my husband, and me. The possible seizure symptoms I had, have long since mostly disappeared. The only times I have hints of them are when I'm severely manic, which I haven't been for over 2 years. According to my email records, I saw the epileptologist in Jamuary 2014, but the seizure-like symptoms also preceded that four to six years, or so. [My detailed electronic journaling started only in 2012. Yea, I'm that type.] A MS Word document shows that in that month (January 2014) I took the following medications, simultaneously:

Lithium ER - 900 mg
Tegretol XR - 1,400 mg *
Lamictal - 100 mg *
Geodon - 160 mg
Navane - 5 to 10 mg
Seroquel XR - 50 mg *
Klonopin - 0.5 mg *
PRN Ativan - 1 to 3 mg *

Also Inderal * and Synthroid *

I think the mix above was just too much! I often wonder if some of the meds (or the cocktail as a whole) exacerbated my situation, especially in regards to the seizure-like symptoms. It had even been worse, before the Lamictal replaced Wellbutrin XL (Bupropion ER). Wellbutrin XL was highly destabilizing for me (ultraradian cycling) so was removed quickly. That was the very last time I was prescribed an antidepressant. All of the other times were prior to (prescribed alone) and during (prescribed with minimum 1 moodstabilizer AND 1 antipsychotic) the worst years of my bipolar illness.

My current medication cocktail is almost half the size of the one I list above, and I've been the most stable in recent years. I mark my current meds above with asterisks *, though some current doses are different (i.e. Seroquel XR is now 650 mg).
This is exactly what I was thinking... Maybe the high dosing of the APs for psychosis or some of the other drugs are exacerbating the seizures. It is worth discussing. I've found the same in my research and I think my docs keeping me on such low doses and only one at a time is perhaps why I've avoided more repeat episodes.

ETA: I haven't run across a big concern for lithium, but Trilafon lists it as a complication more than once in their own documentation.
Hugs from:
bpcyclist, Soupe du jour
Thanks for this!
bpcyclist, Rick7892, Soupe du jour