Lithium for bi polar

I would appreciate hearing from folks who are or have at some time taken lithium to treat bi polar.

A new pdoc is recommending lithium. I am going for another opinion before I agree. I have read a few things about lithium that concern me. I read that it is not very efffective for people with rapid cycling. I cycle rapidly and also have mixed episodes. I also read that it can be problematic for the thyroid. It can bring on hypothyroidism. My thyroid is already shot and I take meds everyday to regulate it. Lithium is hard on the liver and kidneys and the risks are increased if the thyroid is already off. It also sounds like lithium is used to maintain stability. Does that mean you are on it for life? That worries me because we always hear, 'lowest dose for the least amount of time.'

And last but not least the weight gain doesn't sound good.

If you wouldn't mind sharing your experience with lithium I would really appreciate it. This has me confused and scared. I am currently taking 100mg of Lamictal. Increasing to 200 next week. I don't want to make any radical change until I get another opinion. I have some concerns about the last pdocs eventual dx so I am curious what the next one will say and what meds she will recommend. It is still a few weeks before I see her so it is giving me lots of time to obsess about this. lol.

I am generally afraid and sceptical of pmeds so just thinking about this escellate anxiety big time.

lithium has been a lifesaver for me, my only regret is that it was not prescribed 5 years ago. ive been on lithium for around 5 months and the stability it has given me is phenomenal. (it combats my paranioa/anxiety from long term canabis use) and my low moods are much easier to get out of, Im a way nicer husband so much more tolerance to everyday situations. i have had 3 blood tests to check lithium salts thyroid etc and surprising enough my lithium level was like .1 in the most recent of these consequently my gp told me it needs to be from .4 to .8 to be effective. so i had another blood taken today and if my kidneys are still fine they will up my dose currently 500mg at night. so yeah could expect to feel less of the dreaded symptoms of whatever i have in the future(have had three diff dianosis')
****obviously long term use of this drug is something im not going to be able to know about for a while**** Its the first drug ive been on where ive needed to have my blood analyzed, but overall a small price to pay,, oh and i believe it can have anti depressant qualitys...
in a nutshell i will take it until thyroid or kidneys begin to show were and tear, or pdoc says im ready to come off.
also i take the lithium in conjuction with an anti depressant, but im certain of the effects of the lithium as ive switched a/d since being on lithium and what not.
all the best with your mental health
happy days...

Lithium works well for me. I have few side effects (thirst mainly) and it does help maintain my stability. Doctors will monitor your thyroid, lithium levels, etc. to ward off any other serious problems.

I switched from limictal (which was too activating for me) to lithium. I have been on it for 6 months at the highest dose I can take while keeping blood levels reasonable (around .9). Its been so-so for me. I have rapid cycling which hasn't stopped, but has slowed. The Amplitude of my swings has also diminished. I am also taking Depakote, so these change aren't all from the Lithium.

The biggest problem with asking questions on a board about meds (and I have done it many times myself), is that everyone reacts differently. Sad by true. Its why the med-go-round is so common. Not even your pdoc can tell you for sure what's going to happen, so anything you take has a bit of a risk. Keeping yourself informed is one of the best things you can do in this process.

Best of luck to you.

Thank you OneRiffTooMany and farmgirl for sharing you experience with lithium. You ease my mind.... a little. lol. I don't do blood tests very well. Huge anxiety trigger but I guess it will get easier over time to manage it. Stability is an attractive outcome. If I am so lucky I will likely think the same as you OneRiff. If only I had this 5 or even 10 years ago. Here's hoping.

Thanks again.

I switched from depakote to lithium and have reall liked it. Weight gain pretty much stopped.

sanityseeker,
My partner recommended lithium to me as it was used to treat her depression before we met.
this is the second time ive taken to 2 meds together. currently lithium and the ssri.
the other time I was prescibed epilim for a mood stabilizer, along with an a/d but I discontinued use of the epilim after a month. the side effects outweighed the benifits with that one for me

love my lithium, couldn't live with out it

Thanks again OneRiffTooMuch and thank you Moose and BlackPup. I really appreciate your input.

Great to see you again BlackPup. We don't seem to cross paths much these days. As you can see I am making mini steps towards med treatment. Its still scary but I am too tired to fight it anymore. It took me 2 years of hellish exhaustion before I would take meds to stabilize my thyroid. When I finally relented within a week it was like night and day the difference. I said to myself then I had been foolish to resist so long. I can be pretty stubborn. Like that wasn't obvious. lol.

I was put on lithium after my suicide ideation episode in early Jan, and was on it for a month total. (I just finished coming off 900mg.)

I am ambivalent towards lithium. On one hand, it didn't work well for my rapid cycle bi polar II; it increased the rate in which i was cycling, and I had my first serious mixed episode. On the other end, I didn't get manic.

I'm a young man, I will admit, and I didn't have any serious side effects aside from the excessive thirst, and the drying of my hands to the point of the skin was coming off. (No joke, and i was drinking half my weight in ounces in water daily. Like 100 ounces of water, a day.)

I know this probably doesn't help you. But I think i may be against the grain here as most folks here have glowing reviews of it. And i was only on it for a month before i couldn't take the more intense depression and mixed episodes.

Thanks codeWeasel.... sorry I missed your post earlier.

You make a good point about everyone reacting differently. Just the same it is comforting to hear success stories.

One of the challenges I have trying to understand med treatment is the combinations some people are taking. In your case for example you are taking both lithium and Depakote. I thought I read when I was reading about Lithium here on PC that Depakote is used in place of Lithium. I must be confused. No surprise there. lol.

It has been mentioned by a few here that close monitoring of blood levels is important. I wonder how often should bloodwork be done and is that .9 level the optimal target? I am not all that confident with my GP being on top of things so I need to know going in what close monitoring means.

If you don't mind Code could you expand for me what you mean by too activiating means? How long were you taking limictal?

I wonder too if any of you expect to be on lithium forever to manage symptoms or do you see a day when you will be able to function without it? This is really the source of my greatest anxiety. If it is so hard on the liver and kidneys how long can someone be on the med before it adds up to serious problems.

Sorry for all the questions. I have read up on lithium from a few sources but there is little said about length of use and effects of long term use. I suppose like with any med question it varies from person to person. I just wonder for those who are taking lithium what are your expectations in terms of how long you will need to take it.

Thanks again everyone for being so accommodating and supportive. Your patience with me is appreciated.

Thanks CesarioRose. Like Code says... we are all different so while it works for one it may not work for another. You offer a balance to the discussion.

Yea the rapid cycling and mixed episodes worry me. The literature emphasises this point too. The pdoc who recommended it came up with a different dx then a previous pdoc. I am going for a third opinion before I decide anything. I get that dx's are very subjective but at the same time a wrong dx with the wrong meds can be pretty dangerous. I need certainty where there isn't much to be found it seems.

Have been limiting computer access as my thesis is due 31st March.... scary stuff!!!! Been still checking in on BP social society...
The best thing for me with Lithium was it took away the suicidal thoughts I was having.... not sure if that is a problem for you but it is one of the great things about lithium. It is also both an antidepressent and mood stabiliser. I needed a combination of drugs in the end but lithium is essential to keep me balanced.
Bad things about lithium: have to monitor blood levels cos of potential toxicity (esp annoying at the beginning but then it drops down to every 3 months.), also need to monitor thyroid - but you probably have that monitored anyway... Weight gain - I've put on stacks but that is lifestyle as well... if you keep on top of it from the start it is easier and drink only water cos you get really thirsty. My hands used to shake but that went away after a while.....
Despite this huge list of bad things, it is still so worth it to me that I will continue to take it....
Good luck in your search for an answer that works for you.

Thanks again BlackPup and good luck to you too with your thesis. Crunch time hey.

Suicidal thoughts are pretty constant for me. Hardly a day goes by that I don't have some imaging of it happening one way or another. I don't think I would act on the thoughts because of how painful it has been for me to have lost my own mum to it. I would never do that to my son. It would be nice to be free of the thoughts. Sometimes they come out of the blue and I just cringe at the image until I can shake it off. I am really happy for you that the lithium took those thoughts away. That has to be a huge relief. They can be so haunting sometimes.

Yes I do have my thyroid levels checked regularly but probably not as often as I will need to if lithium is added to the mix. Initially anyways as you say. I am not sure if it is related to taking the limictal but my last results indicated a need to increase the med for my thyroid. Came as a bit of a surprise because over the last year or so we have been lowering the dose.

At one point I was being over medicated until a new GP figured it out. And people wonder why I have trust issues with doctors. The over medicating caused me (though no one made the connection at the time DAH!!) to loose way more weight then I can afford and way too fast to be healthy. An ideal weight for me would be around 130-135. I was down to 105 before it was determined my dose was too high. Once they got it right the weight came back on so fast I could see and feel a difference within days. I have since regained the weight and I feel like myself again with a few extra pounds thrown on for good measure. I had always been a little bit 'chubby' while my sister was very slim. I always envied her but not anymore. I didn't like being skinny one tiny little bit. I will never envy a skinny person again. I like my little bit of chub. I feel healthier.

I wonder now if maybe the reason for the need to increase the dose has something to do with taking limictal and seroquel the last few months or so. I have since dropped the seroquel. It lost its effectiveness and the side effects were too uncomfortable. It has me wondering if there might be a link.

Lithium is well documented to have anti-suicidal properties (makes you 6x less likely) Hope it works for you It is so horrible to have those constant thoughts.... I remember what it was like...
I found myself a good doctor and trust him with my meds, tests and managing side effects. Only draw back is that we now live 2 hours drive away... its worth it to have a good doctor.

My grandmother has been on Lithium for a long time. Our family doesn't really talk about it, but she has lived a stable, happy life. She still has episodes that have led her to the hospital for re-evaluations (3 in the last 10 years), but they re-adjust her meds and she's back to her normal self.
I was put on it shortly after my diagnosis in college because of her sucess on it. I also had your same concerns, but decided that being happy & stable was more important to the what-ifs. As it turned out, it doubled my crying. I didn't want to get out of bed and withdrew from my friends. Needless, Lithium wasn't for me.
Mood stablizers effect everyone differently. You just never know until you're able to make the decsion to try it or not. Good Luck with your choice!

Thanks Black... The end to suicidal thoughts would be lovely. It is great that you have a dr you trust. It must be a real source of security for you. I wish I could stay the same. I am still getting acquainted with mine. He is the 4th GP in less then 2 years because of the never ending comings and goings of drs at my clinic. We are so short of drs everywhere that we don't have many options for who we can see. I am grateful to even have a GP even if they don't stick around for very long. Many don't even have that much. The only options they have are walkin clinics.

Thanks jog for sharing your experience. That is great how well it worked for yout grandmother. I hope you have found a med that works for you too. I guess the only way I will know if it works for me is to try it.

I am still not ready to make the plung without the second opinion. I am inclined to keep working with the limictal at least until I see the pdoc. That gives me a few more weeks to see if the new dose at 200 mgs I am just starting to take a day improves anything. I have been told that I am still at a very low dose to get much therapeutic value so I think it might be wisest to run the course with limictal before making any major changes.

Thanks again everyone for sharing your experiences with me. It has been very helpful. I am feeling much less anxious about it then I was. Thats a gift.

My experience is varied. I developed psoriasis on lithium (a rare side effect) that doesn't go away off treatment. I put on about 50lbs over 4 months, so fast I didn't even realize it until I stepped on a scale. I've been off and on it about 3-4 times over 4 years. When I am hurting I think it really does help to stabilize my mood. But with the tremor, thirst, frequent urination, and worsened psoriasis while on it - it rates high on a misery index for me and I just can't take it long term. This greatly disappoints my pdoc and we have had to work things out over it to continue our therapeutic relationship.

Thanks IdoubtIt. I am sorry your experience with lithium was so rough. I hope you have found something else to help you out. Take care.

Confusion is part of the game. lol.
Most bps take a combination of meds, and unfortunatly there is no magic combination that works for everyone. I am taking the max I can of Lithium according to my blood levels and it wasn't enough, so I have supplemented with Depakote.

I get blood tests about every 3 months, but I am still in the med-go-round where my meds and dosages change. If my med regiem was steady, I might only need once a year or so. The optimal target for the med is what gives you relief from your symptoms, however there is an upper range that you don't want to cross due to effects on your organs. I think its 1.2, but don't remember for sure.

Too activating for me means becoming irritable, angry, restless and impatient. Basically becoming an *******. I have taken limictal on two seperate occastions with the same results. Both times I had to stop after 6-8 weeks.

Thank you Codeweasel for your reply. The 'customized' combination of meds makes sense now. The monitor of blood is similar to how my thyroid levels is monitored. Every 3 months until we found an effective dose and once stable for a while blood work was only done sometime between 6 months and year. A need to increase was indicated in my last blood test so it will be check again in 3 months to see where I am at.

Thanks for the information about the range. It gives me a good reference.

That is what I figured you meant by too activating. Good description for the bombardment of emotions.

Thanks again Codeweasel. I wish you well.