Scared

So, I'm currently taking quite a few different medications at the moment and the two that I'm bringing up are Lithium and Abilify.

Currently our goal is to get Abilify to be the ONLY medication that I need, because it seems to be helping a lot.

However, my fear revolves around Lithium. I've been on it for so long, I don't know what would happen if we took me off it completely. What if Abilify isn't enough and I start suffering from deep depressions (I've never had this before, which is also why it's a really scary thought. Being diagnosed so young, I grew up with the medication I needed). Really, I'm just scared of the thought of 'what if Abillify just isn't enough? and I get into an episode that gets me hospitalized or something.

Does anyone have any ideas of how to handle this feeling?
And if something did happen, how to handle that?

Thanks!

Who is ordering your meds? Is it a psychiatrist? Lithium is considered "the Gold Standard" for management of bipolar disorder. Not too long ago, there was a lot of press on how a study found that lithium saves lives by reducing the suicide rate among those who take it. So why are you being taken off lithium, if you were tolerating it well?

Abilify is generally an "add on" drug, and not the primary med given to a patient for combating depression or bipolar mood instability. That's nice that it helps you a lot, but it has been helpful as something you've taken in addition to your lithium.

Could you explain how this goal of making Abilify "be the only medication you need" came to be something to shoot for? There is no particular virtue in being on one med, as opposed to more than one med, though it does seem simpler. Like you wouldn't try to make it a goal to eat just one food that seems to taste good and give you enough calories. It's just curious to me that this goal came up to rely on a medication that is not all that well respected by many psychiatrists.

I do realize that there can be a lot more to your situation than can be learned in one thread. What I'm hearing is that you're scared of this upcoming experiment. So why is your doctor planning something that is scaring you?

If you get deeply depressed, the way to handle that is to go to the hospital and tell them that you are very depressed. You'll get help that will, in all probability, restore you to your usual baseline.

My psychiatrist is.

He thinks I might not be Bipolar, at least, he said it's a possibilty. Possibly Schizoaffective. I get very strong psychosis and my moods do change. He said Abilify can be used as a stand alone medication and that we can try to go off the other medications.

It was partially my choice, I should have added that in there, but that doesn't mean it's still not a scary thought to me.

Lithium has some side effects for me that we'd like to try and eliminate (such as the fact that it's a salt and I have to drink A LOT), which is partially why we want to try and see if something else could work.

Also, I feel like Lithium doesn't do it's job for me. I still feel how I felt before we started Lithium. It might kill it down just a tad, but really, I don't think it helps all that much.

There's probably more to the situation that I'm forgetting, but that's the reasoning behind that.

And thank you for the advice. I don't know if I could do that, though... That'd take a lof of courage that I lack.

Thanks, Hydro, for explaining more. Abilify is good for psychosis. Now it does make sense that your doctor is thinking that Abilify might be more targeted to your symptoms than lithium. Also, the side effects of lithium can be really a problem. In my case, it was discovered that I just can't tolerate lithium. I get bad side effects at a small dosage.

When the diagnosis isn't totally nailed down, then that changes everything. Even the best doctor in the world can really only make an educated guess about what your main problem is, and then he may have to change that guess. It sounds like you have no reason not to feel confident that he is being careful and trying to get you to feel as best as you can. Stay in touch with him, if you find yourself feeling worse.

I have the book "Bipolar II" by Dr. Ronald Fieve. He was one of the first doctors to test and prescribe lithium in the USA in the 70's. He states that lithium is the gold standard for BP, just like Rose said. He also states that if you suffer from psychosis and lithium does nothing for you, you're probably schizophrenic. (pg. 187). He states than in this way, lithium can be a diagnostic tool. If it helps you, you have BP. If it doesn't help you, you have something else. Lithium is specific to BP.
The question therefore is: does lithium by itself help you?

Rose, thanks again! And I'm glad I could help clear that up.

Phoenix, I don't feel it helps me very much but I've never really been off it (I've missed a week's worth of it before, but that's it) so I don't know how I feel off of it. My parents tell me it helps, but we didn't start Lithium until I was older. I could have just learned better by then. So really, I'm sensing a change in diagnosis on the horizon, but we'll see.

Thanks for that bit of information, too. That's really interesting.

I'm on lithium and abilify and efexor. My doctor is removing the lithium so I can have a baby. He thinks it should be ok, but we have a plan to add in seroquel if needed for mania... Hope you can get a med combo that works for you.

I had very bad side effects to Lithium and like was also mentioned above, I just couldn't tolerate it.

If you feel that Lithium isn't helping you, trust your pdoc to find something that will. It took me a very long time to get on the proper meds.

I didn't in anyway want to sound discouraging, but sometimes it does take a while to find the right med cocktail to control whatever symptoms you have.

BlackPup, I want to wish you all the luck in the world in trying to conceive.