[hamster-bamster]

In the past, Lithium alone used to be the gold standard of bp treatment. Kay Jamison has always been on Lithium alone.

Enter newer atypical AP's and most people are on them. I polled people here several months ago and the majority of medicated folks are on some sort of an AP.

I stopped having orgasms. Unclear why: anxiety, stress (which has been through the roof lately), low blood pressure, too much biking, or, perhaps, some pernicious effect from Geodon even at the lowered dose. So I am thinking of going off Geodon for a week to see what happens. But I do not want to try Abilify which I am sure will come with its own set of side effects. I just want to try preventing mania using Lithium alone.

D says that Lithium alone is insufficient - he says an AP of some sort is needed for bp. But then how about Kay Jamison?

[Confusedinomicon]

Ask about using the ap as a prn? If you monitor your mood then youll see the shift and can take the ap as a preventative? Im going off seroquel soon and will be using it similarily. Idk if this will work though.

Recent stress can cause you to not orgasm.

[Ms.Beeblebrox]

I live on Lithium alone! After my disastrous first manic episode in late 2010 I was initially put on Seroquel and Lamotrigine, but both caused horrible rash all over my skin, so I had to be taken off them. My doctor was at a loss on what to do with me, since I showed unusual sensitivity to medication. He decided to try Lithium alone in Summer 2011, but I knew he didn't have high hopes of success.

And now, at the end of 2012, I am completely stable on 750 ml. I had no mood episodes whatsoever in the last year and a half. I know I was extremely lucky, and I am very grateful that other drugs gave me VISIBLE side effects, so no one could blame it on my head being backwards. If not for that, I would be taking three drugs instead of one now, even though one is enough!

But I know it's definitely not the case for everyone. My doctor tells me at each appointment how surprised he is with my case and how uncommon it is for someone who showed severe bp symptoms to recover without APs. So please don't take my post as an endorsement of ditching AP without doctor's OK.

Last little note on the sex drive. Lithium annihilated mine! But I like it! I was way hypersexual before it (when manic/hypo) and it was very uncomfortable. I can enjoy sex now, so there is no impairment in that field, but I don't need it all the time as I did before.

Hope it helps.

[Seaswept]

I have been on Lithium alone in the past and it was fine. I only switched to Lamictal because it had less side effects for me. I was on Lamictal alone for several years. So it is possible. To tell you the truth, I'd also like to get back to taking just one med.

The orgasm thing though, it was going so well for you, it sucks that they stopped! The exercise should make them even better. Like confused said, could be the stress.

[Anika.]

Many many times I was on lithium alone. I swear hammy the more meds added the worse I was. Lithium alone worked.. okish. I'd rather trust someone who has bipolar to judge than someone who does not, in the case of Kay vs. D.

[faerie_moon_x]

I'm on lithium alone at 300 mg which is supposedly under the theraputic level. But at 600 mg I get dry mouth and tremors and at 1200 mg I feel very strange. At 300 mg I feel a bit muted, not drastically. I don't feel like a zombie or anything.

I just feel like I can manage things a bit better. I still can be a bit emotional, but the rollercoaster doesn't seem to have as high of a peak or as low of a valley, if you see what I mean. It lessens the intensity. It softens my range into a more managale anger.

But, I still have intrusive thoughts, obsessive thoughts, lack of focus, difficulty reading, irritability, and I've been hallucinating off and on. I may have paranoid thinking, not sure...

But, I also just restarted at the beginning of the month, and I miss days sometimes because I'm forgetful. So, I may not be the best test subject.

[Gaijin]

My brother, BP I, has survived on lithium alone for some 35 years. He distrusts shrinks because of his early experiences with them, and has not had the opportunity to try any newer meds.

He seems pretty stable, though not terribly successful in marriage or career.

[Odee]

Well, I just got my Lamictal upped to 200mg and I'm doing significantly better. I am convinced that this is 'it' and that I won't even need to be on an AD. My psychiatrist referred to the possibility of using an AP last time I was there, but I think she was reading too far into the giddy energetic days I told her that I have had.

I'm all for monotherapy. That is where I want to be.

I am BP II, my 'highs' are all anxiety and it's hard to tell apart the anxiety from the depression considering that they are both negative. Not a very manic person so I'm not much of a candidate to be on an AP.

[twiddle]

Well I've been on Lithium (m/s), Risperdal (a/p) and Paxil (a/d) for about 5 years now and I'm trying to get my docP to take me off Risperdal. I just feel it makes me dull and logy. Though I've never heard of a person with bipolar I on only Lithium and an a/d.

[Anika.]

Twiddle, I am dx's with Bipolar 1 and psychosis nos, my first psychiatrist was pretty pro monotherapy, my last was pretty pro huge coctails. I am no longer on any meds and have not had an episode since. It has been over a year since my last episode, so I am quite certain that monotherapy can be done with Bipolar 1 if no meds can be done. I think that's pretty good.

AP's are major tranquilizers, hence the dull and loggy feeling.

What does you pdoc say when you ask to come of Risperdal? You say you are trying to get him to take you off?

[Blue Poppy]

Hammy,

Do you think it is the right time to try going off a medication, with all of the stress right now?

Blue Poppy

[hamster-bamster]

Originally Posted by Confusedinomicon

Ask about using the ap as a prn? If you monitor your mood then youll see the shift and can take the ap as a preventative? Im going off seroquel soon and will be using it similarily. Idk if this will work though.

Recent stress can cause you to not orgasm.

I agree. From the stress, I already have: dry mouth, anxiety, problems with concentration, heart palpitations... and dry mouth is a very strong anxiety symptom for me, I do not get it easily at all. So with that set of symptoms, I might also have trouble with lubrication and orgasms. It is all physiology, after all.

So for now I will stick with the current combo without experimentation, to carry me through the stress, and then when the stress subsides, come back to the idea of trying to live on Lithium alone. I am glad some people are able to pull it off!

[hamster-bamster]

Originally Posted by Blue Poppy

Hammy,

Do you think it is the right time to try going off a medication, with all of the stress right now?

Blue Poppy

No, no experimentation, no, you are absolutely right. It is enough that I am still dizzy being new to topamax.

[hamster-bamster]

Originally Posted by Anika.

Many many times I was on lithium alone. I swear hammy the more meds added the worse I was. Lithium alone worked.. okish. I'd rather trust someone who has bipolar to judge than someone who does not, in the case of Kay vs. D.

That is a good contrast.

[hamster-bamster]

Originally Posted by twiddle

Well I've been on Lithium (m/s), Risperdal (a/p) and Paxil (a/d) for about 5 years now and I'm trying to get my docP to take me off Risperdal. I just feel it makes me dull and logy. Though I've never heard of a person with bipolar I on only Lithium and an a/d.

Risperdal did that to me too. Seroquel and Geodon, no, I can be high energy on those.

[hamster-bamster]

I did not express myself correctly. I was not thinking of Lithium as a monotherapy. I would still take Prozac for depression, which gives me no side effects, and no wonder at such a tiny dose. What I meant was "on Lithium alone for MANIA"

[twiddle]

Originally Posted by Anika.

Twiddle, I am dx's with Bipolar 1 and psychosis nos, my first psychiatrist was pretty pro monotherapy, my last was pretty pro huge coctails. I am no longer on any meds and have not had an episode since. It has been over a year since my last episode, so I am quite certain that monotherapy can be done with Bipolar 1 if no meds can be done. I think that's pretty good.

AP's are major tranquilizers, hence the dull and loggy feeling.

What does you pdoc say when you ask to come of Risperdal? You say you are trying to get him to take you off?

Well I've been thinking about it for some time because of the dull/logy feeling but also because I think it's partly responsible for my massive weight gain. I also don't like the idea of being on an AP all the time. I would prefer to use it PRN for hypomania -I haven't been full blown manic since 2003 or 04. I have an appt w/ Pdoc this coming Thurs and will broach the subject with him then.

[hamster-bamster]

As a long-term goal, using Lithium only for mania sounds attractive, but now I will not experiment.

[hamster-bamster]

I am off Geodon and so far so good, plus I have clear skin, which is nice. I thought that Lithium was responsible for acne, but no, it was Geodon. No hallucinations or anything of that sort either. No mania - able to do the most boring job.

At some point I even decided to shoot for Lithium mono therapy for bipolar (plus a little Elavil for sleep), discontinuing or reducing Prozac to get rid of left over hand tremor which it seems to be causing (because if it not Prozac, then what?) but... I have gained all my weight back while on Zyprexa and now I want to ask the p-doc to swap Prozac for Wellbutrin which might lead to some weight loss. But in the long term, yes, I hope to live on Lithium alone. And now that I know that it does not cause acne, it has proven to be a virtually side effect free medicine - the effect on the thyroid function is all I get (in terms of bad things) from using Lithium - the rest is good.

Discontinuing Geodon means saving not just several hundred dollars a month on Geodon (my mental health care will no longer be free starting in Feb) itself, but also enables me to use cheap Retin-A in place of expensive Tazorac. For acne control, Tazorac works better, but I do not need acne control any more. For preventing wrinkles, Retin-A is just as effective - I checked with two dermatologists about it - and Retin-A is old and cheap. Tazorac itself costs $300 which lasts about three months, so being off Geodon really pays off. Lithium costs less than $10 a month.

[hamster-bamster]

Originally Posted by hamster-bamster

D says that Lithium alone is insufficient - he says an AP of some sort is needed for bp.

Either D. went completely out of his mind or today is just a day of reading comprehension lapses worldwide.

I emailed him a short update on my situation, saying that I just take Amitriptyline for sleep, am without symptoms, psychiatrist said this and that etc.

He responded with "not without AP's". And nothing else - a kurt response.

I wrote back to him: "If you have actually read my message and responded this way, do you imply that EVERYBODY should be on AP's, just preemptively??"

[Victoria'smom]

Sorry D's not being supportive.

[hamster-bamster]

Originally Posted by Miguel'smom

Sorry D's not being supportive.

It is OK . He just weirded me out with his response.

[realityocean]

i am bp1, diagnosed 14 years ago after living in chaos for 20 years. in 2001 i went into hospital to be taken off the cocktail of meds i was on. since then i have coped on 1200mg of lithium daily. haven't had an episode in at least 10 years. gained a degree and steady employment during this time. however i do live from day to day as i am to aware of how fragile my stablility might be.
so, in answer to the question 'does anyone live on lithium alone' i can say 'yes'...well, lithium and a prayer, for the time being anyhow...
good luck...
rob

[ultramar]

I hope you don't go off of the Geodon yourself without consulting your doctor. Amongst other things it may need to be titrated in a specific way so you don't get horrible side effects/withdrawals. Maybe that's not your plan, so sorry to butt in if it's not.

Jamison is just one person with Bipolar Disorder, who happens to also have written books and is a psychiatrist. Everyone is different and will have different needs. It looks like Lithium alone works for her, but that doesn't mean it's right for everyone.

I'd tell your psychiatrist that that's what you'd like to try and see what he/she thinks.

I was put on Seroquel when/because I had a manic episode despite the mood stabilizer I'm on and it's increased when I seem to be on my way towards another one (or haven't caught it in time and am well into it). I think it's a good adjunct because it works quickly although no doubt different psychiatrists have different reasons for prescribing it to different people.

I wish you luck with this. I can understand the desire to maintain stability on the least amount of meds possible.

[ultramar]

Originally Posted by hamster-bamster

In the past, Lithium alone used to be the gold standard of bp treatment. Kay Jamison has always been on Lithium alone.

Enter newer atypical AP's and most people are on them. I polled people here several months ago and the majority of medicated folks are on some sort of an AP.

I stopped having orgasms. Unclear why: anxiety, stress (which has been through the roof lately), low blood pressure, too much biking, or, perhaps, some pernicious effect from Geodon even at the lowered dose. So I am thinking of going off Geodon for a week to see what happens. But I do not want to try Abilify which I am sure will come with its own set of side effects. I just want to try preventing mania using Lithium alone.

D says that Lithium alone is insufficient - he says an AP of some sort is needed for bp. But then how about Kay Jamison?

Yikes, sorry I didn't realize D meant Doctor, so you've obviously already talked about this with him/her.

Did your doctor say that an AP is needed for everyone with BP? That sounds like a big generalization. No doubt before atypical antipsychotics many people remained stable on mood stabilizers alone.