A few questions

After having a diagnosis of depression for many months, I've been given the diagnosis of bipolar. After hearing what everyone around me had to say I finally wrote it all down and gave it to my psychiatrist. I'm now on 450mg of lithium twice and a day and xanax 3 times a day. I just started them today so I have a few questions.

1. How long before lithium takes affect?
2. I read that some people need an antipsychotic along with lithium, how is that determined? Will the lithium be enough to level me out by itself? I'm already taking 5 meds a day and it's annoying.
3. This is just a general question. If I ever decide to switch psychiatrists, is there like a record of all of my previous meds/diagnoses and such? Or should I be keeping track of everything?

I don't know about the lithium because I don't take it. As far as meds go, I just tell the Pdoc what I've tried and brought in the Rx bottles. Who's going to walk in a pdoc office with a made up diagnosis to get psych meds? I don't even want to be on them.

Welcome jtasser93,

1. Not sure - I have not tried lithium.
2. Lithium might be enough. Antipsychotics are a great help for many of us. You'll just have to see.
3. My psychiatrist had me get all my records from the previous pdocs so he could review as part of my initial evaluation. I think this is a good idea.

Please keep sharing. You've found a good group here at PC.

moogs

450 mg of lithium is pretty low. The only way to know is to have your blood levels checked. I didn't get to a therapeutic level until I took 900 mg. It was very calming for me. I was at 900 as a stop gap while I ramped up on lamictal. Now that I've started decreasing the lithium, I notice more anxiety and unease. So, for me, it seems to work. I just want to get on something that's less toxic and doesn't require drinking so much water that I walk around sloshing. Bottom line: it's a useful drug. Just make sure it's being monitored with regular blood tests. And drink a lot of water (I drink close to a gallon a day).

Hi jtassar93. Welcome

For me Lithium began taking effect after about two weeks then really kicked in after three months. I take 500mg twice a day so pretty similar. It is an amazing med when it works so I hope it works for you. I find anti-psychotics to be very useful in dealing with agitation, racing thoughts, and irritability. It all depends on your particular symptoms and the trouble they bring you.

My new pdoc was like just listened to my story, asked a few questions, then said Yep he concurred I was bipolar. Then he took my word on meds even though I had my bottles. Who wants to take Lamictal? Lol

Hello jtassar93,

Great questions you got there. I'll try to share some of my experiences with Lithium and what I think.

1) For me it took 6 months until it finally took full effect. My blood levels were always monitors and I got them monthly. Once there's a good level in the Lithium levels in your blood, you'll start feeling the maximum benefit of the medication.

The dose you are on is the starting dose. It just means starting the medication in your body. You really won't feel much improvement until you reached around 0.8 lithium blood level from your blood test to your psychiatrist.

My personal experience is I'm on 1200mg and I didn't start noticing the mood stabilizing effects until 3 months after being on the right level. As the dose got higher, the mood changes were gradual. I'd recommend giving it a chance because it has helped me and my life enormously. I'm working and out and about now.

2) Lithium does not typically need a supplement with an anti-psychotic because Lithium treats both mania and depression symptoms. If your depression symptoms do persist, or you have Bipolar 2, you may be switched to a more anti-depressant mood stabilizer med like Lamictal.

Lithium is awesome because it's just a salt/mineral. It's the most natural mood stabilizer and is the first and gold-standard treatment for treating bipolar. They usually take it off for people whose blood levels show thyroid issues or low white-cell count. Or you experience tremors, or you have a lot of difficulty with the weight gain/thirst issues that come along taking it.

In my personal experience, to see the full effects of Lithium took a lot of time. You definitely need patience because just starting means very little. My advice is to give it more time to work before making a decision to switch meds.

3) All your information is recorded to what's called the #MRN or your Medical Record Number. Their job is to record everything and in case they need to report anything to the government or what not. For your personal growth, it's always a good idea to bring a notepad and something to write with for your own notes and records when you see your doctor. It's a good habit to do in general as well.

I hope my feedback is helpful. Good luck!

-berlingots

Oh yeah. Been through that routine too. To get a good pdoc around here, I had to get out of the insurance game and go private. My pdoc is not cheap and does not take insurance, but he is one thorough mofo. He is wicked smart and experienced and truly cares. He will spend his spare time reviewing his patients' files and make sure he gets it right.

He has been a blessing. Hope you find some good ones!

moogs

Actually this is a private pdoc. To cut through the b.s., I let him know straight up my DX and I just need him for med maintenance. I need a therapist, pref a woman to talk too.

When I was hospitalized, they needed to talk to the pdoc on call, and the last pdoc that I wanted to talk to was mine so he couldn't find out what I did. Out of the hubdreds of pdocs out there, it was mine. That sucked. Lol

I get to do follow up tomorrow.

I need a new doc, i hate the med i'm on now and she won't change it. Is it too much to ask for a new one? how do i get her to see i can't handle what i'm on, clonazapam plus others which don't bother me as much. i even told her my med makes me feel suicidal as i take it at night and go through asking my husband to take me to the pshyc ward every night. Any suggestions?

I am on 300m of lithium but that is just a tiny add-on to my other meds and even that small bit kicked me out of a depressive episode. I am still getting them so I probably need it upped. I have never been on an ap but am on lamictal and wellbutrin. I feel the impact of most meds very quickly- within a week or so.


As for new pdoc- whenever I see a new doctor of any type I usually sign a form to have my records transfered. I just switched therapists and my pdoc faxes all my visit notes to her which is nice.

The pdoc works for you, not the other way around. You pay him to treat you. In a sense, you hired him. You can fire him.

Sounds like a crappy pdoc because he's turning a deaf ear. I'd leave hm right away myself. I'd start calling around, land another appointment, then cancel any future appointments with the crappy pdoc.

I hope things work better for you sweety.

It's pretty common to first be diganosed with depression first then later BP. I can't remember too much about my experience with lithium, but I was also struggling with PTSD and dissociation at the same time. It took awhile to stabilize down to a point I only needed BP meds. Lithium used to be the first line med of BP and some doctors are still more comfortable with the older meds that have known long term effects over the newer ones. Only time will tell if lithium alone will work for you.

I hope the change goes well too!

I remember I had three residency doctors. It was nice to have a younger perspective on everything. My first therapist was a lot older and it didn't work out. But I enjoyed the time I spent with my therapists. Although they weren't long term, but since they switch every year, it might be helpful for you to have different people. Then you can decide and choose who you'd like most.

Good luck!

Thanks for the responses everyone. I've only been on this mix for a few days and have been feeling EXTREMELY tired and depressed. The depression was there before, but I've just been soooo exhausted. I've been sleeping for about 15 hours a days.

Is it the xanax or lithium causing this and is it normal? Will it eventually stop? I feel so drained.

Give it time. The tiredness could be the depression or getting used to the meds. Hang in there!

I am literally in the same boat as you. But I am not on lithium I am on latuda. I am also wondering how long it takes