changing meds

Hi there,
Yes, I've had much experience changing meds when I had OCD, but now, with bp1, it's a different story... so maybe you can help me w your experience.

My last crisis took place last spring and blood test shows lithium levels were optimal... ergo, lithium can't handle my crisis by itself, ergo my pdoc has added valproic acid to the combo. Li + valproic acid is what I'll be taking from now on.

Any takes on that? Can lithium keep screwing my thyroid and valproic affect my liver or anybody knows for sure this combo to be good? Yes, it may depend on the person and dosage, I guess, but still wanted to ask you guys.


Thanks btw to those who suggested taking a gene test. I plan to do that next, many thanks.

Regards.

Hi @MrAbbott - I am not an expert but i heard lithium levels need to be measured regularly plus it is really important to drink a lot of water if someone is not doing that already. Talk to doc or pharmacist for guidelines.

If any med is not keeping someone stable, the best thing I found to do is contact prescriber and tell them what is happening and ask them for recommendations to deal with changing situation.

I have never been on that exact combo myself, but I've been on Li and valproic acid separately. It would make sense if lithium is already affecting your thyroid and you stayed on it at the same dose, it would continue to affect your thyroid and you would also have to start taking something for it. Also, valproic acid can cause liver damage if higher doses are taken for a long amount of time so, like lithium, it's important to get your levels checked frequently. Taking them both as far as I know doesn't lessen the side effects from either.

Hi @CANDC! well, I actually didn't have several manic episodes before being treated with lithium to measure its efficacy, so I don't know how effective lithium may be in my case. I'm looking forward to taking the gene test. My doc never even explained it even existed, I'm a bit pissed for that.... Thanks for your message!

It's not uncommon in my experience for lithium to be paired with another medication, like valproic acid. I have a similar med situation with lithium and another med, lamotrigine. It works really well for me! Like you said though, it does depend on the person.

As far as health effects and dosages go, I know with lithium the really bad effects happen when the blood levels are regularly above a certain point. I fairly certain valproic acid functions the same way.

That said, definitely keep an eye on the thyroid if you're already having trouble with it.

There is research showing that lithium and VPA together are better than either individually. It wasn't enough for me but I seem to need to be on an antipsychotic and while I was on that combination I wasn't on an AP until the last months after which we tapered the VPA as redundant.

I hope it works for you.

Crossed fingers thanks.

Good luck with the meds

I never had luck with lithium and it caused my squired hypothyroidism. I tried it again years later and it made my thyroid out of whack again even though I was taking synthroid and took a year for it to stabilize once off lithium .

I've also taken both lithium and Depakote. Lithium destroyed my thyroid and now I have to take synthroid. I quit taking it after I became toxic on it. My pdoc failed to check my lithium level at my previous appointment. I ended up in the ER shaking uncontrollably and staring unblinkingly with all the commotion - 30+ doctor's and nurses in my little room and overflowing into the hallway . Depakote also made me gain a lot of weight which I still haven't shed many years later. (Of course part of that gain was from Zyprexa which screwed up my liver.)

Now I take Haldol and Rexulti and Trazodone and seem to be ok on those.