That article or blog post about Lithium vs Atypicals

I have recently read (well, scanned) long articles about how Lithium is under prescribed, how it is a gold standard and THE mood stabilizer, and how nothing has ever beat it for Bipolar.

It has not been my experience and now, years after stopping Lithium, I am stuck with hypothyroidism it caused and need to take Levozyl for life. I had never had thyroid problems before Lithium was initiated. So it did not help that much in the end, but I am stuck with a side effect for life

Atypicals, though just a few of them of many I have tried, save the day.

Some years ago I read someplace that there are different presentation of bipolar and one of them is better treated with Lithium and the other, with Atypicals. I am thinking that the classic presentation with regular upswings and downswings was the better candidate for Lithium. I do not have that presentation.

Tried searching for that article but instead found only reviews comparing effectiveness.

Does anyone know which article or blog post I saw?

In the table on this page it mentions the differences b/t Classic and atypical, and says with treatment classic is more responsive to lithium/atypical more responsive to anticonvulsants and atypical antipsychotics

I was pretty responsive to lithium…I do have a pretty typical bipolar I presentation. But then I got lithium toxicity and was taken off it. Cymbalta and later the SAD lamp seemed to help my depression more than lithium BUT I did have less severe intrusive SI thoughts on lithium. With just Seroquel and lamotrigine alone it was the worst I’d ever had with SI thinking.I do seem to tolerate Cymbalta and so far the SAD lamp at least for now. On lithium I still did have depression just not of the “thank God I don’t own a gun variety”.

I’m on lithium despite it buggering up my thyroid because my pdoc says it’s the golden standard for bipolar. My old pdoc took me off it when it messed up my thyroid now I’m on meds for life too. He had me on lamotragine but my current pdoc reckons it’s not as good at preventing a relapse. I absolutely can’t stand the blood tests but I only have to have them every 6 months. Initially I was on 1 tablet in the morning and one at night but I kept missing the evening dose so now I take 2 tablets in the morning even though I’m not a fan of it. My pdoc was worried about rebound depression so he didn’t want to take me off it. Bugger.

I too am not happy with lithium causing my to take Levothyroxin for life. It’s annoying plus it never helped my bipolar sx

I definitely have a more atypical presentation (although I do get some euphoric manias, but that's not a majority of the time). I did have a decent response to lithium except after a 4.9 level after stockpiling for a while, my kidneys are trash. I can't take antipsychotics unless it's PRN because I need sedation, and even then I can't take them more than a couple days in a row without wanting to rip my skin off and remove all my limbs. Right now my only mood stabilizer is Trileptal, but I couldn't tell you how it's working. I'm not doing well, but I'm not saying it wouldn't work if I weren't either high or withdrawaling 24/7

That article, yes! Where the proposal to call the classic presentation Cade disease is mentioned.

I have read it carefully now and it linked to a 100-point bipolar scale to distinguish the presentations. I got a broken link when I followed the link

I'm a typical. They never tried lithium on me because I refuse it.

I tried lithium, but had to go off it almost immediately because I couldn't even physically tolerate 300mg. It made me so weak and fatigued I could barely walk to the front door! I'm schizoaffective bipolar type. I don't know what "type" of bipolar I present though.

I'm thinking this is it (I get a 75)

Downloaded and will take it

75 here as well.

But I was confused when I tried answering section IV. They talk about mood stabilizers, but this word combination does not have an accepted definition. For some people, only Lithium is a "true" MS. For others, it is Lithium, Depakote, Tegretol. For still others, add Tripelpal and some other anticonvulsants. And then lately antipsychotics, esp. Seroquel, have been called mood stabilizers if they can work against both poles of the disorder.

I just kinda assumed it meant anything commonly used for mood improvement but isn't strictly an antidepressant (so lithium, anticonvulsants, antipsychotics).