lithium and mania

so i think i've posted here before about how i used to get manic highs, but that it hadn't happened in so long that pdoc thought maybe it was just a blip on the radar and has been treating me solely for depression lately (past 2years now).

anyway, i recently went off all meds (anti -depressants, -anxiety, -psychotics) and i am on a rollercoaster of a high. it is awesome up to the point where i get tired and get cranky. thankfully it hasn't been accompanied with delusional beliefs, so my feet are still firmly on the ground and nothing 'bad' has happened.

anyway - onto the question: pdoc convinced me to start lithium about a week ago. i've been on 500mg up until today, meant to start on 750mg tonight. the high only started about 4 days ago - do you think the lithium could have anything to do with it? shouldn't the lithium be working enough by now that the high just shouldn't be happening? it seems weird that i haven't had a high for maybe 3+ years now, and then the minute i start lithium one just blows up.

i know i sound ungrateful to be on one, but bloody hell, it's too much. too much saturation of experience and i just want to concentrate and not be distracted by bloody everything.

hi deli, i'm thinking maybe this high is a result of coming off all the other meds, imho. i'm not sure that you have reached a theraputic level with your lithium to counteract your mood swing. to be sure tho i'd contact your pdoc and get his/her take on this. but to me it sounds like a mood swing from the absence of the other meds and your lithium not at the correct level yet. hope this helps and please let us know how this works out for you.

Hi sweetie, Madisgram right.......it took about 6 months for my lithium to level out but I am on 1000mg.......wondering if your dose is high enough(check with doc?). While I was waiting for lithium to work, my psych put me on Olanzapine (anti-psychotic) to "take the edge off" and it worked a treat. I don't need that medication anymore.

Now, I hardly even know that I am on the lithium, but I am having thyroid problems so I may have to change mood stabilisers. Don't want to! Love the lithium. And the only time I have felt a bit manic is when I was non-compliant for a few days due to thyroid problems.

Know what you mean about concentration......love the high but hate the chaos.
Hope you feel better soon

thanks (((((madisgram and michah))))) .

i am due for my first blood test this week, so should know soon whether it's at an optimal level. i hope i don't have to increase the dose too much more, because it's making me feel pretty nauseous.

madisgram - that's a good point you made about maybe coming off my previous meds triggering the high now. i have been on an antipsychotic on and off ever since i stopped using mood stabilisers, so that has probably prevented any highs from coming.

it just feels funny that after all this time i might have to lump myself back in to the 'bipolar' category. not that i mind so much, but things were less complicated when i just unipolar depressive (didnt eat away my bank balance, for one ).

hopefully lithium will work well for me. michah - i'm sorry to hear that your lithium is making your thyroid poop out . is there anything you can do to prevent it from happening, or can it just happen to anyone?

Good luck with blood tests babe.......I have a genetic predisposition to goiter and thyroid problems but i didn't know that till it started to fall apart.......my surgeon explained it to me. I had the thyroid problem before the lithium but I have been on so many pharmaceuticals over the years so who knows when my condition was actually triggered........

When you get blood done please, please, please get thyroid function tests done along with lithium levels. And even if results in range, check for inconsistencies over time.......very important. I would not wish my worst enemy to feel this sick.

In saying that, you may not have any problems at all. I do not want to put you off because I find lithium to be great......but it can reek havoc if not monitored. Go for it Eddie!!!!!

thanks, darling!

blood test is tomorrow, so guess what i've been obsessing over all day today . i am *bad* with needles, bad bad bad, but pdoc has given me some ativan to pop just before the blood test.

ok on my blood test request, it says:
- lithium level (fasting)
- tft
- uec

i think pdoc mentioned one is kidney and the other is thyroid, so i should be ok - right? like, he won't discover next week that he forgot a test and have to send me back (for another needle)?

michah - is there anything that can be done about your thyroid issues? i know one of my friends had a low level (?) or something and just needed to take tablets, but is it that easy to fix?

Excellent blood panel!!! TFT (thyroid function test-standard testing for thyroid. TSH(thyroid stimulating hormone) is the level doctors tend to look for. If a bit funny, Ft3, Ft4, thyroid anti bodies are generally next in the list. One word, if your TFTs are in range but are on the lower end or higher end of the range and you feel unwell or notice any changes in your physical wellbeing, hassle your doctor!!. I lived for 3 years with debilitating symptoms and it was all put down to my mental illness. Make your doctor listen if you have any concerns)

UEC(urea, electrolytes and creatinine panel-lithium can effect sodium levels in the body. You should not do exercise that makes you sweat excessively nor drink sports drinks. Do not go on a low sodium diet - eat sea salt if you like it, it is better for you. The kidney excretes salt and lithium can effect this process. Drink at least 8 glasses of water a day, no more otherwise you will dilute electrolytes too much. Also I found eating smaller but more regular meals helped with blood glucose and lithium absorption. Nausea usually abated if I did this, that will pass by the way. If not, tell your doc. You may be toxic.)

As for thyroid treatment, I would be lying if I said it was easy. This is the most physically ill I have ever been in my life. I have nodules and cysts on my thyroid so I have had to go through biopsies, cat scans, ultrasounds and multiple blood tests. I am now on thyroxine to help the goiter go down but the symptoms flare up big time and then level out when the meds do. But some people take months to get better even with the meds. I get really scared sometimes and the women on my thyroid forum have all gone through the same thing.

There is every likelihood that you will be fine on the lithium. It just pays to be vigilant on this drug as it is a heavy metal.

Good luck with your blood tests.......I know the fear......I worked in a hospital for 5 years and i still cannot handle needles. Mind you after the biopsy it kind of put my blood tests in perspective!! I still have to take valium.......Good luck babe, and let us know how you go....

This may sound weird del, but if you are a BPI this may be a blessing as it is probably the most treatable of major mental illnesses. As severe as your moodswings are, if you are one of the fortunate ones whose body can handle lithium, you may find that the simple salt lithium will stabilize your moods well. 30 years ago I was in and out of the hospital with major depressive and psychotic manic episodes. I prolonged this agony by resisting my diagnosis as an arrogant young man. When my son was born and I found myself in the state institution I vowed to do whatever it took to stay out. I began to become compliant with my lithium. I keep my serum lithium around .7 (sorry, forgot my daily dosage) which is considered a low lithium level and I have not had a major manic or depressed episode in 30 years. I get dysthymic and a little hypomanic every now and then but can manage these moods usually by just taking better care of myself and maybe an Ambien to help me get a good night's sleep. Maybe lithium alone will not be the answer for you and thank God there are many other options. But since you originally asked about lithium I just want to say that form me, since I see so any people struggling with their meds, I feel actually fortunate that I am Bipolar I and that someone managed to get me to trust lithium.

Is everything OK mate?

thank you for asking after me, topher .

the high has stopped, back into depression. i stopped the lithium because it was giving me hallucinations, but pdoc wants to ease me back into it over the weekend and see if a slower introduction to it might avoid the nasty side effects.

hopefully it will work out well, because the depression is getting worse, and i dont have much time to wait for results as i'm back at uni and in the assessment mill .

Not to get to technical Michah, but lithium is actually in the class of alkali metals. These are defined as any of a group of soft, white, low-density, low-melting, highly reactive metallic elements, including lithium, sodium, potassium, rubidium, cesium, and francium. Heavy metals are elements with a high specific gravity, usually defined as over 5.0 including lead, mercury, copper, zinc and the like.

I hope you found something to help you with your depression del. It can make functioning so difficult.

thanks topher .

i am off the lithium for good - went back on it and the hallucinations started again! terribly bizarre.

atm, i'm not on anything. my pdoc suggested going back on my old meds the last time we met, but i have since decided not to. i'm not interested in something that clearly wasn't as effective as it was meant ot be - i'd like to try something new. so i am seeing him tomorrow and hopefully he will have some new ideas.

Sorry to hear about your problems with lithium, but there are a number of different mood stablizers to try. No drug works for everyone, that's what makes all this so hard.

I think that Seroquel is the only drug that is FDA approved to treat both ends of the bipolar spectrum, though they could have added something else. At any rate, it has helped me dramtically. I still have enough problems to be disabled, but at least I don't want to hurt myself and my head doesn't feel like it's going to explode, so that's a good thing!

thanks, daveyjones! i don't think we've bumped into each other before, so nice to meet you!

i think i must be super sensitive to drugs, or something . seroquel got my body so heated up that i passed out, and couldn't be roused for 15hrs. i finally woke up, had some water, and slept it over for another 12. GRAH!!!

i hate hearing about all these good meds and all of them pooping out on me.

i've also tried epilim and lamictal. no side effects on those, but no gains either. i struggle with the depression side, and lamictal helped a bit, but not enough as a standard anti-depressant.

have also tried all the atypical antipsychotics, hoping they might provide relief as a mood stabiliser. so far, no real luck. zyprexa is good when i'm agitated, but i'm not agitated when i'm depressed. abilify did help a bit, but i need it to augment a good antidepressant first - so need to track one down .

so i think i might be venturing back into the older antidepressants class soon. i'm reluctant, but whatever works, right?