Lithium question

Hi,
Can anyone tell me if this is the "power of suggestion" happening? I started lithium about a week ago while being weaned off of the depakote that for almost a year I have been taking for bipolar disorder, and I think already I can feel a change (optimistic one) is it possible to feel something this soon? I know one thing I am not as wiped out like when I was on the full dose of depakote. My brother has been on lithiun for about 26-30yrs and it has been a miracle drug for him after he had been through many different drug therapies. I hope it will prove to be that effective for me too. I also have been on celexa for almost a year too, I have not had any side effects at a 30mg per day dose but the 40mg gave me the "jerks". If anyone can tell me if this is my imagination or can it really be taking effect already, I just started on 3 pills a day (total 900mg a day) . I also would like to hear if anyone at this forum is or has been on lithium and what it did or did not do for you. Thanks
Stay well,
"darkeyes"

hi darkeyes,

well, if i read <A target="_blank" HREF=http://www.rxlist.com/cgi/generic/lithium_ids.htm>this</A> correctly (under Indications) it can take as little as a week for symptoms to improve. i also don't think it hurts to have a little faith in something, too. (placebo effect?) i haven't taken lithium, but i've talked with a few people over the years who have had good results.

take care,

splash

I have been taking Lithium for almost a year and a half and when i was put on it I was on the depakote, which wasn't working. I worked almost immediately I was released from hospital shrtly there after and I haven't been back since.
To give you some reference on Lithium the greek or Roman physicians would send what they called "crazy" patients to bathed in the hot springs in the mountains. We know have come to knwo that the springs are rich in Lithium Salts so Even in small absorbed doses Lithium is quite effective. I have had little to no problem with the drug. Although the blood test to come to be a pain sometime, but you get used to them as I sure you have with the depakote.

Lithium is a salt not a chemical so it sort of replaces the sodium in your blood and because your body needs salt it can be accessed better versus getting used to a chemical or sorts like depakote that takes time to cause a reaction.

Good luck,
Adam

Dear Adaml,
So far the nice part of the lithium is that I do not feel "zombified" like while on depakote, that sucked and did not reallymake me feel any better just worse plus I was starting to feel a mild manic episode brewing so I told the doctor I was ready to try lithium, my brother has had success with it for 30+ years. The historical background of "lithos" and it's "magic" has fascinated me over the years reading about. I had purchased a large rock of unprocessed lithium I keep on my fireplace mantle as a reminder of how "natural" it is. I hope I do not start "fattening" up like I have while on depakote!! My brother did not seem to "pound" up while on it, that just happened over the years leading up to the middle aged group (mid 50's), I am 44 and do have to always battle weight so it does not "win over me". Seems like there is always some sort of battle we have to deal with in life it just sucks when there is multiples of them
Take care and stay well,
"darkeyes"

Dear Splash,
Thanks for your reply, it is possible that I am already feeling the positive end of lithium, so far the dry mouth is quenched with drinking more water and diet ice teas (snapple raspberry ice tea, goooood using the bathroom more is a little rough when on the road the bladder can take only a certain amount of traffic. Well I guess I'll survive, I have thus far. Hope all is going well for you.
Take care and stay well,
"darkeyes"

I used Lithium successfully in getting off Valium (and alcohol )without withdrawl. I had abused Valium for a period of about 20 years while continuing to drink alcohol.

Then I was told that I did not need a tranquilizer, that what I needed was an antidepressant. I took Lithium for about a year and then quit taking it. I joined A.A. in March, 1985.

About five years ago, I asked for Lithium again but was unable to take it, so I tried Lithobid and found I could not take it either. I would not take Lithobid again unless it was absolutely necessary.

I have been taking Trazadone as needed for two or three years. Recently I complained about not feeling well the next day and my doctor recommended that I take it earlier in the evening or to cut it in half. I find that cutting it in half has helped. I take it as needed for sleep. If I am upset, I take a whole pill. I am aware that if I don't take it as prescribed that it will not help me with my depression. I would say that I have found Trazadone to be helpful.

NETA - Lower doses of trazodone have little antidepressant activity anyway. Taking half a tablet is perfectly okay.

Antidepressant doses of trazodone run around 300mg to 400mg daily, in divided doses (eg. 200mg twice daily or 100mg three times daily). I have seen doses up to 600mg/day. Shortly after Desyrel™ (trazodone; in U.S. also Trialodine™ and Trazon™) was released in the early 1980s, it was found to be far too sedating to be regularily used as an antidepressant. It was effective in depressions with an anxiety component, but even these people were oversedated. The sedation was worse at the beginning of therapy (ie. drowsiness is a particularily bothersome start-up side effect), but the sedation continued beyond the start-up period. This led to many reports of associated fatigue, lethargy, concentration difficulty, and impaired memory.

Another troubling side effect was increases in prolactin, leading, in some cases, to gynecomastia (enlargement of breast) and galactorrhea (leaking breasts).

Desyrel at higher doses also caused heart problems in some "at risk" people (eg. orthostatic hypotension - dizziness & fainting upon rising from a sitting or prone position; shortness of breath; heart palpitations; etc.). Desyrel was developed to be a safer antidepressant than the tricyclic antidepressants (TCAs) and the monoamine oxidase inhibitors (MAOIs), but clinically it was seen that it caused similar problems as the older drugs at therapeutic doses.

One interesting side effect of Desyrel is increased libido. When I had first graduated from pharmacy school in 1984 I was following the drug file of an older lady (approx. 80 years old) who was taking Desyrel. Her husband pulled me aside one day (he was in his mid-80s) and said that his wife had become insatiable, and he could not keep up with her demands. I really felt sorry for him; he did look very tired. That was my introduction to Desyrel.

A particularily nasty side effect of trazodone at high doses is priapism (sustained, painful erection). This can be a medical emergency, requiring a discontinuation of the drug, and a trip to the ER. Permanent damage can occur if priapism lasts longer than 24 hours, because of the stagnant, unoxygenated blood remaining in one place too long, possibly leading to permanent erectile damage and impotence in the worst cases. In about a third of cases of priapism, surgical intervention is required. Again, this was only seen at higher, antidepressant doses (400mg to 600mg/day) of trazodone.

Because of these problems, trazodone was not widely used as an antidepressant after the initial surge in use shortly after it's release. For many years trazodone was a drug looking for an indication (disorder). It was tried as an impotence cure, but was overall ineffective in most cases. Then in 1990 Prozac™ (fluoxetine) was released, and it seemed that trazodone was headed for "obsolete drug heaven".

Prozac, for many people, was found to be activating and these people had trouble sleeping. Some doctors started using trazodone as an alternative to the more dangerous barbiturate sleeping pills and benzodiazepines (like Valium™ and Dalmane™). At the time, benzos were being bashed by the media, due to horror stories of addiction and severe withdrawl symptoms. The anti-benzo media hype was blown out of proportion to the actual problems with this class of drugs.

Psychiatrists needed a hypnotic (sleeping pill) that was safer in instances where there was a risk of suicide (barbiturates can be lethal in overdose) &/or in instances where the drug abuse was a concern (benzodiazepines were - and are - being used recreationally &/or as an "escape").

Although there are few placebo-controlled clinical trials testing trazodone as a hypnotic, many psychiatrists began using low doses of trazodone to induce sleep. Trazodone was found to be safe and effective as a hypnotic in doses of 25mg to 100mg at bedtimes. Clinical experience with this drug resulted in many case reports being written to psychiatry journals in the form of "letters to the editor" and trazodone use increased. Word of trazodone effectiveness spread.

It was found that at lower doses, trazodone use was not associated with the frightening, sometimes debilitating, side effects seen at the higher antidepressant doses. Being a serotonergic antidepressant, there was some initial concern of using trazodone as a hypnotic in combination with other serotonergic antidepressants (eg. Prozac and other SSRIs). There is a theoretical risk of "serotonin syndrome", characterized by arrythmias (rapid heartbeat), hyperpyrexia (high fever), malaise, profuse sweating, nausea, and vomiting. This can, if not treated promptly lead to hypertensive crisis.

There "does not" seem to be a problem with serotonin syndrome when combining SSRIs [like Prozac, Paxil™ (paroxetine), Zoloft™ (sertraline), Luvox™ (fluvoxamine), or Celexa™ (citalopram)] with low doses (less than 150mg) of trazodone. Some psychiatrists I know also give trazodone to their patients with insomnia who are taking activating TCAs [like Norpramin™ (desipramine) or Aventyl™ (nortriptyline - Pamelor™ - U.S.)] or even some serotonergic TCAs [like Anafranil™ (clomipramine)]. Most psychiatrists do avoid giving trazodone with the MAOIs [Nardil™ (phenelzine); Parnate™ (tranylcypromine); or Marplan™ (isocarboxazid)] because of the potential for MAOIs to induce serotonin syndrome, even when combined with low doses of serotonergic antidepressants.

Just another note on drug interactions (other than MAOIs). Trazodone may potentiate the effects of other CNS depressants (eg. alcohol, benzodiazepines, barbiturates, other sedatives) causing increased sedation. Also, trazodone may increase blood levels of digoxin (Lanoxin™) and phenytoin (Dilantin™), but this does not mean that these two drugs cannot be used with trazodone. Their dosage may (or may not) need to be lowered slightly if trazodone is added.

So, in conclusion, Desyrel™ (trazodone) in low doses (25mg to 100mg) at bedtimes is an inexpensive, safe and effective hypnotic, with no abuse potential. It can be added to most psychiatric medication regimens and one only needs to take as much as is needed to induce sleep, when used for insomnia.

Still NETA, I would tell your doc that you are only taking half the dose of your trazodone; it keeps everyone on the same page, with regard to your medication regimen.

I apologize for the lengthy post, but I was bored this morning, and I wanted to see if I could remember all that I am supposed to know about trazodone used as a sleeping pill.

Is there anything that I wrote that you would like me to explain further or more clearly? - Cam

In addition to Trazadone, which I take occasionally, I am taking Clonidine and Indural. There were also several heart and blood pressure medications that I could not take because of adverse affects. I also have a problem with fatigue and depression.

darkeyes,
I think that would be really neat to have the rock of unprocessed Lithium. I just think that Lithium is a really neat element to begin with. I don't think you will fatten up, although I have talked with people who have lost a few pounds. I guess cause it is a salt, and adding an regular dose of it can cause you lose a weight, mostly due to lack of water then the body burning fat. (just guessing). Life seems to keep fighting the person, and bipolar just doesn't help the fight.

Good Luck,
adam

Adaml,
Actually lithium is really a metal in a host rock like gold, silver, then it is processed. I think I read that it is then combined or something like that to a sodium so that it can be safely absorbed by the body helping to "dilute" it so you will not get toxic levels of the metal which is the same reason you need to maintain a balance of sodium in your body by not taking diuretics, and be sure to drink plenty of fluids to keep the kidneys functioning properly. Oh I am sorry, I am rambling.
Any way I am happy to hear "lithos" has been good for you, I hope over time I will be happy that I made this choice, cause depakote sucked. Stay in touch
"darkeyes"
CamW , am I right about this? Perhaps you could explain this correctly?

Darkeyes - I have no idea how lithium is found in nature. I've never really thought about it before. I am going to make a point of looking it up, though; especially now that you have piqued my curiosity.

I am doing fine. I saw my therapist today and (her and) I think that I am starting to understand this grief thing. Finally I am removing the layers blocked emotions that I have insulated myself in over the past (almost) 40 years. I would guess that the most important thing that I have learned is that I do not have to be a product of my past. That in itself lifted a burden that I had been living with for as long as I can remember.

I have isolated myself within my head for so long, I no longer had a body (if that makes any sense). I thought that by learning all that I could about my chosen field (psychopharmacology) would be all I needed to survive. I thought that I could reach the pinacle of knowledge by doing this. Then, during a session, it came to me. I may have oodles of knowledge, but no real wisdom (ie knowledge isn't wisdom). Wisdom involves feeling and emotion. Wisdom involves other people. A person cannot be wise without others. That is so cool. No wonder I have been chronically depressed. I have stifled (ie. depressed) my emotions for so long, how could my HPA axis (body's stress regulator) work properly.

Now I think that I realize why I have to work so hard at karate. I think too much about it; I should be just doing it. I need to allow my body to feel the moves, to learn them. Knowing the moves and what they do is only an abstraction of reality.

Finally, I may be on the road to "true" recovery. Fairly soon, when I do get a grasp on how this structure below my neck works and feels, I will be able to begin to grieve for my daughter (God, I miss her!). Did you know that true, heartfelt crying really hurts? I found that out today.

Thank you for letting me vent. How are you doing? Do you think that you have made the right decision in opting for the lithium? Your posts sound so much more upbeat than they did a week or two ago. Ya know, there may be hope for us old poops after all. ;^)

Thanks again for listening. I think that I am going to go and remember the good times I shared with Suzanne (my daughter) for awhile. Treat yourself well. I am backing you in your quest for balance. It looks like we are headed in the same direction.

Peace and Kindness - Cam

Pure lithium is an extremely reactive metal, just like sodium or potassium. In its metallic form, it would react violently with water, which is why darkeyes doesn't have a chunk of lithium on her mantle. Lithium automatically forms ionic compounds, so it is found in nature in several rare salts. It exists mostly as a trace element, although it can occasionally be found in more concentrated forms. However, it's somewhat unlikely that the lithium in hot springs ever helped anyone: there wouldn't be nearly enough lithium absorbed through the skin. It was popular for a brief time in the middle of the 19th century as a panacea, and was the touted "ingredient" in many snake-oil cures, although they didn't actually contain any.

While lithium is a relatively dangerous drug, and there's a great deal of controversy over whether its clinical effects are actually subclinical metal poisoning, I'm pleased that it's been helpful for you, darkeyes.

Hey Cal,
It is good to hear from you, it has been a while since I have seen any posts by you. How are you?? As you can see things are coming along fine, I just hope it will continue. I am still unpacking in between the hours I put in at the raptor center I am interning at. Moving is a ***** isn't it? Since Aug. we have got a lot of things done, but there is still a lot more to do. I hope you are doing well Stay well and keep in touch,
"darkeyes"