Is anyone just on Lithium alone without A/Ds?

My pdoc recently took me off my effexor and increased my lithium, but I still feel depressed and working hard to pull out of it. I understand that antidepressants increase the mania but everyone seems to like to see me more depressed than slightly happy.

Has just lithium alone helped anyone else?

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Actually, your pdoc is "up-to-date" regarding treatment. Within the last 5-7 years, research is suggesting that antidepressants do not help bipolar depression, and actually may make it worse. Bipolar depression is not the same as unipolar depression. (See the link to an article at the end)

Researchers are still investigating how antidepressants work on a bipolar brain, so there is no "gold standard" for treatment yet. But they are working on it, at least!

Many pdocs who are "up-to-date" still try antidepressants first, but if they do not work "immediately" they stop prescribing them and focus on increasing the mood stabilizer (lithium or lamictal) or the anti-psychotic (ex. seroquel works on mania and depression).
Lithium has long been known to prevent suicide and works moderately well as an antidepressant.

There is a huge "negative" stereotype and lack of understanding about Lithium. Even some of the comments here on PC are like "I would never try Lithium." "Lithium is so dangerous, you can die." The reality is that every drug affects the body. Lithium is perhaps one of the most studied psychiatric medications because it has been around for-ever! A person can die from any medication if they overdose.
Compared with the "newer" medications today.... Think about Seroquel. So many people have been prescribed this medication, but the reality is that Seroquel is very harmful to the body. It causes weight gain and in many cases 50+ pounds, increased triglycerides, high blood glucose, etc, etc.
How is that better than Lithium?

**Sounds like your pdoc is good. I would be more concerned if pdoc kept trying different antidepressants when they do not work, because then I would question whether pdoc was up-to-date with bipolar treatment.

FYI: I am classic Bipolar 1 and not on an anti-depressant. My main medications for bipolar are lithium and seroquel. My pdocs tried antidepressants years ago and nothing worked... which goes to support the new theories in research about our brains!


"Although antidepressant drugs remain the mainstay of treatment for unipolar major depression in both primary and secondary care settings, the evidence to support antidepressant treatment for bipolar depression is limited and increasingly controversial."
Antidepressants for Bipolar Disorder - Psychiatric Times

Wow. thanks emptyspace for that information. How much lithium are you currently on? I'm currently on 950mg and due for a level this week then another adjustment. I'm also on Seroquel.

Im BP1 and take Lithium . AD"s flip me right into an ugly mania.

Lithium comes in 300 mg capsules or pills. No?

To OP: read this book An Unquiet Mind: A Memoir of Moods and Madness: Kay Redfield Jamison: 9780679763307: Amazon.com: Books

It is a classic in the literature about the manic depressive illness and the author is on Lithium alone. Very good read - she has a literary talent. Highly recommended.

Yes. Lithobid and Eskalith comes in 300 mg tablets
But Eskalith CR comes in 450 mg tablets.

And Lithium Carbonate comes in 150 mg, 300 mg or 600 mg capsules.
And Lithium Carbonate comes in 300 mg tablets.

Lots of different choices. There is even an oral solution that you drink.

Not sure how you get 950 mg.... I am too tired to do the math.

I take Eskalith CR and take a total of 1125 mg per day. The extended release is much easier on my stomach.

Lithium is different from other mood stabilizers. What is perfect for someone, is toxic for another. It is metabolized differently for everyone. Blood tests are CRUCIAL, not just for the range, but to watch kidney function! Once you find that therapeutic range or in the process of finding it, you should be getting blood tests a minimum of every 6months.

I do 1200mg. 1500 mg is borderline toxic for me and is above the therapeutic range. 900mg is not even in my therapeutic range.

It just doesn't work like other drugs. Once you are at your therapeutic drug level for lithium, if you are still depressed or manic, they have to add another mood stabilizer or something. There is no "upping the dose."

Anti-d's scare me... too much manic stuff. That is where I will drag my feet on, even with a mood stabilizer.

absolutely!

I'm just coming of Abilify and Effexor because they're doing nothing for me and I'm going up to 600 mg of Lithium today. Anti-depressants either do nothing or make me manic and the couple of mood stabilizers I've tried (Lamictal and Tegretol) do nothing for me. So this is the next step. It's very interesting to read that ADs can make bipolar depression worse because they are mostly what I've tried, and I've been really bad before (especially lately on Effexor). If Lithium doesn't work, I try Seroquel. But I'm hoping it works and I don't have to worry about that.

The therapeutic and toxic levels for lithium are very close together so it's hard to find the right dosage and get relief w/o getting severe side effects. I hit the therapeutic level once over last 10 yrs and my muscles stopped working and couldn't walk. Otherwise it does nothing for me.

There are studies that show that 20% of BP patients experience mania when taking an AD. (Search the web for legit studies.)

Most ADs cause severe agitation for me or hypomania. Especially SSRIs. But effexor is doing a decent job for me now.

And bottom line is psychiatrists don't know a great deal about mood disorders or how psychotropics work in the brain. All they have on meds is empirical evidence at most.

Thanks everyone. here in australia Lithium comes in 250mg rablets and 450 mg tablets.

Yes, i am on Lithium only - 1200mg a day and it keeps me quite stable.