let's talk lithium!!! (unipolar depression here)

hi guys,

my pdoc has asked me to "think seriously" about taking this drug. actually, he had the script all set up and ready to go, but finally picked up on my hesitancy, so decided to defer the trial until after the hols.

i'm scared. i don't know why, but in my mind, lithium is your prototypical "crazy drug".

has anyone had any success using lithium as an adjunct treatment for unipolar depression? i'm currently on lovan (=prozac) and edronax. lithium will be in addition to these.

also, i've heard you need to have blood tests done regularly? does anyone know how often these are when you start off, and also how often you they are once you've stabilized on the drug?

ive already tried a fair few mood stabilizers and antipsychotics in addition to my ADs, so lithium is kind of like a last effort. if it doesn't work, i'll scrap the current regime and start taking parnate.

i'm reluctant to go on lithium. am i just letting prejudice get the better of me?

I'm bi-polar II--hypomanic but not manic. I've been on Lithium for 8 years or so.

After so long, it's hard to address it: I guess it does something for me. There's a slight weight gain--5 pounds or so for me. It seems to help moderate my mood swings a bit.

Blood tests aren't a big deal. They do periodic tests for "liver functions" and lithium level in the blood. Depends on doc on how often. I'm not on a schedule--maybe 2x a year. More often at first to see how you react, tests when maybe you have something going on and they want to see if the liver/lithium levels might be the culprit.

Lithium is a mood stabilizer.
I would think you would attach more stigma to anti-psychotics.
In this context, crazy is an odious word to me.
I don't mean to be combative or disrespectful to you. I am asserting my opinion and reaction.
I am and have been on anti-psychotics and mood stabilizers, including Lithium. Lithium didn't not help me at all.

My psychiatrist broached the possibility of lithium carefully with me...

There is some societal prejudice toward lithium. There's no real basis for it, but it is there.

That said, I don't think you should be afraid of taking it if it might help.

I am on 450 mg/day, which is a "low" dose, and my doc does not bother with the blood tests. Your mileage may vary...

I have bipolar II, which consists mostly of stubborn depression...I think lithium has helped, particularly with sudden plunges into very severe depressed moods.

thanks for your posts, guys. i think another reason i am scared of it is because i know someone who is on it, and he has really bad tremors - so much so that he can't hold a pen sometimes without dropping it.

has anyone had any adverse side effects like that?

yes, i don't think my mind is very straightforward when it comes to stigma, is it? but i guess i took the anti-psychotics because i was going through really bad anxiety back then, and they were the only things that helped to calm me down. also, i don't think many people know the names of common anti-psychotics, whereas almost everyone knows that lithium is used to treat mental illnesses. and there still is stigma attached to MIs, which i would prefer to avoid.

i'm sorry that my use of 'crazy' caused offense . thank you for letting me know. i guess i am still torn over how i view myself and my depression. i will happily self-identify as "crazy", and do not mind if my pdoc calls me that also (because i know he holds me in high regard), but i am very keen to avoid the "general public" from knowing i have an MI, and i don't want anyone to think i'm somehow insane or incapable because of it.

thank you for sharing this, slothrop, it gives me a bit of hope. my shrink would like me to try it to prevent the sudden fall into the abyss also.

i was on it for about 8 months...the blood tests were nothing to worry about...honestly i didn't like the way it made it made me feel...i felt sick from almost the first day on it. the problem was my dr also started abilfy the same time and i had huge problems with that also..so it was difficult getting off that first and then the other drugs he tried after that. it seemed that no matter what drug my pdoc tried to comabt my symptoms the side effects were jsut horrific...i literally lost like 10 months of memory from all of this...a total nightmare! it took some time to finally get off the lithium and all the drugs with the exception of effexor and topomax. now things are much better

some folks do well on lithium some don't...i was one who didn't...i just didn't tolerate it well.

Deli, for short, I have tremors. I have had them anyway all my life, but worse with Lithium. Everyone notices--I'm on 450 mg. I've known that people have wondered what's up with me because of the tremors. It doesn't interfere with anything--I don't notice it. Sometimes when I'm really, really strung out--lack of sleep, not eating, stress, sick--I do get really trembly, but like I said, I trembled long before I took Lithium.

On the stigma, I let some people know due to the trembling by way of an explanation. But those are med pros mostly--I'm into health policy. I think some people have thought I was a junkie or a serious alcoholic, so saying I’m on Lithium is sort of an improvement.

I keep hearing that more and more people are on Lithium so I don't care much. It's so out there in the discourse that people understand that taking it doesn't mean that you are....whatever might be viewed as more serious.

thanks for your post, imapatient. every new med that i've started has caused me some amount of grief when it comes to tremors (even those where it's only noted as a very rare side effect), so i guess i'm wary of lithium. the first med i tried -- prozac -- gave me tremors for months. i couldn't navigate the stairs at uni very well, i shook that much. ppl probably thought i was a junkie too .

i guess i'll just have to hold out hope that my body will adapt, like it has all the other times.

thank you especially for this last line -- " keep hearing that more and more people are on Lithium so I don't care much. It's so out there in the discourse that people understand that taking it doesn't mean that you are....whatever might be viewed as more serious." you're right. i think i need to work through my own prejudice first, and also remind myself that perceptions are changing.

i think i must be having a hard time, because i recently 'outed' myself as taking meds to a group of people i thought would be supportive at best, or just be indifferent. instead, i felt completely attacked. it's silly that i'm letting the perception of others dictate my choices on what could ultimately prove to be very beneficial to me.

thank you so much for coming back to respond to this thread. it's given me a good space to work through some of this.

People attacked you for being on meds? Because of their opposition to meds or to your revelation of getting mental health help?

Re: Stigma. It also doesn't seem to be as big a deal these days to be/say you're on an anti-depressant as it used to be. I think Prozac started that. So many were on it, it became part of the cultural lexicon. So I don't mind telling (some) people I'm on an anti-depressant; depression is seen as far less serious of a disease than almost everything else. It's "sadness" not mental illness to a lot of people, and that's fine by me for them to think so.

i think you've hit the nail on the head with that post, in more ways than one.

re: stigma. it's precisely because antidepressants aren't seen as "that serious" that i'm ok with letting people know i'm on it. i'm a bit scared about lithium, just because it's seen (over here, anyway) as a "step up".

on the flip side -- i think the reason i wasn't supported was because depression is only seen as sadness... and who needs medication for that? one of the girls that i told - we shared some similar childhood experiences - and she is sad about them (and seeking therapy to help her through it) but she doesn't have depression, like me. she thinks i am weak to be on medication, because obviously if she could get through what she did without "extra" help, then why can't i?

Arrgh! That's maddening... Why does she think meds are "extra" and therapy isn't? Either way you're getting help.

In The Road Less Traveled, Scott Peck pointed out that, if anything, seeking psychotherapy shows your strength. I think the same goes for meds. A willingness to admit you need help, and a desire to get better, show inner strength, not weakness.

thanks, sweetie. i might pick up that book and have a read. is it something you'd recommend?

Wow, it's been so long since I read it! You'd probably get better-informed opinions from Amazon.com reviewers or something.

In many ways I thought it was an inspiring book. One complaint I had was that he seems to think everyone needs psychotherapy to untangle their minds, and that drugs don't really solve the underlying problems...perhaps true for some people, but not all. It also takes a religious turn toward the end...not necessarily a bad thing, but it surprised me.