Posted by maryanne on September 26, 1999, at 6:06:30
In reply to lithium, posted by bob on September 25, 1999, at 18:14:06
> My 20 year old daughter has been diagnoised with bipolar disorder, and has been given lithium and paxil. I am concerned with the rush to medication and the type. I'm new to this-any advice?
I believe your concerns are valid. Several reasons why. For one, starting two medications at the same time isn't wise. It opens a whole can of worms in terms of side effects, titration, and results. Too much confusion. Too many variables. It seems prudent to become stabilized on one and add another later if needed. It's hard enough managing one drug, not to mention two at the same time. Second, Lithium is FDA approved for acute mania. Is that where your daughter is at? It is also used to stabilize and potentiate an antidepressant, but almost always added later if needed. Third, other newer choices such as Lamictal or Neurontin have a much more favorable side effect profile. Many people can't tolerate Lithium. In the long run it is hazardous to kidneys. It can be nasty. Finally, if bipolar, it might be wise to start with Lamictal or Neurontin first, see how it goes, then depending on the results either add an antidepressant or revert back to one of the older mood stabilizers like Lithium or Depakote. I know several doctors, and have seen more in literature, who never use Lithium as a first-line treatment. Especially for someone so young with no medication experience. I would postpone your docs approach and re-evaluate the whole situation. Get a second opinion/second approach from another doc, preferably one who specializes in mental illness drugs and is well-read on cutting-edge advancements. Lots of choices. Many make a lot more sense than the one you've been given. I strongly agree with your concerns and I believe this is an appropriate situation to cause hesitation. In my opinion Lithium is a poor first-choice unless the person is experiencing acute mania. Get a second opinion. If your daughter's life is not in danger, there is no reason to rush blindly into this can of worms. It all depends on the degree or severity of the bipolar condition, but she might be fine on a simple treatment of Paxil. If it throws her into a mania that is of concern, then we would know a mood stabilizer is warranted. But again, more and more they are not using Lithium as first-line treatment.
poster:maryanne
thread:12039
URL: http://www.dr-bob.org/babble/19990914/msgs/12065.html