Posted by med_empowered on August 5, 2005, at 8:51:12
In reply to Re: does LITHIUM cognitive problems go away??? » bipolarspectrum, posted by ramsea on August 5, 2005, at 6:05:55
hey! Just a thought: if agitation is a problem, and you're OK with trying an atypical antipsychotic, you could probably lower your Lithium levels a bit and add a low-to-mid range atypical. My personal preference would be Abilify--you can start at the "optimal" dose of 15, or start at 10 (both doses are effective) and there isn't really a risk of weight gain and (so far) the diabetes risk seems minimal (if you opt for ANY atypical, please keep tabs on your blood sugar though). Antipsychotics help with agitation and they can control (hypo)mania and mixed-episodes. The new ones seem to have antidepressant effects as well...the symbyax combo is an example of this. Anyway, you might be able to get control of the agitation, lower the lithium dose (hence reducing cognitive dulling), and improve your mood overall with an atypical. Abilify is usually non-drowsy and kind of "activating," so the risk of cognitive problems from taking it are lower than with, say, Seroquel (that said: when I moved into higher abilify doses, I felt apathetic and stupid. Low doses were good though). Another option would be a benzo for the agitation..you run the risk of worsening your depression (not all that common, but still a problem) and some docs would rather gouge out their eyes with salad forks than RX a little Valium, but still...its a viable option. Good luck!
poster:med_empowered
thread:537243
URL: http://www.dr-bob.org/babble/20050803/msgs/537797.html