Posted by Bob on August 31, 2009, at 13:56:34
In reply to Re: Going back to old-school - lithium. » Bob, posted by SLS on August 31, 2009, at 3:40:27
> Hi Bob.
>
> I really appreciate your concern and input. I am particularly grateful for your sharing that it was the lower dosages of lithium that you did best with.
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> > I may have missed it, but what specific symptoms or situation brought you around to giving the lithium a go?
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> 1. Simple clinical logic: I never tried lithium with the combination of drugs that I have been taking.
>
> 2. My illness is probably closer to being bipolar I disorder than bipolar II because of the severity of my drug-induced manias. Bipolar I disorder is more amenable to lithium treatment than is bipolar II. It is interesting that lithium never acted as an antimanic drug for me. Higher dosages were of little value to control my mania acutely. Depakote and Zyprexa are far more effective for me.
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> 3. I wanted to take lithium indefinitely for its potential to produce neuroprotection and neurogenesis.
>
> 4. Desperation.
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> > Were you experiencing instability,
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> No. I was quite stable in my depressed state.
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> > or maybe the AD cocktail just wasn't making you feel as good as you thought it could be? I guess stated another way I'm wondering if you were looking for a 'smoothing out' or maybe an actual augmenting boost to your antidepressants?
>
> There was really nothing to smooth out. My objective was to use lithium as an augmenter of antidepressants in the low dosage range that it is often employed when it is used in this role (300-600mg). I am more comfortable at 450mg than I was at 600mg.
>
> In what ways were higher dosages of lithium not good for you?__________________________________________________
I have a very different condition than you it seems, dominated by dysphoric anhedonia and depression among other things. The higher the dose or the longer the duration on a certain dose of any anti-manic or calming medicine eventually results in extreme fatigue, apathy and almost absolute indifference. Celexa actually falls into this category too.I have never in my recollection experienced any type of true mania or hypomania in the absence of a psychiatric drug, and I've never experienced pure mania under any circumstances. What I have experienced on many occasions is anxiety, panic, or more likely, agitation, akathisia, irritation, and outright anger. I guess this is why anti-convulsants and mood stabilizers have been tried for me. At higher doses of lithium I just shut down, gain weight, sleep all day, and just... don't... care any longer. Yes, many of these endeavors have involved combinations of drugs such as Welbutrin with lithium. The activating drugs always lose the battle to the less activating ones.
Treat the depression and I get what I call 'active negative symptoms' I mentioned above like anger and dysphoric agitation. Try to tamp that down and inevitably I will switch to being a zombie. There has never been a lasting compromise. I've never felt relaxed yet energized, calm yet interested and engaged. None of this even addresses the litany of serious physical problems I've developed over the years of being treated with these drugs. Add into the mix on top of that a serious intolerance of psychiatric drugs in general with a history of many bad responses and side-effects at uncommonly low doses.
It may sound ridiculous but on many occasions I have wished for a little hypomania or mania after months or years of feeling nothing. I just don't understand why no treatment can give me a calm, useable energy without it turning into anger, irritation, and then eventually sadness and severe depression as the treatment is withdrawn because of inefficacy. I guess some would diagnose me as some treatment resistant variant of BP-III except these days I'm pushed into anger from drugs instead of joy, happiness or contentment. A 'dysphoric mania' of sorts. I like to think of it as all the bad parts of a hypomanic episode with none of the good. Of course, some would say this is not a form of mania/hypomania at all but just an irritable depression.
Sorry about the long response. I do hope your lithium augmentation works as you hope.
Bob
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> - Scott
poster:Bob
thread:904699
URL: http://www.dr-bob.org/babble/20090826/msgs/915073.html