Posted by SLS on February 29, 2012, at 16:40:13
In reply to Re: Scary lithium questions PLS answer » SLS, posted by Roslynn on February 29, 2012, at 15:29:42
Hi again.
> My lithium dosage was adjusted from 600mg to 300mg at my request because I feel that my meds are interfering whenever I try to increase my anafranil (the only med that has worked for me in 4 yrs.)
You have nothing to worry about.
For depression, lithium dosages can be lower than what is necessary for bipolar disorder. 300 - 600 mg is the range for depression. I take 300 mg, and am responding well to it. 600 mg does not help me any more than 300 mg. I just get more side effects. If you begin to deteriorate, I am all but sure that you will recapture the full benefit by returning to 600 mg. Your blood level at 600 mg is higher than what I believe is necessary for depression. I would guess that a range for unipolar depression would be somewhere between 0.2 - 0.6 mEq/L. I think mine is around 0.2 mEq/L.
> I have depression...at 600mg my blood levels are usually about .7, although I don't believe the medication is helping me in the first place.
I know that if I were in your position, I would want to try reducing the lithium dosage, too.
> I guess my fear is that the lithium could be doing *something* to help, something that I am not aware of, and so i will start to feel worse while weaning off Li.This is, of course, a possibility.
> However, like you said I am not going off the med entirely and I could just increase the dose again.
You should be okay.
> Question: If I start to feel bad, how do I know it's due to less lithium in my system or if it's some kind of rebound effect? Weird question, i know.
That is a great question. There is nothing at all weird about it. The issue of lithium rebound has been written about in medical journals. Its existence has not been proven. I doubt that a dosage reduction from 600 mg to 300 mg would elicit a rebound effect. Actually, I haven't come across anyone describing a rebound phenomena for lithium discontinuation. Acute relapse - yes. The thing is, a rebound relapse would resolve on its own without restarting treatment if it were a true rebound.
> Why does it take so long to know how a drug discontinuation will effect you?I guess you could conceptualize it as an inertia effect. Physiologically, some changes (receptor reregulation for example) take weeks to occur. For some people, there is an inertia that can last for months before relapse occurs. However, most relapses occur withing the first four months after drug discontinuation. I recently tried to discontinue Abilify. I tapered gradually. It took about three weeks for me to relapse after complete discontinuation.
I am anxious to see how well you do with increasing your Anafranil dosage.
Good luck.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1012012
URL: http://www.dr-bob.org/babble/20120221/msgs/1012034.html