Re: SLS... » Christ_empowered

Posted by SLS on October 2, 2012, at 12:12:52

In reply to SLS..., posted by Christ_empowered on October 2, 2012, at 9:40:31

> hey man. Yeah, from what I've read, lithium+neuroleptics=increased NMS risk (particularly in younger men...don't know where I read that, though), increased EPS+increased severity of EPS.
>
> I also read one small study from way back in the day in which they found that bipolar I patients who were kept on long-term, usually low dose neuroleptics+lithium (I'm guessing the more psychotic and/or agitated ones) had significant cognitive impairment after several years. Something about a battery of cognitive tests showing more impairment than lithium patients or neuroleptic patients. Weird.
>
> I imagine its affected by the choice of neuroleptic, other meds, underlying problem(s), and lithium dose/blood levels. My own experience with mood stabilizers (anticonvsulants, in my case) plus neuroleptics is that things work better when one or both are low dosed.
>
> To me--as a complete non-expert--it seems that you're on a full dose of Abilify (lower end of the range, though), plus an anti-depressant dose of lithium. That's a lot different than, say, 30+mgs Abilify plus full on, anti-manic level lithium intake. Plus, there doesn't seem to be any EPS or TD or anything. If it was me, I'd pick one or the other (I'd probably pick the Abilify, just because its so easy to take), and either simply drop the lithium or work in a less hardcore replacement. Then again, you're on a fairly low dose.
>
> Sometimes, lithium+neuroleptic combos are dangerous. Lithium+haloperidol, for instance, not only results in severe EPS (I would expect as much, personally), but it can also result in permanent brain damage. Some kind of drug induced encephalitis or something...I read about it only briefly. Scary. Makes me wonder what would happen with, say, high doses of Risperdal+lithium, given how risperdal isn't much better than Haldol once the dose gets high enough (thank you, "Mad in America" for this tidbit).
>
> Anyway, yeah....I'm not an expert or anything, so feel free to completely ignore what I'm saying. I imagine Abilify+anything is a lot more tolerable than older (even some atypical) meds+anything.

Thanks for the information and your insights. I really do appreciate it.
I tried reducing my dosage of Abilify from 10 mg to 5 mg in the hopes of being able to discontinue it entirely. Within three days, I relapsed. I am concerned with the metabolic side effects, especially high triglycerides.

- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.
- George Bernard Shaw

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