Posted by SLS on January 5, 2013, at 23:15:29
In reply to Re: Lower dosages of lithium not effective for bipolar » SLS, posted by Beckett on January 5, 2013, at 22:30:46
> Hi Scott,
Hi. I've been wondering about you. You are not easy to forget. You are good people who deserves better than to suffer. I hope the lithium works for you.
Are you taking Saphris?
> I'm titrating up lithium this week and needed some more upbeat news, so I searched the archives and found what follows. There is no way of knowing, but would you guess that they used high doses in the following study to achieve their results?I think they probably used a dosage of lithium that was accepted as being therapeutic at the time.
Blood level: 0.8 - 1.2 mEq/L (ng/dl).
Average dosage range: 900 - 1500 mg/day.
Some people are now using 0.6 mEq/L as the low end of therapeutic.
> Posted by SLS on November 30, 2009, at 7:45:08
>
> In reply to Re: Lithium Monotherapy for Depression, posted by SLS on November 28, 2009, at 14:48:43
>
> > I think the bipolar I/II dichotomy is valid as each responds to a different set of treatments.
>
> Some of the more current literature calls into question whether there is such a large difference in the way bipolar I and bipolar II respond to lithium. Perhaps there isn't as large a difference in the way the two subtypes respond to medication as was initially reported.
>
>
> - Scott
>
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> Lithium Maintenance Treatment of Depression and Mania in Bipolar I and Bipolar II Disorders
> Leonardo Tondo, M.D., Ross J. Baldessarini, M.D., John Hennen, Ph.D., and Gianfranco Floris, M.D.
>
> OBJECTIVE: Effects of long-term lithium treatment for depressive and manic phases of type I and type II bipolar disorders were compared. METHOD: Clinical research records of 317 patients with DSM-IV-defined bipolar disorder (188 with type I and 129 with type II) were analyzed for frequency and duration of affective episodes and hospitalizations before (mean=8.38 years) versus during (mean=6.35 years) lithium maintenance treatment. Treatment effects were also assessed by survival analysis of interepisode intervals and by multivariate regression testing for factors associated with response to treatment. RESULTS: Bipolar I and bipolar II patients were ill before treatment a similar percentage of time, but the subtype distinction was supported descriptively. Lithium had superior benefits in type II patients, with significantly greater reduction of episodes per year and of the percentage of time ill. Reduction of depressive morbidity was similarly strong in both diagnostic types. During treatment, bipolar II patients had 5.9-fold longer interepisode intervals and were twice as likely as type I patients to have no new episodes. Starting lithium maintenance earlier predicted greater improvement. CONCLUSIONS: Lithium maintenance yielded striking long-term reductions of depressive as well as manic morbidity in both bipolar disorder subtypes, with greater overall benefits in type II patients and with earlier treatment
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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:1034757
URL: http://www.dr-bob.org/babble/20121231/msgs/1034772.html