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Dr. Bob is Robert Hsiung, MD,
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Posted by Sabino on June 19, 2005, at 9:17:19
In reply to Re: Lithium: How many times do you dose per day? » Sabino, posted by ed_uk on June 18, 2005, at 19:58:22
Hi Ed,
Nardil was occasionally effective for social anxiety issues, but far more often than not, I was very exhausted on it, and really cognitively dulled. I work in IT, and my work noticeably suffered. This is a med that I think I gave a legit shot too. Think I tried it for a good two months at a therapeutic level. I actually tried Parnate for a couple of days too, but it caused a lot of anxiety. That was my trip down MAOI lane.
A lot of my one or two day trials had everything to do with bad initial effects, and if I'd have had the luxury to stay at home for a couple of months, maybe I'd have ridden out the sfx's and found success, but the need to earn the paycheck always precluded that... until, one gets to the point where you seriously have to do everything possible to get better, or you don't want to stay around, money be damned.
Strattera made me confused, agitated, and just out of it, which, of course, is very depressing.
I don't remember what I didn't like about Zyprexa.
Anyway, so far, so good with Li. I take it from your 'benefits of a low dose' comment that my energizing and non-cognitive impairment response is quite typical on a low dose. I suspect I won't need more than 600 mgs. I'm scaling back on the Effexor now too.
All of which says, I guess, that I aint where I want to be yet, but I'm still in the game.
The fact that I still have not returned to work is huge. My company has been extraordinarily understanding, but they can't be in limbo forever.
As a famous lady once said, 'I'll think about that tomorrow'.
Posted by Sabino on June 19, 2005, at 9:28:10
In reply to Re: Lithium: How many times do you dose per day? » Sabino, posted by barbaracat on June 18, 2005, at 21:14:00
Barb, thanks for all the useful info. Interesting about the fast metabolism. Surely makes med taking more problematic.
Zoloft was the one that actually made me feel the best too (but only for 3 hours or so daily). For those 3 hours though, I felt great. That's a rough ride every day, up and down.
I'm taking Lithobid 300. I think it is an extended release formula, but I think I'll cut them in half, and dose around every few hours to see how that goes. Will ask the pdoc to prescribe 600 daily when I see him on Monday.
You sound happy and content. That's terrific.
Thanks a bunch for all the support.
Posted by ed_uk on June 19, 2005, at 11:26:47
In reply to Re: Lithium: How many times do you dose per day? » ed_uk, posted by Sabino on June 19, 2005, at 9:17:19
Hi Sabino,
Thank you for your reply :-)
>MAOI
I think you said you live in Mexico. How easy was it to get hold of Nardil and Parnate? Cliffstone - who lives in Mexico, wants to try an MAOI.
Kind regards,
Ed.
Posted by Sabino on June 19, 2005, at 12:38:32
In reply to Re: Lithium: How many times do you dose per day? » Sabino, posted by ed_uk on June 19, 2005, at 11:26:47
Hey Ed,
I'm not really from Mexico. That's just a silly line from a song... and I have no idea why I threw that in there. I get a little goofy sometimes.
Hey, just out of curiousity, what meds are you on now, and are you doing well?
Best
Posted by ed_uk on June 19, 2005, at 18:11:17
In reply to Re: Lithium: How many times do you dose per day? » ed_uk, posted by Sabino on June 19, 2005, at 12:38:32
Hi Sabino,
>I'm not really from Mexico. That's just a silly line from a song... and I have no idea why I threw that in there. I get a little goofy sometimes.
LOL!
>Hey, just out of curiousity, what meds are you on now, and are you doing well?
I'm on citalopram 60mg for OCD. It seems to be helping some :-)
Kind regards,
Ed.
Posted by yesac on June 20, 2005, at 12:58:43
In reply to Re: Lithium: How many times do you dose per day? » barbaracat, posted by Sabino on June 18, 2005, at 19:04:51
Wow, Sabino, you sound just like me! I too have been on a zillion different drugs with pretty bad results or basic lack of efficacy. I don't know if I'm bipolar either, but I have severe agitated depression and have some anxiety, and I have a lot of attention issues as well (possibly ADD-- not really sure-- like you said, it's all ambiguous and there's so much overlap).
Prozac caused pretty much of a mixed state for me too. And I didn't like Adderall and Ritalin that much-- they seemed to worsen my mood lability. I haven't tried Dexedrine or Strattera yet but probably will soon.
I totally hear you on the leave of absense thing. I have been back in school for a year (1st year grad school). Now it's summer break, thank god, but I had a very grueling struggle trying to get through this past year. Thank goodness I'm only in a 2 year program. My attention problems and organization problems have gotten so bad. I kind of got into trouble and had to meet with this committee because I skipped an important exam one day. I don't know what on earth possessed me to do that, but I woke up and just decided not to go. Hard to explain. I don't even understand it myself. But there has hardly been a day that went by that I haven't thought about taking time off from school. Ultimately though, I sort of think that it might be best if I just grit my teeth and get through it if at all possible.
Anyways, I'm on lithium now too, and Seroquel, adn they are the first drugs that I am finding very helpful in terms of overall mood state. I feel much less agitated and more calm. I still have my attention problems pretty badly, and I still feel somewhat depressed-- more of a mild, gloomy feeling kind of depression.
I am glad you found something and hope it works out for you.
Oh I take my whole dose (600mgs) at night. I wonder if there's some advantage to splitting it. I had never thought of that.
Posted by yesac on June 20, 2005, at 13:14:16
In reply to Re: Lithium: How many times do you dose per day? » Sabino, posted by barbaracat on June 18, 2005, at 21:14:00
> But I can be normally focused and as I understand it, ADD is pretty much a constant thing.
Yeah that's what I understand too... but for me, it's hard to tell because I have attention problems pretty much all the time, but for the most part I have mood probs all the time too! But now the mood probs are much more "tame" because of li++/Seroquel, but my attn problems are as bad as ever.... so I don't know.
Did you say Ritalin was better when you were on lithium?
>
> Your micro-dosing ADs situation is not that uncommon, as I'm finding out as I research this stuff.
> I've communicated with a number of people who have had a similar experience, most notably with
Cymbalta (the norepinephrine kicks in almost immediately), but have found micro-dosing to work with other ADs as well. All of these people are bipolar. Those with unipolar depression without significant agitation seem to tolerate much higher doses.That's interesting. I've tolerated fairly high doses of a lot of drugs (ADs and others). Most seemed to basically do nothing, even at high doses. But others wacked me out, for example Cymbalta... and I wonder if a low LOW dose might be useful. I'm looking for an antidepressant now, as it happens, so maybe that's something to consider. They never seem to make me happy though, just worsen my agitation and increase suicidal/homicidal ideation and aggression and hyped-up-ness.
>
> www.psycheducation.org
>That's a great website. It is what got me really considering if I might have some kind of bipolar variant.
Posted by barbaracat on June 20, 2005, at 15:25:10
In reply to Re: Lithium: How many times do you dose per day? » barbaracat, posted by yesac on June 20, 2005, at 13:14:16
> > But I can be normally focused and as I understand it, ADD is pretty much a constant thing.
>
> Yeah that's what I understand too... but for me, it's hard to tell because I have attention problems pretty much all the time, but for the most part I have mood probs all the time too!**I look back on growing up and can recognize typical attention problems along with mood problems. No matter how I tried, my room was always a disaster area. I crave order and neatness but it's beyond me. My ADD can be either total disorganization, which runs hand in hand with the frenzy of bipolar - I'll be doing one thing and my attention is captured by a new idea or distraction, so I leave a trail of unfinished projects. Or, I can be so hyperfocused that nothing can distract me even when it should. So, I'd say that I have an ADD-type disorder.
It all probably falls within the same glitch area in my brain that causes the rest of it. I am considering talking to my pdoc about some treatment for it. I was given Ritalin a few years back but any agitation was the last thing I needed since I was so exhausted at that time. But now, I'm doing so much better physically and psychically and able to start tackling things that were left to rot for years and years. I have alot more motivation in general and am much healthier, so I think I can tolerate a stimulant. However, even though I have the will and the energy, I still need help with the organization and focus part and found the Ritalin helps now where it didn't before. I'm even able to sleep on it, which tells me something.
So, whether it's a product of lithium making it work better or differently, or me just being in a stronger place in general I don't know. All of the above, probably. I'd like to try a few different ones to see what works best. All I know is that my drug of choice when I was going through very difficult late teens was meth. Taking meth and dancing were the only times I remember being happy back then.
> That's interesting. I've tolerated fairly high doses of a lot of drugs (ADs and others). Most seemed to basically do nothing, even at high doses. But others wacked me out, for example Cymbalta... and I wonder if a low LOW dose might be useful.
**When you say wacked out?? Cymbalta has a strong norepinephrine kick that hits right off the bat. The NE is stronger at lower doses and serotonin kicks in at higher. Even though I'm still prone to anxiety, the NE doesn't seem to bother me with Cymbalta. It's a bit of a pain counting out those miniscule pellets but I'll gladly do it to feel better. I've tried a full 30jmg capsule a few times now that I've been on it for 5 months and nope, can't take that much. My pdoc says she's been having a mixed bag as far as results with her clients. Some people do horribly on it and some think it's the best thing they've ever done, however, I'm the only one of her clients on a micro dose. If nothing else has worked, I'd encourage you to give it a try.
> That's a great website. It is what got me really considering if I might have some kind of bipolar variant.
**Isn't it? Have you delved into the mixed states area? You'll probably go 'huh, that's me!'. I think it's a link in one of the main articles, but like the whole website, you can immerse yourself deeper and follow links forever.
Posted by yesac on June 22, 2005, at 13:13:48
In reply to Re: Lithium: How many times do you dose per day? » yesac, posted by barbaracat on June 20, 2005, at 15:25:10
> So, I'd say that I have an ADD-type disorder.
> It all probably falls within the same glitch area in my brain that causes the rest of it. I am considering talking to my pdoc about some treatment for it.I think there's a lot of overlap between ADD and BP. But the DSM is so picky that it's like, either you meet the criteria, or your fine. Black and white. No room for "ADD-type disorders" that aren't exactly ADD.
>However, even though I have the will and the energy, I still need help with the organization and focus part and found the Ritalin helps now where it didn't before. I'm even able to sleep on it, which tells me something.
I wonder why it would work now but not before. I'm curious because neither Ritalin or Adderall worked for me before, but maybe they would now. Still Adderall had really bad side effects for me, increased mood lability, despondency, dysphoric feelings... so maybe I should stay away from it and other stimulants. Are you looking to try something other than Ritalin? Or could you just take Ritalin if it helps?
>
> **When you say wacked out?? Cymbalta has a strong norepinephrine kick that hits right off the bat. The NE is stronger at lower doses and serotonin kicks in at higher.I just felt kind of crazy. Hyper and agitated and like my mind was out of control. I wanted to bash my head into a wall, and I felt like I was basically losing my mind. I needed to pace around my apartment. My head was spinning. A few times, I called my shrink late at night (and woke both him and his wife). I could barely talk to him-- I was like mumbling. It was really the definition of "meltdown" I think. Sometimes it was not quite that bad, but just kind of feeling weird and revved up and constantly upset and my mind was spinning and I felt very easily set-off. This was worse at 60mgs but still occurred at 30.
> **Isn't it? Have you delved into the mixed states area? You'll probably go 'huh, that's me!'. I think it's a link in one of the main articles, but like the whole website, you can immerse yourself deeper and follow links forever.
I probably have but can't remember. It's been a while since I've checked it out. Sometimes it's too overwhelming for me, even though I'm interested, I'm put off by the sheer volume of info and it just seems like a lot to handle. This might be an ADD thing!
Posted by yesac on June 22, 2005, at 13:14:49
In reply to Re: Lithium: How many times do you dose per day?, posted by yesac on June 22, 2005, at 13:13:48
Posted by barbaracat on June 22, 2005, at 19:01:11
In reply to Re: Lithium: How many times do you dose per day?, posted by yesac on June 22, 2005, at 13:13:48
Well, today I'm totally sick of meds. I took a small amount of Seroquel last night. I should've known better from my previous Seroquel attempts. Woke up but barely and the whole day is now shot. I can't do a thing and have been trying to numb myself with various benzos just to sleep, but it's like my GABA receptors are fried.
As for the Ritalin, I'll probably just stick with it as needed, when I want to get extra work done. No way do I want to add another chemical on an ongoing basis. I think I'm doing damage to my poor liver trying to handle all these foreign substances.
Cymbalta at 30mg sent me into such a tailspin that it brought back vivid memories of acid trips, and not good ones. I know some people can start at 60mg and barely feel it, but I'm only at 8mg after 5 months of slowly titrating and if I take even 5 pellets more I feel it. So it's a dance. It seems to be helping me considering the bleak place I was in last February.
One more interesting note I don't have the energy to get into right now is I've decided to try to stop lithium for a while. My prescription ran out, my pdoc has been taking her sweet time to authorize the refill and I've been without for over a week. I'm starting to feel that old feeling, but this time by God, I'm determined to observe the course of this and ride it. I don't need to brand it sickness but I do need to look straight into the face of this entity now, while I have strength and support nearby. There's some puzzling need in me to throw down the gauntlet - that it's time to prove to IT that something, some light within me can contain and use that high energy state without getting burned. I've got plenty of books on the subject and lot's of good philosophy and spiritual practice, and as long as my mind can hold together to remember, I'll fight the good fight.
I'm no fool, I'll wean off slowly, but I'm needing to do this for as long as I'm able. Right now I don't even have a choice because she hasn't gotten back to the pharmacy and here I am trying to make the best of it. Hence the Seroquel last night - but never again. Never did like that stuff. Will keep you posted. - Barbara
Posted by Sabino on June 23, 2005, at 15:59:30
In reply to Re: Lithium: How many times do you dose per day? » yesac, posted by barbaracat on June 22, 2005, at 19:01:11
Interesting, you guys talking about the overlap of ADD like symptoms in BP.
I didn't like the pstims either. I'm only 1 weeks into my Li experiment. I still think it's a keeper, though I did feel a little mushy headed when I tried to kick it up from 300 to 600.
I don't know if I'm BP or not, but the symptoms for me are that I feel frazzled, like I can't gather in and harness my thoughts, and I feel damn near like a moron when that happens. Now, I can take Li and it fixes that in less than an hour, better than the stims or benzos ever did.
Barb, good luck with the no meds. Yesac, sometimes your symptoms seems really similar to mine. I'm sort of hopeful at the particular moment.
Best...
Posted by yesac on June 23, 2005, at 16:00:50
In reply to Re: Lithium: How many times do you dose per day? » yesac, posted by barbaracat on June 22, 2005, at 19:01:11
Why do you want to stop lithium? I thought that it was the best thing that ever happened to you? I realize that you don't have a choice right now because of your doctor not calling in the refill.... but other than that? Do you think you'll be better off without it?
I'm not trying to be patronizing, I just don't quite understand why you want to stop.
Posted by Sabino on June 23, 2005, at 19:31:01
In reply to stopping lithium » barbaracat, posted by yesac on June 23, 2005, at 16:00:50
Yesac,
Are you still taking Li? If so, how much do you take? Just curious.
Thanks
Posted by ravenstorm on June 23, 2005, at 21:42:15
In reply to Re: Lithium: How many times do you dose per day? » yesac, posted by barbaracat on June 22, 2005, at 19:01:11
Barbcat--
Noone but you can decide if you are going to continue to take a med that, according to past posts by you, is a god send.
As an impartial observer, and someone who used to visit this site more often, I have to say that I have read of at least two other occassions where you decided to discontinue your lithium with disasterous results. I particularly remember you describing a nasty mixed state you descended into for quite a while upon stopping the drug. You were so grateful for it once you finally went back on. Why do you want to put yourself through that again.
Hope you don't find this intrusive. I am going solely on what you have previously posted about your experiences off lithium and how horrible they have been. Hang in there and love to you no matter what you decide to do.
Posted by barbaracat on June 23, 2005, at 21:54:51
In reply to stopping lithium » barbaracat, posted by yesac on June 23, 2005, at 16:00:50
I ask myself the same question. When I first started lithium and everytime I started up again, I was in a very bad place physically and emotionally, had to stop work, bad fibromyalgia depression, bipolar mixed states depression. Pretty awful.
Since then, in the last few years, I've been on a quest to figure out my fibromyalgia and the thing that kept coming up was hormones way out of balance - every one of them, including human growth hormone. I take thyroid hormone, bioidentical sex hormones, I inject myself with human growth hormone. I've finally gotten all of them in balance and am feeling physically and emotional better than in the last 10 years.
When this screw up with my refill happened, a little voice (hmmm, hearing voices are we?) spoke up and wondered how much all that hormonal imbalance had to do with my symptoms. So, I'm curious is mainly the reason. If I am bipolar but if I can manage my symptoms as others have learned to do, I'd rather do it that way. I think physical health and balance has so much to do with it and I didn't have that before, whereas I do now.
The only major side effect I've had with Li has been the rollercoaster thyroid ride but it's been enough. I'm already hypothyroid and I'd like to prevent more damage.
I got my prescription refilled and I'll be titrating off very slowly. I'm no fool - I've quit cold turkey before and that's a recipe for disaster. If I start obviously skidding I've got an attentive husband and friends who won't hesitate to force feed me the stuff. I've also got the time and support structure right now. Not working, summmer time, lots to keep me busy. It will be interesting. I still feel Lithium is the best thing that happened to me - but that was then and I'm interested in how it will go now. I'll keep you posted. - Barbara
> Why do you want to stop lithium? I thought that it was the best thing that ever happened to you? I realize that you don't have a choice right now because of your doctor not calling in the refill.... but other than that? Do you think you'll be better off without it?
>
> I'm not trying to be patronizing, I just don't quite understand why you want to stop.
>
>
Posted by barbaracat on June 23, 2005, at 22:04:11
In reply to Re: Barbcat, I've read past posts when you've drop, posted by ravenstorm on June 23, 2005, at 21:42:15
Thanks, Ravenstorm. I appreciate your concern and alarm. Yes, I know what you mean entirely, I gladly crawled back in the past. This is just going to be a time limited test that will stop immediately if I start getting weird. Please see my post to Yesac for the reasons I'm trying this.
One thing that will be different this time is that I won't be going off all at once like I did every time before. It's going to go very slowly and with as much common sense as I can keep together. My husband, bless his heart, won't let me get too far out.
But in a nutshell, I need to know how bipolar I really am, or how much of it was my severe hormonal imbalance that's been corrected. Maybe I need less lithium now that my hormones are normalized. We'll see. Don't worry, I'm not into needless suffering, more like mad chemistry. - Barbara
> Barbcat--
>
> Noone but you can decide if you are going to continue to take a med that, according to past posts by you, is a god send.
>
> As an impartial observer, and someone who used to visit this site more often, I have to say that I have read of at least two other occassions where you decided to discontinue your lithium with disasterous results. I particularly remember you describing a nasty mixed state you descended into for quite a while upon stopping the drug. You were so grateful for it once you finally went back on. Why do you want to put yourself through that again.
>
> Hope you don't find this intrusive. I am going solely on what you have previously posted about your experiences off lithium and how horrible they have been. Hang in there and love to you no matter what you decide to do.
Posted by yesac on June 24, 2005, at 10:46:38
In reply to Re: stopping lithium » yesac, posted by Sabino on June 23, 2005, at 19:31:01
> Are you still taking Li? If so, how much do you take? Just curious.
Yes, I'm still taking it. I take 600 mgs/day. Considering trying to go down to 450 just to see if it still works okay, because why be on a higher dose than you need, right? Plus, I think that it might be making my attention problems worse. I've been on it for about 2 months, and it seemed like it started to work after about 5 weeks.
Posted by yesac on June 24, 2005, at 13:34:25
In reply to Re: stopping lithium » yesac, posted by barbaracat on June 23, 2005, at 21:54:51
Good luck. It sounds like you've got it pretty well planned out, so maybe it will work out okay. I hope it does. Let us know how things go.
Posted by barbaracat on June 24, 2005, at 15:17:47
In reply to Re: stopping lithium » barbaracat, posted by yesac on June 24, 2005, at 13:34:25
> Good luck. It sounds like you've got it pretty well planned out, so maybe it will work out okay. I hope it does. Let us know how things go.
**Thanks. I definitely will let you all know, as I suspect there are alot of us who will be interested in this trial. At the merest whiff of unpleasantness I will go back on my usual 600mg. But if all goes smoothly I'll be reducing by 25mg a week, or as long as it takes.
Posted by Sabino on June 24, 2005, at 17:16:28
In reply to Re: stopping lithium » Sabino, posted by yesac on June 24, 2005, at 10:46:38
Hi. One more. When you say it started to work after 5 weeks, how did it start to work? How did it make you feel versus the way you felt before it worked?
I was wondering if you experienced any startup SFX, and how long they took to resolve (if they did).
Have you tried the pstims for help with the attention issues yet? Hope you find some help for that. There're lots of things to try, as you know. The pstims, Parnate is said to be good for ADD too, if you want to hassle with the diet. There's Strattera, which I personally hated. Now that I have Lithium on board, I'd maybe go back and revisit a couple of the more activating ADs, like Prozac, which gave me an anxiety attack the first day I took it, at least that's the way I characterized it. The symptoms of what I call an anxiety attack, I think, are the same as what I've seen referred to as mixed states. Awful. But, maybe with Li I could possibly try that again. Parnate caused me a good deal of anxiety too, as did Wellbutrin.
The only ADs I had any sort of success with have been Zoloft (the first one I ever tried). For around 3 or so hours a day, my thoughts were razor sharp on that, followed by a crash for the rest of the day. Serzone, when taken really infrequently, caused euphoria for 3 or so hours, but it only worked like that if I hadn't taken it in a couple of weeks. When I tried to take it as prescribed, it caused a lot of mood lability. Remeron provided some much needed sleep, but did little in the way of mood improvement. And finally to Effexor, which I'm trying now at 150 a day, along with 15 Remeron for sleep. I really have to conclude that this has not really done the trick yet, although things seem to have improved since I started Li. I'm probably only doing around 400 or so a day of Li. I pushed it to 600 my third day, and I felt pretty mush-headed (that is to say, mush for brains).
All of which brings me back to asking how you felt when you say Li kicked in?
Good luck, whatever you decide to try. Let us know how it goes. It's always heartening to see someone that at long last finds some peace of mind.
Posted by ravenstorm on June 24, 2005, at 18:58:44
In reply to More newbie Lithium questions » yesac, posted by Sabino on June 24, 2005, at 17:16:28
Just wondering if you'll have to stop the cymbalta to have a better chance at making it without a mood stabilizer. I would think taking an SNRI without the Lithium might really be problematic for you.
Posted by crazyteresa on June 24, 2005, at 22:37:55
In reply to Does anyone like lithium?, posted by yesac on June 8, 2005, at 14:02:37
I've only been taking Lithium about 2 wks and I am so sick! I don't think I can continue to take it. If I continue will this get better?
crazy t
Posted by barbaracat on June 25, 2005, at 1:11:52
In reply to Re: barbcat, won't you have to stop the cymbalta?, posted by ravenstorm on June 24, 2005, at 18:58:44
We'll see and I wonder about ADs minus a decreased MS (decided I won't quit it completely, just try for the bare minimum). So far I'm doing fine at 8mg Cym and 400 lithium. It's only been a little over a week. Looking back, every time I stopped in the past was because I had run out and decided to see how it went, just like this time. The difference was that I wasn't on an AD and I was either very depressed or manic - not a good time to stop. The other thing was I was very physically ill with fibro and couldn't distract or work the stress off. I'm feeling healthy now and working like a dray horse outside and clearing up years worth of clutter. Being able to be busy is the best therapy.
To hedge my bets though, I'm going to take L-
Taurine 1000mg twice a day. Hey, if it works for Margot Kidder it's worth a try.> Just wondering if you'll have to stop the cymbalta to have a better chance at making it without a mood stabilizer. I would think taking an SNRI without the Lithium might really be problematic for you.
Posted by ed_uk on June 25, 2005, at 16:02:13
In reply to Re: Does anyone like lithium?, posted by crazyteresa on June 24, 2005, at 22:37:55
Hi,
>I've only been taking Lithium about 2 wks and I am so sick!
What brand are you taking and what dose? What side effects have you had so far?
~Ed
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