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Dr. Bob is Robert Hsiung, MD,
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Posted by bob on January 27, 2002, at 23:31:43
Does anyone know of any other compound which, like Lithium, is NOT classified as an anticonvulsant, yet is indicated for mood stabilazion as well as depression? It seems to me that every other single compound I've heard of as having applicability to mood stabilization is actually an anticonvulsant, or was originally conceived as one. I've never heard of Lithium being used as an anticonvulsant, and I've also never heard of it having straightforward reuptake inhibitor properties, or the like. It is truly an enigma, it seems. I've read theories of its mechanism of action involving the modification of voltage sensitive ion channels, but that doesn't seem much different from the descriptions of modes of action of anticonvulsants.
Just wondering.
Bob
Posted by bob on January 28, 2002, at 0:07:01
In reply to The Uniqueness of Lithium?, posted by bob on January 27, 2002, at 23:31:43
I just found out through a little of my own sleuthing that Lithium is actually indicated as an "anti-manic" agent rather than a mood stabilizer. The info even said that the substance is easier to tolerate during the manic phase of bipolar illness than during a depressive phase.
Posted by Chloe on January 28, 2002, at 19:23:42
In reply to Re: The Uniqueness of Lithium?, posted by bob on January 28, 2002, at 0:07:01
I do agree that Li is a truly unique med, in that is not an anticonvulsant, but is a mood stabilizer. Where I don't agree is that it is harder to tolerate in the "depressed" phase. Lithium does have some serotineric properties that make lithium an antidepressant as well as an antimanic.
Lithium is one of my favorite "antidepressants". I feel rapid relief from depression when I take the initail 300 mgs. In fact, sometimes I feel a little "high" until the stabilization effects kick in.
If you do a search of the archives, both medlib and CamW gave me some great insight and info on lithium and how it "works" in the body. I think lithium is a wonderful med, that can be used for AD augmentation, for mood stabilization or mania. And I think it is widely underutilized in it's extended release form. I just wish I could tolerate it's side effects...Unfortunately I have had to turn to Depakote.Are you taking or planning a trial of lithium?
Chloe> I just found out through a little of my own sleuthing that Lithium is actually indicated as an "anti-manic" agent rather than a mood stabilizer. The info even said that the substance is easier to tolerate during the manic phase of bipolar illness than during a depressive phase.
Posted by bob on January 28, 2002, at 19:38:32
In reply to Re: The Uniqueness of Lithium? » bob, posted by Chloe on January 28, 2002, at 19:23:42
> I do agree that Li is a truly unique med, in that is not an anticonvulsant, but is a mood stabilizer. Where I don't agree is that it is harder to tolerate in the "depressed" phase. Lithium does have some serotineric properties that make lithium an antidepressant as well as an antimanic.
>
> Lithium is one of my favorite "antidepressants". I feel rapid relief from depression when I take the initail 300 mgs. In fact, sometimes I feel a little "high" until the stabilization effects kick in.
> If you do a search of the archives, both medlib and CamW gave me some great insight and info on lithium and how it "works" in the body. I think lithium is a wonderful med, that can be used for AD augmentation, for mood stabilization or mania. And I think it is widely underutilized in it's extended release form. I just wish I could tolerate it's side effects...Unfortunately I have had to turn to Depakote.
>
> Are you taking or planning a trial of lithium?
> Chloe
Chloe:I think the literature was saying that the side-effects become more pronounced when an individual is not in a manic phase of an illness. Whether that holds any water or not, I don't know, as I've never been on it for an extended period of time.
I have trouble raving about a drug that people eventually cannot tolerate, no matter how good the mental benefits. In my view, a truly successful treatment would be well tolerated - not barely tolerated, as so many psychotropics are. That doesn't mean that a particular drug is an utter failure, just that it is a therapeutic contradiction. If it was like chemotherapy, and only had to be for a set period of time, it would be different, but it seems the treatment periods for these illnesses often last forever. That's when intolerability rears its ugly head.
Trying Lithium is a thought I mull over every now and again. I always see evidence of intolerability though. What stopped you?
Depakote was very tiring (extreme drowsiness), as well as giving me weight gain, and hair loss. For the 1.5 years I was on it, I don't think I ever got excited about anything. It flattened me big time.
Posted by spike4848 on January 28, 2002, at 19:59:29
In reply to The Uniqueness of Lithium?, posted by bob on January 27, 2002, at 23:31:43
> Does anyone know of any other compound which, like Lithium, is NOT classified as an anticonvulsant, yet is indicated for mood stabilazion as well as depression?
You might have heard of these ..... but other mood stablizer are the calcium channel blockers, verapamil and nimodipine. Studies have shown them effective for panic disorder as well, although there maybe only be two or three and very small study population. There is some fishy connection, I can't figure it out-
1. elavil, depakote, verapamil all good for migraines
2. people with migraines often have mood disorders
3. elavil, depakote, verapamil good for mood disordersI wonder if there is a common mode of action between the medications.
If verapamil works, it would be a good med ... low incidence of sexual, cognitive and weight side effects.
Spike
Posted by Chloe on January 28, 2002, at 20:15:17
In reply to Re: The Uniqueness of Lithium? » Chloe, posted by bob on January 28, 2002, at 19:38:32
> I think the literature was saying that the side-effects become more pronounced when an individual is not in a manic phase of an illness. Whether that holds any water or not, I don't know, as I've never been on it for an extended period of time.I think many true Bipolars, BP1, tend to not want to stay on lithium after the acute manic phase is over. The theory being that the manic person dislikes the "dulling" effect of lithium and feel that they have lost all creativity or ability to feel things in the intense ways they have grown accustome to living with bipolar illness. At least that is my sense of it...My cousin reports this.
> I have trouble raving about a drug that people eventually cannot tolerate, no matter how good the mental benefits. In my view, a truly successful treatment would be well tolerated - not barely tolerated, as so many psychotropics are. That doesn't mean that a particular drug is an utter failure, just that it is a therapeutic contradiction.
> Trying Lithium is a thought I mull over every now and again. I always see evidence of intolerability though. What stopped you?After a few months on lithium I get a burning sensation on my scalp that just continues to escalate. It becomes so painful that is all I can focus on...All rashes and psoriasis have been ruled out. It is a neuropathic pain I developed, I think from the drying effects of lithium (it is a salt...). I restarted it just recently with a TCAntidepressant to help with the neuropathic pain. But I was unable to get to a therapuetic dose without pain...So it was not effective in stabilizing my mood.
This adverse effect I had with Li, is almost unheard of. I think it's just my bad luck. I would encourage anyone with a mood disorder to give Li EXTENDED RELEASE FORMULA (ie lithobid, eskalith CR. Regular release is very difficult to tolerate imho) a try. I found the typical side effects of ER very benign. No gi upset. No hand tremor. No weight gain. The only side effects was slight polyuria. And the AD and mood stabilizaation effects were profound. I am very sad to loose this med. But the scalp issues persist even without the lithium now.
> Depakote was very tiring (extreme drowsiness), as well as giving me weight gain, and hair loss. For the 1.5 years I was on it, I don't think I ever got excited about anything. It flattened me big time.You have completely summed up my experience of Depakote, except it doesn't make me tired. I really am not a fan of this med. And dread all the impeding problems with side effects (esp. hair loss and weight gain) ahead. But for the moment it's a hell of a lot better than agitated mixed states and cycling. I am hoping a low dose of 250 mgs with my neurontin will put a stop to my cycling. One can only hope.
I would really consider lithium. It is useful for the things you mentioned above in your post about cycling and irritability...
Keep us posted
Chloe
Posted by bob on January 28, 2002, at 21:07:30
In reply to Re: The Uniqueness of Lithium? » bob, posted by Chloe on January 28, 2002, at 20:15:17
Chloe:
I have read about the burning scalp issue on this board. I could swear that more than one person complained of it, but maybe it was you. There were also complaints of brittle hair.
There is another thing I'm worried about if I try that med: cold hands. I tried Topomax about year ago, and developed cold, painful hands while on it. The Topomax didn't work out, but the cold hand syndrome is still with me, often cycling on a daily basis. It is not painful, like it was on Topomax, but is very annoying and hard to ignore. People will shake my hand and then get startled and exclaim, "Wow, your hands are cold!" It's embarrassing. To my horror, while surfing the internet the other day to find out about the tolerability of Lithium, they mentioned that every once in awhile, a Raynaud's Syndrome type of effect develops on Lithium and the drug must be discontinued. The Syndrome is characterized my extremely cold, often discolored extremeties - especially the hands. Sometimes it has discomfort associated with it. I'm afraid I've contracted a form of it from the Topomax! The last thing I need is another drug contributing to it. I still may give it a go, though.
http://www.methodisthealth.com/arthritis/reynauds.htm
Posted by Chloe on January 28, 2002, at 21:47:37
In reply to Re: The Uniqueness of Lithium? » Chloe, posted by bob on January 28, 2002, at 21:07:30
> Chloe:
>
> I have read about the burning scalp issue on this board. I could swear that more than one person complained of it, but maybe it was you. There were also complaints of brittle hair.Burning scalp, yup, that was me. Hair can also dry out over time. Using a mild shampoo and deep conditioner can really prevent that, along with a good diet and LOTS of h2o.
> There is another thing I'm worried about if I try that med: cold hands. I tried Topomax about year ago, and developed cold, painful hands while on it. The Topomax didn't work out, but the cold hand syndrome is still with me, often cycling on a daily basis. It is not painful, like it was on Topomax, but is very annoying and hard to ignore. People will shake my hand and then get startled and exclaim, "Wow, your hands are cold!" It's embarrassing. To my horror, while surfing the internet the other day to find out about the tolerability of Lithium, they mentioned that every once in awhile, a Raynaud's Syndrome type of effect develops on Lithium and the drug must be discontinued. The Syndrome is characterized my extremely cold, often discolored extremeties - especially the hands. Sometimes it has discomfort associated with it. I'm afraid I've contracted a form of it from the Topomax! The last thing I need is another drug contributing to it. I still may give it a go, though.I found topamax to be intolerabe too. The numb/cold hands and feet was very disconcerting. I am sorry you still have this issue. Have you consulted a doctor about this?
In terms of lithium (or any med!)and reports on the www, I would be very cautious. It is very easy to scare oneself. I didn't retry lithium for years because I read of all the horror stories about weight gain, hair loss, etc. And I had my own experiences of being on it for years in the eighties and having this horrendous hand tremor. I don't know how I managed, shaking like I did...But my retry on the ER formula was like a different, very effective med. Not at all what I remember or was rumored out there on the web.I can see why you would be leery about try anything that would exacerbate you cold hands...But you know what they say, "Cold hands, warm heart?" But seriously, I think you have to weigh the benefits of some relief from mental torture and some uncomfortable side effects. And I guess we have to be hopeful that any adverse effects that do develop aren't permanent...But untreated mental illness can become permanent too. The brain seems to get intrenched into patterns of depression, cycling or anxiety or whatever your issues are. And digging yourself out from this state can be extremely difficult, if not impossible as time elapses.
And finally, imho, there is no "perfect" drug. In fact, you may find that you have to keep trying different agents as your illness/issues and metabolism evolve. I encourage you to try something to help you with your pain as soon as possible. Do you have a good pdoc to work with? I am sorry you are suffering...
Chloe
Posted by bob on January 28, 2002, at 22:18:08
In reply to Re: The Uniqueness of Lithium? » bob, posted by Chloe on January 28, 2002, at 21:47:37
> Burning scalp, yup, that was me. Hair can also dry out over time. Using a mild shampoo and deep conditioner can really prevent that, along with a good diet and LOTS of h2o.I'm very, very sorry you couldn't overcome the burning scalp. That really sucks.
> I found topamax to be intolerabe too. The numb/cold hands and feet was very disconcerting. I am sorry you still have this issue. Have you consulted a doctor about this?
I've told pdocs about it, but it's one of those things that seems to go right in one ear and out the other for them. You know, I've never heard mention of cold hands and feet in the Topomax side-effect profile list. I'm thinking may I should submit an FDA complaint.
> In terms of lithium (or any med!)and reports on the www, I would be very cautious. It is very easy to scare oneself. I didn't retry lithium for years because I read of all the horror stories about weight gain, hair loss, etc. And I had my own experiences of being on it for years in the eighties and having this horrendous hand tremor. I don't know how I managed, shaking like I did...But my retry on the ER formula was like a different, very effective med. Not at all what I remember or was rumored out there on the web.Yes, you're right... it is very easy to scare yourself. Sometimes it's my own experiences that scare me though. I had a very bad time on Anafranil, and now don't want to try any more tricyclics. I also had a life-threatening experience with Topomax, and don't want to touch anything like it anymore.
>
> I can see why you would be leery about try anything that would exacerbate you cold hands...But you know what they say, "Cold hands, warm heart?" But seriously, I think you have to weigh the benefits of some relief from mental torture and some uncomfortable side effects. And I guess we have to be hopeful that any adverse effects that do develop aren't permanent...But untreated mental illness can become permanent too. The brain seems to get intrenched into patterns of depression, cycling or anxiety or whatever your issues are. And digging yourself out from this state can be extremely difficult, if not impossible as time elapses.Yes... I think you have a point.
>
> And finally, imho, there is no "perfect" drug. In fact, you may find that you have to keep trying different agents as your illness/issues and metabolism evolve. I encourage you to try something to help you with your pain as soon as possible. Do you have a good pdoc to work with? I am sorry you are suffering...Well, that's definitely what I've been doing so far: trying different drugs as different symptoms arise. I definitely think both my illness and metabolism is evolving.
I'm sorry for any suffering you are undergoing also. Hopefully you are doing better than I.
Bob
Posted by Mr. Scott on January 29, 2002, at 19:46:48
In reply to The Uniqueness of Lithium?, posted by bob on January 27, 2002, at 23:31:43
Zyprexa? No expert here though...
Posted by BarbaraCat on January 31, 2002, at 4:03:17
In reply to The Uniqueness of Lithium?, posted by bob on January 27, 2002, at 23:31:43
I've been taking lithium for about 1 month now at 300 mgs and I have to say I love it! I can actually feel my brain being 'fed' on it, like a nutrient. In fact, recent posts here and on the web have stated its 'neurotrophic growth factor' benefits, along with increasing neural grey matter. I resisted lithium for years because of it's stigma and bad press, but it, along with my Klonopin, cocktail are saving my life. No side effect except for extra thirst, but more water is good for me anyhow.
Posted by Lorraine on January 31, 2002, at 10:13:12
In reply to Re: The Uniqueness of Lithium? » bob, posted by BarbaraCat on January 31, 2002, at 4:03:17
Babara:
I've been following some of your posts and think we may have something in common. I suspect I am misdiagnosed as well. I have been thinking of lithium. Anyway, wanted to let you know that I have enjoyed your posts.
Lorraine> I've been taking lithium for about 1 month now at 300 mgs and I have to say I love it! I can actually feel my brain being 'fed' on it, like a nutrient. In fact, recent posts here and on the web have stated its 'neurotrophic growth factor' benefits, along with increasing neural grey matter. I resisted lithium for years because of it's stigma and bad press, but it, along with my Klonopin, cocktail are saving my life. No side effect except for extra thirst, but more water is good for me anyhow.
Posted by BarbaraCat on January 31, 2002, at 13:36:42
In reply to Re: The Uniqueness of Lithium? » BarbaraCat, posted by Lorraine on January 31, 2002, at 10:13:12
Thanks, Lorraine. Why do you think you've been misdiagnosed - what are your symptoms? I still have questions as to the difference between Bipolar II, ADHD, GAD. I do know, however, that my suffering becomes morbid when I'm stressed, worried, anxious and afraid. That sends me into an overamped state where I wear myself out and become sick, and from that place of stress exaustion I spiral into depression. SSRI's, beyond not even working after a while, created an inner tension and disquiet and made it very difficult to stay in my 'center'. So whatever the diagnosis, for me, treating and healing the fried-out wired feeling is allowing me the clarity and energy to continue healing, resting and restoring. Keep in touch. Barbara
> Babara:
>
> I've been following some of your posts and think we may have something in common. I suspect I am misdiagnosed as well. I have been thinking of lithium. Anyway, wanted to let you know that I have enjoyed your posts.
>
>
> Lorraine
>
> > I've been taking lithium for about 1 month now at 300 mgs and I have to say I love it! I can actually feel my brain being 'fed' on it, like a nutrient. In fact, recent posts here and on the web have stated its 'neurotrophic growth factor' benefits, along with increasing neural grey matter. I resisted lithium for years because of it's stigma and bad press, but it, along with my Klonopin, cocktail are saving my life. No side effect except for extra thirst, but more water is good for me anyhow.
Posted by Lorraine on January 31, 2002, at 18:34:58
In reply to Re: The Uniqueness of Lithium? » Lorraine, posted by BarbaraCat on January 31, 2002, at 13:36:42
> Thanks, Lorraine. Why do you think you've been misdiagnosed - what are your symptoms?
I guess it's just because anti-depressants don't work for me and I can get a bit over zealous with my projects, many more open than closed, though I don't really crash afterward. But I seem to ride the waves up and down a bit; no sleep deprivation or risk taking behaviors.Who knows? I'm not remotely sure that I believe in DSM categories anyway. We are not talking etiology but symptom clusters of unknown (and most likely) numerous origin.
Hope your course continues upward:-)
Lorraine
I still have questions as to the difference between Bipolar II, ADHD, GAD. I do know, however, that my suffering becomes morbid when I'm stressed, worried, anxious and afraid. That sends me into an overamped state where I wear myself out and become sick, and from that place of stress exaustion I spiral into depression. SSRI's, beyond not even working after a while, created an inner tension and disquiet and made it very difficult to stay in my 'center'. So whatever the diagnosis, for me, treating and healing the fried-out wired feeling is allowing me the clarity and energy to continue healing, resting and restoring. Keep in touch. Barbara
>
> > Babara:
> >
> > I've been following some of your posts and think we may have something in common. I suspect I am misdiagnosed as well. I have been thinking of lithium. Anyway, wanted to let you know that I have enjoyed your posts.
> >
> >
> > Lorraine
> >
> > > I've been taking lithium for about 1 month now at 300 mgs and I have to say I love it! I can actually feel my brain being 'fed' on it, like a nutrient. In fact, recent posts here and on the web have stated its 'neurotrophic growth factor' benefits, along with increasing neural grey matter. I resisted lithium for years because of it's stigma and bad press, but it, along with my Klonopin, cocktail are saving my life. No side effect except for extra thirst, but more water is good for me anyhow.
Posted by Mr.Scott on January 31, 2002, at 18:47:43
In reply to Re: The Uniqueness of Lithium? » Lorraine, posted by BarbaraCat on January 31, 2002, at 13:36:42
"I still have questions as to the difference between Bipolar II, ADHD, GAD." "SSRI's, beyond not even working after a while, created an inner tension and disquiet and made it very difficult to stay in my 'center'."
Word for word...Me too.
Scott
Posted by Toph on October 22, 2018, at 19:45:44
In reply to The Uniqueness of Lithium?, posted by bob on January 27, 2002, at 23:31:43
Seems what is unique is me not just Lithium. I have been taking LI for over 40 years with no serious side effects other than some diarrhea and a slight hand tremor that may or may not be attributed to either the drug or aging. My creatinine levels are fine and my thyroid tests are also normal (the two most common problems with long term use). I have read here about all kinds of side effects people have experienced adjusting to this simple salt. No doubt it can be toxic if levels exceed therapeutic amounts. But mainly I feel fortunate that a medication that I have no sensation taking effectively keeps me from the repeated hospitalizations I endured before I finally conceded that I needed it.
Posted by SLS on October 31, 2018, at 8:04:25
In reply to Re: The Uniqueness of Lithium? » bob, posted by Toph on October 22, 2018, at 19:45:44
> Seems what is unique is me not just Lithium. I have been taking LI for over 40 years with no serious side effects other than some diarrhea and a slight hand tremor that may or may not be attributed to either the drug or aging. My creatinine levels are fine and my thyroid tests are also normal (the two most common problems with long term use). I have read here about all kinds of side effects people have experienced adjusting to this simple salt. No doubt it can be toxic if levels exceed therapeutic amounts. But mainly I feel fortunate that a medication that I have no sensation taking effectively keeps me from the repeated hospitalizations I endured before I finally conceded that I needed it.
I am hugely glad to hear this.
- Scott
Posted by SLS on October 31, 2018, at 8:05:27
In reply to Re: The Uniqueness of Lithium? » bob, posted by Toph on October 22, 2018, at 19:45:44
I'm curious, Toph. What is your lithium dosage?
- Scott
Posted by Lamdage22 on November 1, 2018, at 13:59:39
In reply to Re: The Uniqueness of Lithium? » Toph, posted by SLS on October 31, 2018, at 8:05:27
I swear by a low amount of lithium for neuroprotection and anti-suicidal effects. I think i take 200mg
Posted by Jay2112 on January 19, 2019, at 14:12:26
In reply to Re: The Uniqueness of Lithium?, posted by Lamdage22 on November 1, 2018, at 13:59:39
> I swear by a low amount of lithium for neuroprotection and anti-suicidal effects. I think i take 200mg
I found Lithium was, well, ackward. It made me very angry and grumpy. I think it caused serotonin syndrome, and I was only on 300mg's.
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