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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by zeliva on March 13, 2003, at 0:13:05
My pdoc gave me Lithium 300mg 1x day. Can anyone who has taken it tell me how it was and any side effects. See above post. Mt doc said it works well with Prozac and I take that 40mg. I just hear Lithium and I think of "crazy" people. Sorry for the stereotype! I have cyclothymia. Please give me feedback good or bad. I don't know anyone who takes it and I can't find much on the net about it.
Jill
Posted by Rainbowlight on March 13, 2003, at 0:32:40
In reply to Sorry to ask again but need answers about Lithium, posted by zeliva on March 13, 2003, at 0:13:05
I used to take it. The side effects I got from it were shaky hands and it made me feel blah, kind of emotionless. Also, make sure they test the levels in your blood.
Posted by ace on March 13, 2003, at 18:47:25
In reply to Re: Sorry to ask again but need answers about Lithium, posted by Rainbowlight on March 13, 2003, at 0:32:40
> I used to take it. The side effects I got from it were shaky hands and it made me feel blah, kind of emotionless. Also, make sure they test the levels in your blood.
I'm about to start it with Nardil. Apperently is is very good with other ad's like Nardil for OCD. I have been told it makes you calm and peaceful to.
How often did you do the blood plasma monitoring?
Is it EXTREMELY NECESSARY - My doc is starting me on 500mg.
Thanks,
Ace.
Posted by Rainbowlight on March 14, 2003, at 2:09:01
In reply to Re: Sorry to ask again but need answers about Lithium, posted by ace on March 13, 2003, at 18:47:25
Actually, I NEVER had blood levels done. I was young and naive and didn't realize I had an IDIOT for a pdoc who never required Lithium levels. VERY SCARY!
Posted by stjames on March 14, 2003, at 18:49:56
In reply to Re: Sorry to ask again but need answers about Lithium, posted by ace on March 13, 2003, at 18:47:25
> Is it EXTREMELY NECESSARY - My doc is starting me on 500mg.
Yes, if you want to avoid Lithium toxicity.
Posted by wendy b. on March 17, 2003, at 7:39:26
In reply to Sorry to ask again but need answers about Lithium, posted by zeliva on March 13, 2003, at 0:13:05
> Please give me feedback good or bad. I don't know anyone who takes it and I can't find much on the net about it.
>
> Jillhey Jill,
There is a yahoo group called, simply, Lithium, run by the exceedingly well-informed Squiggles, as she's known here on PB. It's got an archive you can search, and Squiggles posts anything new she finds in the medical literature, and other news items. You can ask questions and get good answers from the group members. I think it's worth looking at, if you haven't already...
http://groups.yahoo.com/group/Lithium/
best wishes,
Wendy
Posted by zeliva on March 17, 2003, at 14:07:44
In reply to Re: Sorry to ask again - Lith » zeliva, posted by wendy b. on March 17, 2003, at 7:39:26
thanks Wendy, I joined.
Posted by wendy b. on March 18, 2003, at 7:34:58
In reply to Re: Sorry to ask again - Lith, posted by zeliva on March 17, 2003, at 14:07:44
Posted by BarbaraCat on March 18, 2003, at 15:43:06
In reply to Sorry to ask again but need answers about Lithium, posted by zeliva on March 13, 2003, at 0:13:05
I started taking lithium one year ago at the prompting of my pdoc because everything else pooped out after a few months. I recoiled in horror - lithium! that's for Patty Duke and people who think they're Jesus Christ! Not me! It was the best thing I've done. Within 3 days (I also started at 300mg) I felt calmer and more focussed and my agitated depression started lifting. It turns out after going back and reading some of my old journals that I had clear signs on hypomania and frequent bouts of mixed states depression. I never considered myself BPII, just severely depressed.
Since then I've stopped taking it 'just to see' and within days my scattered fractured thinking came back. I really need it, but I also need additional things as well, like a tricyclic for the depression. One does not work without the other. I'm stable at 600mg which is very low and not in the therapeutic range according to blood tests. But that's the amount that works for me. I get some shakiness in the hands, pee alot, and drink lots of water. But for what it's done for me, I am so grateful. It has not caused any flattening of mood at all. You definitely want to get your thyroid checked every few months. It's worsened my already existing hypothyroidism and I now take extra thyroid med. This is very important. Alot of doctors don't seem to know about this very common side effect. Good luck - BarbaraCat
and > My pdoc gave me Lithium 300mg 1x day. Can anyone who has taken it tell me how it was and any side effects. See above post. Mt doc said it works well with Prozac and I take that 40mg. I just hear Lithium and I think of "crazy" people. Sorry for the stereotype! I have cyclothymia. Please give me feedback good or bad. I don't know anyone who takes it and I can't find much on the net about it.
>
> Jill
Posted by zeliva on March 18, 2003, at 15:55:25
In reply to Re: Sorry to ask again but need answers about Lithium » zeliva, posted by BarbaraCat on March 18, 2003, at 15:43:06
Thanks Barbara- Excuse the bluntness of this but I have IBS so I have diarrhea often. Ever since I started the Lithium I have had it every day. It could just be the IBS, but it sucks. Did you have this problem at all. I don't know what it is.
Jill
Posted by BarbaraCat on March 18, 2003, at 17:41:12
In reply to Re: Sorry to ask again but need answers about Lithium, posted by zeliva on March 18, 2003, at 15:55:25
Hey, never mind about being up front with stuff like that, I appreciate it. I was told to expect diarrhea for the first few weeks with Lithium but it never happened. I was actually looking forward to it because I've had more of a problem with constipation -- a byproduct of other meds I'm taking. I also have fibromyalgia and have to occasionaly take a narcotic pain reliever and that slows things down quite a bit. I keep it under control by drinking water and taking herbal products. When I was in the worst of the fibromyalgia (a syndrome identified by aching muscles, intense fatigue, sleep disruption, flu-like symptoms) I had IBS with very bad cramping and urgency and blow-outs. But thankfully, that has resolved itself as my fibro has healed.
You might want to try a bulking agent, like psyllium or flax seeds. These regulate the condition, whether loose or hard. Another very good product is an Indian (Ayurvedic) herbal composition called triphala. It again regulates the bowel so if you're one way or the other it will reach a middle ground. It also detoxifies the system, and that is always a good thing. You can find it in health food stores usually as part of digestive products, or if you have an herbalist you can get the raw bulk product. It tastes awful but is a very gentle and effective regulator. Stay away from the drug store bunger-uppers. They cause more problems in the long term.
> Thanks Barbara- Excuse the bluntness of this but I have IBS so I have diarrhea often. Ever since I started the Lithium I have had it every day. It could just be the IBS, but it sucks. Did you have this problem at all. I don't know what it is.
>
> Jill
Posted by zeliva on March 18, 2003, at 18:44:53
In reply to Re: Sorry to ask again but need answers about Lithium » zeliva, posted by BarbaraCat on March 18, 2003, at 17:41:12
Thanks Barb
Posted by Ritch on March 18, 2003, at 23:04:40
In reply to Re: Sorry to ask again but need answers about Lithium, posted by zeliva on March 18, 2003, at 15:55:25
> Thanks Barbara- Excuse the bluntness of this but I have IBS so I have diarrhea often. Ever since I started the Lithium I have had it every day. It could just be the IBS, but it sucks. Did you have this problem at all. I don't know what it is.
>
> JillJill, the single most troublesome side-effect I got from lithium when I was on it was IBS-related diarrhea. I took sub-therapeutic doses (300mg/day) to try to keep it manageable when higher doses of lithium worked much better mood-wise (450-600mg/day was my *spot*). Just an FYI, but I was reading on one of the grand rounds slides here that the calcium-channel blocker verapamil is sometimes used to counter lithium-induced diarrhea. You might mention this to your pdoc. I wished I would have known about this strategy 20 years ago!
Posted by BarbaraCat on March 18, 2003, at 23:51:46
In reply to Re: Sorry to ask again but need answers about Lithium » zeliva, posted by Ritch on March 18, 2003, at 23:04:40
Be real careful with calcium channel blockers. They can exacerbate mood disorders. No one knows for sure how mood stabilizers work, but one theory has to do with regulating calcium channels effect on neural electrical potentials. It could be that taking verapamil, propanolol, etc. counteracts the action of lithium, which would by definition reduce the side effects, but cancel out the effectiveness. Just a thought.
> Jill, the single most troublesome side-effect I got from lithium when I was on it was IBS-related diarrhea. I took sub-therapeutic doses (300mg/day) to try to keep it manageable when higher doses of lithium worked much better mood-wise (450-600mg/day was my *spot*). Just an FYI, but I was reading on one of the grand rounds slides here that the calcium-channel blocker verapamil is sometimes used to counter lithium-induced diarrhea. You might mention this to your pdoc. I wished I would have known about this strategy 20 years ago!
Posted by Ritch on March 19, 2003, at 9:08:58
In reply to Re: Sorry to ask again but need answers about Lithium » Ritch, posted by BarbaraCat on March 18, 2003, at 23:51:46
Hi Barb, Susan C. has been trying verapamil for awhile and it seems to be working well for her from what she posted the last time. I saw the link in a previous post about CCB's causing depression in heart patients but verapamil wasn't specifically mentioned. I'm not sure what "context" that verapamil is used with lithium (besides controlling IBS sx)-perhaps it is intractable mania that isn't controlled? Perhaps the possible danger with verapamil is aggravated depression (not cycling or mania). Many AED's affect voltage sensitive calcium channels which reduce neuronal firing to help prevent seizures, but I think their activity is much more selective than a CCB that is used to control high blood pressure.
> Be real careful with calcium channel blockers. They can exacerbate mood disorders. No one knows for sure how mood stabilizers work, but one theory has to do with regulating calcium channels effect on neural electrical potentials. It could be that taking verapamil, propanolol, etc. counteracts the action of lithium, which would by definition reduce the side effects, but cancel out the effectiveness. Just a thought.
>
>
> > Jill, the single most troublesome side-effect I got from lithium when I was on it was IBS-related diarrhea. I took sub-therapeutic doses (300mg/day) to try to keep it manageable when higher doses of lithium worked much better mood-wise (450-600mg/day was my *spot*). Just an FYI, but I was reading on one of the grand rounds slides here that the calcium-channel blocker verapamil is sometimes used to counter lithium-induced diarrhea. You might mention this to your pdoc. I wished I would have known about this strategy 20 years ago!
>
>
Posted by BarbaraCat on March 19, 2003, at 12:55:35
In reply to Re: Sorry to ask again but need answers about Lithium » BarbaraCat, posted by Ritch on March 19, 2003, at 9:08:58
Hi Ritch,
Yeah, it's confusing. Until we know how these mood meds work it's pretty much a crap shoot (er, I guess that was a pun). Most of what I've heard has to do with propanolol. I've seen anecdotal reports that it's a good augmentor with mood stabilizer activities and other reports that it aggravates depression. Probably worth a try with verapamil. What I'm curious about is if it helps IBS in general, alleviating both constipation and diarrea, or if it's primarily a constipating agent and so helps mainly with diarrea. - Barbara> Hi Barb, Susan C. has been trying verapamil for awhile and it seems to be working well for her from what she posted the last time. I saw the link in a previous post about CCB's causing depression in heart patients but verapamil wasn't specifically mentioned. I'm not sure what "context" that verapamil is used with lithium (besides controlling IBS sx)-perhaps it is intractable mania that isn't controlled? Perhaps the possible danger with verapamil is aggravated depression (not cycling or mania). Many AED's affect voltage sensitive calcium channels which reduce neuronal firing to help prevent seizures, but I think their activity is much more selective than a CCB that is used to control high blood pressure.
>
>
> > Be real careful with calcium channel blockers. They can exacerbate mood disorders. No one knows for sure how mood stabilizers work, but one theory has to do with regulating calcium channels effect on neural electrical potentials. It could be that taking verapamil, propanolol, etc. counteracts the action of lithium, which would by definition reduce the side effects, but cancel out the effectiveness. Just a thought.
> >
> >
> > > Jill, the single most troublesome side-effect I got from lithium when I was on it was IBS-related diarrhea. I took sub-therapeutic doses (300mg/day) to try to keep it manageable when higher doses of lithium worked much better mood-wise (450-600mg/day was my *spot*). Just an FYI, but I was reading on one of the grand rounds slides here that the calcium-channel blocker verapamil is sometimes used to counter lithium-induced diarrhea. You might mention this to your pdoc. I wished I would have known about this strategy 20 years ago!
> >
> >
>
>
Posted by Ritch on March 19, 2003, at 23:34:33
In reply to Re: Sorry to ask again but need answers about Lithium » Ritch, posted by BarbaraCat on March 19, 2003, at 12:55:35
Yes, I think it does help with diarrhea generally. Constipation is the most prominent side effect of verapamil from what I understand (and what Susan reported). She wasn't taking it to counter a side effect. Her pdoc added it for improved cognitive function and mood stability and she reported that it helped a lot. However, her pdoc said that she only got positive response with it in a minority of BP patients (but a significant minority). I hope Susan jumps in and tells us the skinny. If I could find something for IBS that also helps mood stability that would be pretty cool. This is weird, but Neurontin did reduce IBS symptoms. Lithium and to a lesser extent Depakote tend to increase them. Neurontin blocks calcium channels selectively in the hippocampus. Too bad I can't tolerate taking Neurontin anymore. It caused this esophageal spasm/chest pain thing that I can't put up with.
> Hi Ritch,
> Yeah, it's confusing. Until we know how these mood meds work it's pretty much a crap shoot (er, I guess that was a pun). Most of what I've heard has to do with propanolol. I've seen anecdotal reports that it's a good augmentor with mood stabilizer activities and other reports that it aggravates depression. Probably worth a try with verapamil. What I'm curious about is if it helps IBS in general, alleviating both constipation and diarrea, or if it's primarily a constipating agent and so helps mainly with diarrea. - Barbara
>
> > Hi Barb, Susan C. has been trying verapamil for awhile and it seems to be working well for her from what she posted the last time. I saw the link in a previous post about CCB's causing depression in heart patients but verapamil wasn't specifically mentioned. I'm not sure what "context" that verapamil is used with lithium (besides controlling IBS sx)-perhaps it is intractable mania that isn't controlled? Perhaps the possible danger with verapamil is aggravated depression (not cycling or mania). Many AED's affect voltage sensitive calcium channels which reduce neuronal firing to help prevent seizures, but I think their activity is much more selective than a CCB that is used to control high blood pressure.
> >
> >
> > > Be real careful with calcium channel blockers. They can exacerbate mood disorders. No one knows for sure how mood stabilizers work, but one theory has to do with regulating calcium channels effect on neural electrical potentials. It could be that taking verapamil, propanolol, etc. counteracts the action of lithium, which would by definition reduce the side effects, but cancel out the effectiveness. Just a thought.
> > >
> > >
> > > > Jill, the single most troublesome side-effect I got from lithium when I was on it was IBS-related diarrhea. I took sub-therapeutic doses (300mg/day) to try to keep it manageable when higher doses of lithium worked much better mood-wise (450-600mg/day was my *spot*). Just an FYI, but I was reading on one of the grand rounds slides here that the calcium-channel blocker verapamil is sometimes used to counter lithium-induced diarrhea. You might mention this to your pdoc. I wished I would have known about this strategy 20 years ago!
> > >
> > >
> >
> >
>
>
Posted by BarbaraCat on March 19, 2003, at 23:46:18
In reply to HEY Susan C. are you still on verapamil? » BarbaraCat, posted by Ritch on March 19, 2003, at 23:34:33
Ritch,
I was on Neurontin for a while, mainly for fibromyalgia neuropathic pain. At first it caused a lovely warm fuzzy glow that I've been searching high and low for. But then that gave out I had to back off for a few weeks and then ramp up again. It also did nothing for the fibro pain. I though 'fooey with this' and figure that warm fuzzy feeling has to do with endorphins, which I do not understand within the current miasma of psychopharmceutical reasoning. I think it probably has more to do with oxytocin production than anything we're routinely given by our pdocs. Oh, for a decent GABA agonist that isn't a dumb pill or addictive...
Posted by susan C on April 3, 2003, at 23:35:22
In reply to HEY Susan C. are you still on verapamil? » BarbaraCat, posted by Ritch on March 19, 2003, at 23:34:33
Hi all,
I was counting up the months since I added Verapamil to my 1000mg of depakote and came up with seven months. It continues to work, providing me with more of a middleground in my rapid cycling bipolar experience. I have had enough forgotten am doses where I experienced the return of symptoms, that I am pretty confident it is the med, not coincidence. Because of these missed doses I am now switched to dosing everything at night. I still go up, but not so much down. I still have to be careful to manage the stress in my life and keep my life as simple and predictable as possible. Oh, and I think there is some water retention and weight gain due to it. Plus, I need to watch fiber and water to keep the system going. That is one of my next adventures, is to try and lose weight, again.My dr gave me the name of one of the drs who has done the most work on verapamil and bipolar, Dr.Paul J. Goodnick. I wrote an email to him inquiring as to resources to explain how and why it works. He emailed me the next day with three suggestions. I purchased Mania, Clinical and Research Perspectives. I just got it, so havent yet pulled out my dictionary to sit down and try and understand it all.
It is wonderful to have some stability. With in a month of beginning, everyone who saw me commented on how much "better" I was...everyone from my family to my eye doctor, to my dentist, to the water aerobics instructor, and not all these people knew the "inside" story. The latest comment was from my doctor, saying, you need to review, I said why, he said, because you are a new patient to me...
"you always find your keys in the last place you look"
-S.I. Clarkmouse tips her hat to all and sundry
Posted by Ritch on April 4, 2003, at 9:18:23
In reply to Re: HEY Susan C. are you still on verapamil?, posted by susan C on April 3, 2003, at 23:35:22
> Hi all,
> I was counting up the months since I added Verapamil to my 1000mg of depakote and came up with seven months. It continues to work, providing me with more of a middleground in my rapid cycling bipolar experience. I have had enough forgotten am doses where I experienced the return of symptoms, that I am pretty confident it is the med, not coincidence. Because of these missed doses I am now switched to dosing everything at night. I still go up, but not so much down. I still have to be careful to manage the stress in my life and keep my life as simple and predictable as possible. Oh, and I think there is some water retention and weight gain due to it. Plus, I need to watch fiber and water to keep the system going. That is one of my next adventures, is to try and lose weight, again.
>
> My dr gave me the name of one of the drs who has done the most work on verapamil and bipolar, Dr.Paul J. Goodnick. I wrote an email to him inquiring as to resources to explain how and why it works. He emailed me the next day with three suggestions. I purchased Mania, Clinical and Research Perspectives. I just got it, so havent yet pulled out my dictionary to sit down and try and understand it all.
>
> It is wonderful to have some stability. With in a month of beginning, everyone who saw me commented on how much "better" I was...everyone from my family to my eye doctor, to my dentist, to the water aerobics instructor, and not all these people knew the "inside" story. The latest comment was from my doctor, saying, you need to review, I said why, he said, because you are a new patient to me...
>
> "you always find your keys in the last place you look"
> -S.I. Clark
>
> mouse tips her hat to all and sundry
Susan, that's certainly nice to hear! So....just taking Depakote and verapamil? No AD's? What's your dose of Verapamil every day? Any sfx other than constipation-any mental slowing or dizziness, etc.? Sorry for the questions. When you dig out any info about "how it works", let us know OK?thanks, Mitch
Posted by Ron Hill on April 4, 2003, at 11:25:35
In reply to Re: HEY Susan C. are you still on verapamil?, posted by susan C on April 3, 2003, at 23:35:22
Hi Susan C,
I've been thinking about you a lot recently and wondering if you were still reading the board. Glad to see that you are around and I'm very happy that the calcium channel blocker is working so well for you. I echo Mitch; please keep us informed.
Every home needs at least one friendly mouse.
-- Ron
Posted by susan C on April 4, 2003, at 23:51:24
In reply to Re: HEY Susan C. are you still on verapamil? » susan C, posted by Ritch on April 4, 2003, at 9:18:23
Lets see,dosages, depakote 1000mg 1x a day, 360 mg verapamil 1x day. (maximum in 480, I think)
No other side effects. Apparently, verapamil can cause dizziness, lightheadedness when standing...but not for me. My blood pressure is now even lower than it was before. Doc says I should live forever. As far as mental slowing the opposit is the case. I would say that is the number one first improvement I noticed and bless every day.
I would vote for anyone to try it,as I understand it to be a fairly benign drug (yes, yes, I know there are reports of depression associated with it, what drug doesnt??) and for some of us hard to treat it may just be a part of the puzzle.
I have started to read the Mania book and am finding it pretty good, written for the layish person, I think. Thanks for the encouragement to begin.I will keep you posted.
your friend under foot
mouse"When there appears to be no answer, perhaps the right question has not been asked."
-S.I.Clark
Posted by Ritch on April 5, 2003, at 9:22:48
In reply to Hey all, you make me feel so at home, posted by susan C on April 4, 2003, at 23:51:24
This is the end of the thread.
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