![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by rod on July 19, 2005, at 4:43:47
HiHo Scott
So, I have tried Depakote for some days. After an initial positive response at 150mg I experienced some bad side effects on cognition. and 300mg gave me the worst sutpor I ever had.
Ok, now I am giving those Li ions a chance...
I have taken 225mg Lithium Carbonate. And well, I like it. its calming and distressing, makes me think more clearly.. and has some antidepressant effect. But I fear its just some kind of temporary improvement.
Scott, my question, you get a temporary relief on Lithium? Did you check your thyroid when you got worse? It has some antithyroid properties. (and it also activates the HPA axis, anyway). T4 (lithium, bipolar) augmentation provides better results than T3 augemtation (unipolar).
To be on the safe side, I will have my thyroid checked. I will see my doc in ~3 weeks. I hope nothing goes wrong in the meanwhile. (You might ask yourself who on earth prescribes you it without making any blood test :-P .. well its possible where I live.... ehehehe refills for free :-D .. nuff said (it wont be possible anymore when they introduce the chip card system, which is soon to happen)).
I will stay at 225mg in the meanwhile.
I am thinking about dropping Lyrica, because Li has a similar effect to me. And Lyrica caused some ugly weight gain and its positive effect is still here, but weak.
I hope Li does the trick on the long term for me...
Nort 100mg
Amisulp 50mg
Nicergoline 30mg
Lithium 225mgmight drop:
Lyrica 300mg
Pentoxifylline 600mgbye
Roland
Posted by SLS on July 19, 2005, at 9:19:30
In reply to Lithium experience - Scott?, posted by rod on July 19, 2005, at 4:43:47
> HiHo Scott
HiHo Roland.
Do you think that you are bipolar?
> So, I have tried Depakote for some days. After an initial positive response at 150mg I experienced some bad side effects on cognition. and 300mg gave me the worst sutpor I ever had.
Hmm. I don't think I've ever heard of such a reaction to such a low dosage. If there is one thing these drugs have taught us is that there is great variability in the brains of individuals who present with the same illness.
> Ok, now I am giving those Li ions a chance...
No more Depakote?
> I have taken 225mg Lithium Carbonate. And well, I like it. its calming and distressing, makes me think more clearly.. and has some antidepressant effect. But I fear its just some kind of temporary improvement.
It is interesting how quickly lithium can produce an antidepressant effect. It can happen within the first three days, especially when an antidepressant is already on board. Psychiatry has had much experience combining lithium and tricyclics. Unfortunately, much of that experience has disappeared through attrition of practitioners. I get the impression that when lithium begins to work in such a situation, it tends to continue working. I wish there were guarantees, but the choice of lithium was a smart one.
> Scott, my question, you get a temporary relief on Lithium?Not really. In fact, it makes me feel worse. Actually, I'm pretty angry with lithium. It abolished my ultra rapid cycle. My cycle had a consistent period of 11 days: 8 days down and 3 days up. Switches in mood state occurred over the course of 30-45 minutes. It was very abrupt. Now, I never see euthymia. At least I could count on 3 days to accomplish things prior to taking lithium. Once, lithium gave me a few days of mild relief when it was added blindly while I was a research patient. I was continued on lithium 600mg for over 9 months. If my thyroid levels were affected, I would have been treated for it. It never became an issue.
Did you check your thyroid when you got worse? It has some antithyroid properties. (and it also activates the HPA axis, anyway). T4 (lithium, bipolar) augmentation provides better results than T3 augmentation (unipolar).
This has been my contention for over 10 years. T3 made me much, much worse. I am so glad that you reaffirmed my suspicions. I found T4 to be helpful. I have approached my current pdoc to consider adding it. He was not too interested in it.
> To be on the safe side, I will have my thyroid checked. I will see my doc in ~3 weeks. I hope nothing goes wrong in the meanwhile. (You might ask yourself who on earth prescribes you it without making any blood test :-P .. well its possible where I live.... ehehehe refills for free :-D .. nuff said (it wont be possible anymore when they introduce the chip card system, which is soon to happen)).
>
> I will stay at 225mg in the meanwhile.I hope it works it works for you, Roland. In the meantime, just know that the low-dosage strategy of lithium augmentation to antidepressants is usually stated to use dosages between 300-600mg, so you have quite a bit of room left. 225 is a nice number too. :-)
> I am thinking about dropping Lyrica, because Li has a similar effect to me.
Interesting. I have placed Lyrica on my list of things to try in the near future. Can you describe what your experience with it was?
> I hope Li does the trick on the long term for me...
That would be hugely convenient, wouldn't it?
:-)
I hope so too.
Good luck and be well.
- Scott
Posted by rod on July 19, 2005, at 10:31:24
In reply to Re: Lithium experience - Scott?, posted by SLS on July 19, 2005, at 9:19:30
Hi Scott!
> Do you think that you are bipolar?
might be. It surely isnt bipolar I. But I do experience some repid cycling sometimes. Like you, it often occured over the course of 30-45 minutes... and didnt last more than few hours... But most of the time I am donw.
And like dysthymia , bipolar depression is more linked to dopamine than "normal" major depression is. I suspect there is, apart from other stuff, something wrong with my dopamineric neuronal circuits. poor facial expression, poverty of speech etc....>
> > Ok, now I am giving those Li ions a chance...
>
> No more Depakote?No. It gave me a stupor, did freeze my facial muscels.. it just dampened me too much down..
> the choice of lithium was a smart one.
well, actually you where the one who suggested it to me! thanks :-)
> > I am thinking about dropping Lyrica, because Li has a similar effect to me.
>
> Interesting. I have placed Lyrica on my list of things to try in the near future. Can you describe what your experience with it was?Lyrica has some claming, relaxing effect. Not sedation. As a result (I guess) of the calming, distresing effect my concentration and memory improved. My thoughts get some kind of more "organised" and thinking goes more "fluently". And it brightens mood a little bit. It improves my overall functionality..
But as it seems, Lithium does the same, but just better :-)
> > I hope Li does the trick on the long term for me...
>
> That would be hugely convenient, wouldn't it?Sure. It would be soooo cool. Time to start my life again.... :-) (Or get a new one.. cause my old sucks :-O )
> :-)
>
> I hope so too.
>
> Good luck and be well.thanks for your kind words, Scott :-)
kind regards and good luck with Lyrica! Its worth a try.
Roland
Posted by ed_uk on July 19, 2005, at 18:12:04
In reply to Re: Lithium experience - Scott? » SLS, posted by rod on July 19, 2005, at 10:31:24
HiHo Roli!
I hope the Li keeps working well :-)
Kind regards
~Ed
Posted by ed_uk on July 19, 2005, at 18:41:58
In reply to Re: Lithium experience - Scott? » SLS, posted by rod on July 19, 2005, at 10:31:24
Hi!
If Li + nortriptyline doesn't work as well as you'd like, will you try Li + clomipramine?
Kind regards
~Ed
Posted by rod on July 19, 2005, at 20:26:35
In reply to Re: Lithium experience - Scott? » rod, posted by ed_uk on July 19, 2005, at 18:41:58
Hi!
> If Li + nortriptyline doesn't work as well as you'd like, will you try Li + clomipramine?maybe I will, yes. Lets see...
byeRoland
Posted by ed_uk on July 20, 2005, at 17:33:10
In reply to Re: Lithium experience - Scott? » ed_uk, posted by rod on July 19, 2005, at 20:26:35
>maybe I will, yes. Lets see...
I hope you won't need to :-)
~Ed
Posted by rod on July 20, 2005, at 18:08:23
In reply to Re: Lithium experience - Scott? » rod, posted by ed_uk on July 20, 2005, at 17:33:10
> >maybe I will, yes. Lets see...
>
> I hope you won't need to :-)
>
> ~Edhehe
today was another nice day in my life... (like yesterday)
its really a great drug so far. But being it for 3 days might not tell much. anyway. But it seems to get better every day. no worsening at all!!
I am so glad I gave this drug a try instead of plugiing some clomi into my brain awww brain numbing straightjacked clomi.... anyway. clomi is still a very useful drug. But I hope Nort + Li works out. Nort has no numbing or negative cognitive effects. if any, its rather restoring cognition than disrupting it. Like Li so far :))
ehehe
thanks buddies :)
bye
Roland
Posted by ed_uk on July 21, 2005, at 16:48:34
In reply to Re: Lithium experience - Scott?, posted by rod on July 20, 2005, at 18:08:23
Hi Roli!
What dose of Li are you on? I'm so glad it's helping! :-)
~Ed
Posted by rod on July 21, 2005, at 18:03:38
In reply to Re: Lithium experience - Scott? » rod, posted by ed_uk on July 21, 2005, at 16:48:34
> Hi Roli!
>
> What dose of Li are you on? I'm so glad it's helping! :-)
>
> ~EdHi Eddie :-P
Still on just 225 (1/2 tab of Quilonoerm (Extended Release)
its cool so far.... Its almost stimulating, energysing, de-numbing, brain fog lifting, chronic nose swelling is gone, anti akathisia effect (anti restlesness), sleep quality seems to be better, I am more refrehsed in the morning, and getting up is easier.
hehe :-D
I will try to email my doc and ask him about the dosage.
what do you think? should I take 1/2 (225) in the morning and the other 225 at the evening? Could anything bad happen? I seem to tolerate it very good. no side effects so far. except insomnia, but 0,25 clonazepam sqeezes it out nicely.
Oh great ed, my lord of the pills, any advice? :)
I think about dropping Pentoxifylline tomorrow and see how it goes without. Its a Xanthine derivate, and Xanthines are known to lower serum level of Li..
I dont want to keep it, so I think I will get rid of it before I settle on a dose of Li..bye
Regards
Roland
Posted by ed_uk on July 22, 2005, at 13:59:30
In reply to Re: Lithium experience - Scott? » ed_uk, posted by rod on July 21, 2005, at 18:03:38
Hi Roli :-P
>Its almost stimulating, energysing, de-numbing, brain fog lifting, chronic nose swelling is gone, anti akathisia effect (anti restlesness), sleep quality seems to be better, I am more refrehsed in the morning, and getting up is easier.
Wow that IS cool!!! :-) Is your depression almost completely gone???
>I will try to email my doc and ask him about the dosage.
Have you had a blood test yet?
>...should I take 1/2 (225) in the morning and the other 225 at the evening?
If you haven't had a blood test it would make sense to increase the dose very gradually. Perhaps you could try taking 3/4 of a tab daily?
Kind regards
~ed
PS. Can you describe the effect that lithium is having on your sleep?
Posted by rod on July 22, 2005, at 14:17:59
In reply to Re: Lithium experience - Scott? » rod, posted by ed_uk on July 22, 2005, at 13:59:30
Hi Ed
> Is your depression almost completely gone???
no. but a dramatic step towards remission. I expect it to gradually get better over the course of weeks, months...
>
> >I will try to email my doc and ask him about the dosage.
>
> Have you had a blood test yet?nope.
> >...should I take 1/2 (225) in the morning and the other 225 at the evening?
>
> If you haven't had a blood test it would make sense to increase the dose very gradually. Perhaps you could try taking 3/4 of a tab daily?hmmm difficult, because the are only designed to be easely split into 2 halfes. you know what I mean.
Can the blood level vary that much? I thought ~400mg is 99,999% ont the lower end of the window. But thats just a guess.
byeRoland
PS: brain@roli:> apt-get install life :-OOO (some computer nerds will know what I mean)
hihi
Posted by ed_uk on July 22, 2005, at 14:53:12
In reply to Re: Lithium experience - Scott? » ed_uk, posted by rod on July 22, 2005, at 14:17:59
Hi Roli!
>no. but a dramatic step towards remission. I expect it to gradually get better over the course of weeks, months...
:-) Perhaps you should stay on 225mg for a couple of weeks before deciding whether to increase. What do you think?
>hmmm difficult, because the are only designed to be easely split into 2 halfes. you know what I mean.
A tablet cutter might come in handy :-P
> I thought ~400mg is 99,999% ont the lower end of the window.
Although 450mg is a 'low' dose, blood levels vary widely between different patients being treated with the same dose - hence the blood monitoring.
Kind regards
~ed
Posted by rod on July 22, 2005, at 15:09:44
In reply to Re: Lithium experience - Scott? » rod, posted by ed_uk on July 22, 2005, at 14:53:12
hi ed
> >no. but a dramatic step towards remission. I expect it to gradually get better over the course of weeks, months...
>
> :-) Perhaps you should stay on 225mg for a couple of weeks before deciding whether to increase. What do you think?hmm maybe you are right. low and slow, here we go...
thanks
bye
Roland
Posted by ed_uk on July 22, 2005, at 15:16:32
In reply to Re: Lithium experience - Scott? » ed_uk, posted by rod on July 22, 2005, at 15:09:44
Hi Roli!
>low and slow, here we go...
.....and minimise side effects :-D
~ed
Posted by Sabino on July 23, 2005, at 19:13:07
In reply to Re: Lithium experience - Scott? » SLS, posted by rod on July 19, 2005, at 10:31:24
>> Lyrica has some claming, relaxing effect. Not sedation. As a result (I guess) of the calming, distresing effect my concentration and memory improved. My thoughts get some kind of more "organised" and thinking goes more "fluently". And it brightens mood a little bit. It improves my overall functionality..
But as it seems, Lithium does the same, but just better :-)
<< Roland
Roland, just wanted to say that both your symptoms and your response to Lithium seem remarkably similar to my own. I'd been saying many of the same things you are in a different thread.Good luck with it!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.