![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by bipolarspectrum on August 3, 2005, at 21:00:46
Hi,
I'm at 1200 mgs of Lithium and I'm just wondering whether the cognitive fog would go away over time as my body adjusts? anyone experience this?
bps
Posted by Squiggles on August 4, 2005, at 11:51:27
In reply to does LITHIUM cognitive problems go away???, posted by bipolarspectrum on August 3, 2005, at 21:00:46
How about asking your doctor to
work on adjusting the dose? 900mg
is what I take. Bloods should be
0.6 - 1.2 at most;Squiggles
Posted by bipolarspectrum on August 4, 2005, at 17:13:42
In reply to Re: does LITHIUM cognitive problems go away???, posted by Squiggles on August 4, 2005, at 11:51:27
Hey Squiggles,
What else do u take along with lithium?
bps
Posted by Squiggles on August 4, 2005, at 17:31:43
In reply to Re: does LITHIUM cognitive problems go away???, posted by bipolarspectrum on August 4, 2005, at 17:13:42
> Hey Squiggles,
> What else do u take along with lithium?
> bps1.50 mg clonazepam
used to take Xanax, but no longer necessary -
may have been a high thyroid induced necessity;0.112 Synthroid (this drug was taken about
a year after the lithium initiation) -- like
many, my thyroid was hammered down by the
lithium and a supplement became necessary;
not surprisingly lithium is a treatment for
hyperthyroidism (too much);Your dr. will probably check you for this.
I'm sure drs. think lithium is a royal pain,
lol. Someone on the net said it's a high
maintenance drug - yeah, well, i'm a high
maintenance patient :-)Squiggles
Posted by Squiggles on August 4, 2005, at 19:19:50
In reply to Re: does LITHIUM cognitive problems go away???, posted by Squiggles on August 4, 2005, at 17:31:43
BTW, in case this message is coming
from the Anti-psychiatry field, I
would like to make an appeal to such
people. Often drugs, such as lithium
are called "poison" ('it has to be
excreted by the kidneys and eventually
they will rot, etc.'). May I suggest
that depression-induced suicide is
not new. You can read about it in
Pre-Thorazine history. Thus, it is not
the drugs or ECT that were responsible.Granted, we still do not know what the
cause(s) of mental illness is exactly. But the
fact that it is a chemical imbalance and
that drugs change the brain to another
chemical imbalance, is not something to
sneeze at- that chemical imbalance allows
people to live a more or less normal life.Regarding the poison, take a look at the etymology
of "pharmakon" - from the Gk. -- it means
exactly that - poison. Why -- because
all drugs are poisons. That does not mean
they are evil, or bad, or immoral. They
are external substances which to do some good
inevitably must do some harm.My hope is that the academic or puritan
priority of this school will give way
to the true compassionate goal of psychiatry --
to alleviate the misery this disease brings.Squiggles
Posted by med_empowered on August 5, 2005, at 2:02:05
In reply to Re: does LITHIUM cognitive problems go away???, posted by Squiggles on August 4, 2005, at 19:19:50
hey! Lithium is a tricky drug. It work absolute miracles for some people, but it definitely has side-effects. First, review your treatment with your doc--make sure that lithium is *the* drug you should be taking. Lots of people (especially "rapid cyclers") do better on the other mood-stabilizers, such as Depakote or Trileptal...some others find the most help with the atypical antipsychotics. Even if lithium is good for you, you may be able to lower your dosage OR lower your dose and add a second mood stabilizer; if done well, this kind of mix would (theoretically) lead to minimized side effects and maximized benefits. Lithium's cognitive side effects do get better in some people; over time, you might adjust. On the other hand...non-compliance rates for Lithium are pretty high b/c some people just can't take the side-effects (cognitive and other side effects). Personally, I found that Trileptal plus an atypical antipsychotic (abilify, in my case) provided *excellent* control of my mixed-episodes and reduced the severity of my depressions (I still got depressed, though). After a while though, I got fed up with the side-effects and ditched both meds. Still...something like that might work for you, and it might allow you to avoid blood tests (the antipsychotics, Trileptal, Keppra, and Lamictal can usually be administered without periodic blood work, although if you opt for Trileptal its a good idea to check your blood sodium now and then). Good luck!
Posted by bipolarspectrum on August 5, 2005, at 3:27:59
In reply to Re: does LITHIUM cognitive problems go away???, posted by med_empowered on August 5, 2005, at 2:02:05
Thanx for the posts,
Yeah, Ive ran the gauntlet of drugs and lithium is the only one which provides a direct antidepressant effect... Its just it leaves feeling very agitated and irritability.. also, i get the cognitive fog.... anyone have cures for the agitation because i think the cognitive problems will fade...
bps
Posted by ramsea on August 5, 2005, at 6:05:55
In reply to Re: does LITHIUM cognitive problems go away???, posted by bipolarspectrum on August 5, 2005, at 3:27:59
I have only experience cognitive dulling at doses above 800mgs. We're all different. Post-lith I feel in some ways more capable of cognitive and creative tasks (previously my lifework), because I am no longer so exhausted from cycling to hell and back, not to mention all the rocketing around the universe. I have more energy and more sensibility. Though I do miss the really "groovy" highs that were---well--so exquisite. But then I'd hit earth with a nasty bang and believe me, I accomplished nothing then, nothing at all. So the overall picture has been okay for me. You may need another med, or you may enquire if a tweaking your dose would help. Good luck.
Posted by Squiggles on August 5, 2005, at 8:45:49
In reply to Re: does LITHIUM cognitive problems go away???, posted by med_empowered on August 5, 2005, at 2:02:05
I think those might be helpful hints
for relative beginners on lithium;
btw, the blood test is the least of the
drawbacks of lithium - i get one once
a year. It should be noted that switching
drugs is no picnic, especially if other
drugs you are already on, have to be adjusted
or withdrawn - may take years to get it
right.Squiggles
Posted by med_empowered on August 5, 2005, at 8:51:12
In reply to Re: does LITHIUM cognitive problems go away??? » bipolarspectrum, posted by ramsea on August 5, 2005, at 6:05:55
hey! Just a thought: if agitation is a problem, and you're OK with trying an atypical antipsychotic, you could probably lower your Lithium levels a bit and add a low-to-mid range atypical. My personal preference would be Abilify--you can start at the "optimal" dose of 15, or start at 10 (both doses are effective) and there isn't really a risk of weight gain and (so far) the diabetes risk seems minimal (if you opt for ANY atypical, please keep tabs on your blood sugar though). Antipsychotics help with agitation and they can control (hypo)mania and mixed-episodes. The new ones seem to have antidepressant effects as well...the symbyax combo is an example of this. Anyway, you might be able to get control of the agitation, lower the lithium dose (hence reducing cognitive dulling), and improve your mood overall with an atypical. Abilify is usually non-drowsy and kind of "activating," so the risk of cognitive problems from taking it are lower than with, say, Seroquel (that said: when I moved into higher abilify doses, I felt apathetic and stupid. Low doses were good though). Another option would be a benzo for the agitation..you run the risk of worsening your depression (not all that common, but still a problem) and some docs would rather gouge out their eyes with salad forks than RX a little Valium, but still...its a viable option. Good luck!
Posted by bipolarspectrum on August 5, 2005, at 16:05:22
In reply to Re: does LITHIUM cognitive problems go away???, posted by med_empowered on August 5, 2005, at 8:51:12
Hey,
I'm wondering if a little gabapentin may be good for my agitation/restelessness... I;ve tred zyprexa and it made me slep 13=14 hours a night! Although u do say abilify is more activating...
BTW. I'm currently at 1500 mg Lithium
bps
Posted by ramsea on August 6, 2005, at 4:45:36
In reply to Re: does LITHIUM cognitive problems go away???, posted by bipolarspectrum on August 5, 2005, at 16:05:22
Gabapentin remains controversial for a lot of folks. I have to admit that it helps me in dealing with social anxiety, it really can have a calming affect. But getting the dose right can be hard. And according to side effect profile it can make **some** guys agitated and restless--i.e., a little manicky, bad kind. It also is one hec of a gainer. If you're enclined that way. That's the sole reason I don't include it in my med regime anymore--lithium is bad enough for me, but with the gabapentin I go up one or two sizes within a matter of weeks. So--maybe worth a go, it could be helpful in calming. ramsea
Posted by linkadge on August 8, 2005, at 21:20:19
In reply to Re: does LITHIUM cognitive problems go away??? » bipolarspectrum, posted by ramsea on August 6, 2005, at 4:45:36
Try folic acid. I have heard that folic acid can lessen the cogntivie effects effects of lithium. I would try 400mcg twice a day.
Linkadge
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.