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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Squiggles on January 25, 2006, at 8:42:47
Some time ago, I posted that over a 4 month
period, I crashed into mixed states, after
taking a bad lithium supply (counterfeit, or
low, or old). I did have the symptoms of
bipolar disorder (rapid cycling, suicidal,
psychotic, etc.). I immediately got better
after taking the "good" supply from another
pharmacy.However, I forgot to consider the role
that the Synthroid (and clonazepam) may
have played as the lithium must have reached
0. For anyone curious about thyrotoxicosis
and its role in emotional lability, i thought
i might bring this up.I did not have sweats, or typical thyrotoxicosis
symptoms, but i did have severe anxiety and
mania. In the absence of lithium, how severe would the impact of 0.112 mg Synthroid be, i wonder.Squiggles
Posted by Tomatheus on January 25, 2006, at 20:22:27
In reply to Forgotten Factor in Counterfeit lithium case, posted by Squiggles on January 25, 2006, at 8:42:47
Squiggles,
How do you know that you had a bad lithium supply? Do you believe that your supply might have been bad just because of the way you responded to it, or was there something else that led you to believe that your lithium might have been counterfeit, low, or old?
I'm just curious because I was taking the generic lithium manufactured by Able Laboratories at the time when the product was recalled. It is my understanding that Able recalled all of its products out of concerns that some of them might have been either "subpotent or superpotent." But I have not been able (no pun intended) to locate any information suggesting that there were any specific problems with Able's lithium. By any chance, was the "counterfeit" lithium that you were taking manufactured by Able? If so, do you have any idea as to what the specific problem with it was?
I took lithium in combination with Wellbutrin for about a year for my depressive symptoms (and following the temporary mood cycling that I had in response to Paxil), and I had a partial but largely inadequate response to the combo. I usually ended up taking rather large doses of a variety of different supplements and consuming excessive amounts of caffeine (which I know is a no-no for patients taking lithium) just to be able to get through each day when I was on the Wellbutrin-lithium combo, and it is obvious in retrospect that this reckless use of so many different (legal) substances just ended up making matters worse for me, especially in terms of my depressive symptoms. At any rate, I eventually discontinued with my Wellbutrin-lithium combo due to lack of efficacy -- the combo was especially ineffective when I took it "alone" and without all those supplements that I used to use to give myself short-term boosts. I did notice that I felt more anxious and agitated in my last few months or so on lithium (right before it was recalled), but it's difficult to figure out whether this change was due to changes in my Wellbutrin dosage, the adverse effects of mixing lithium with excessive amounts of caffeine and various supplements, or a problem with the lithium itself.
Of course, it doesn't really matter to me at this point whether the somewhat adverse feelings of anxiety and agitation that I experienced late into my Wellbutrin-lithium trial were a result of poorly manufactured lithium, because I have no plans to return to take either Wellbutrin or lithium at any point in the future. But I'm just curious as to whether you have any information concerning the possibility that the Able lithium might have been "counterfeit," or faulty in some way.
Tomatheus
> Some time ago, I posted that over a 4 month
> period, I crashed into mixed states, after
> taking a bad lithium supply (counterfeit, or
> low, or old). I did have the symptoms of
> bipolar disorder (rapid cycling, suicidal,
> psychotic, etc.). I immediately got better
> after taking the "good" supply from another
> pharmacy.
>
> However, I forgot to consider the role
> that the Synthroid (and clonazepam) may
> have played as the lithium must have reached
> 0. For anyone curious about thyrotoxicosis
> and its role in emotional lability, i thought
> i might bring this up.
>
> I did not have sweats, or typical thyrotoxicosis
> symptoms, but i did have severe anxiety and
> mania. In the absence of lithium, how severe would the impact of 0.112 mg Synthroid be, i wonder.
>
> Squiggles
>
>
Posted by Squiggles on January 25, 2006, at 21:09:56
In reply to Re: Forgotten Factor in Counterfeit lithium case » Squiggles, posted by Tomatheus on January 25, 2006, at 20:22:27
Well, first i would like to thank you for
taking so much time to answer this post.
I have many detailed posts here on the topic,
as well as SOS ones where someone by the name
of Scott tried to help me, and also on my
Lithium site, and letters to the drug companies.
As I am not suing I will not mention the companies
except to say that Health Canada did issue
a warning about bad lithium batches around the
time I was taking this. I have filed a report
with them._________________
> Squiggles,
>
> How do you know that you had a bad lithium supply? Do you believe that your supply might have been bad just because of the way you responded to it, or was there something else that led you to believe that your lithium might have been counterfeit, low, or old?__________________________
There were not side effects at all. I was
delighted. Gradually, this turned to hypomania.___________________________
>
> I'm just curious because I was taking the generic lithium manufactured by Able Laboratories at the time when the product was recalled. It is my understanding that Able recalled all of its products out of concerns that some of them might have been either "subpotent or superpotent." But I have not been able (no pun intended) to locate any information suggesting that there were any specific problems with Able's lithium. By any chance, was the "counterfeit" lithium that you were taking manufactured by Able? If so, do you have any idea as to what the specific problem with it was?________________________
No, it was VALEANT (but the distributors
may have been the same). See below:Canadian Company Recalls Bipolar Disorder Drug
The FDA is warning people not to buy or use Carbolith (lithium carbonate) 150-milligram capsules for treating bipolar disorder, also called manic-depressive illness, a serious psychiatric condition. Valeant Canada Ltd. of Montreal recalled the capsules after testing indicated that the product may not deliver adequate amounts of the drug to ensure effective treatment.
Health Canada recently advised people taking Carbolith 150 to continue taking their medicine and to consult with their health care professionals as soon as possible. Americans who have purchased the drug through the Internet and taken it for bipolar disorder could experience adverse events associated with lowered blood lithium levels, including a worsening of the illness.
In addition, people who may have taken the Carbolith product for several weeks or longer may experience toxic effects, such as confusion, muscle twitching, vomiting, and diarrhea, when they switch to a lithium carbonate product that delivers adequate amounts of the drug.
See the public advisory issued by Health Canada about this recall.
October, 2004.
----------------
Squigglesp.s. I crashed on the 300mg lithium caps by another company but it may
have been an individual batch, as I have not seen any public announcement of other cases; they were without side effects
but that was an ominous sign which led to suicidal psychosis by
4 months (in 2005);________________________
It was another company i bought from but who distributed
it, i am not sure. I have the letters in my
files referring to company communiation. I will
say that upon complaint the drug was changed
to another company and something about "this
is the old one" was a reply. But as I said I
am not suing so I will not go further. I simply
changed pharmacies._______________________
>
> I took lithium in combination with Wellbutrin for about a year for my depressive symptoms (and following the temporary mood cycling that I had in response to Paxil), and I had a partial but largely inadequate response to the combo. I usually ended up taking rather large doses of a variety of different supplements and consuming excessive amounts of caffeine (which I know is a no-no for patients taking lithium) just to be able to get through each day when I was on the Wellbutrin-lithium combo, and it is obvious in retrospect that this reckless use of so many different (legal) substances just ended up making matters worse for me, especially in terms of my depressive symptoms. At any rate, I eventually discontinued with my Wellbutrin-lithium combo due to lack of efficacy -- the combo was especially ineffective when I took it "alone" and without all those supplements that I used to use to give myself short-term boosts. I did notice that I felt more anxious and agitated in my last few months or so on lithium (right before it was recalled), but it's difficult to figure out whether this change was due to changes in my Wellbutrin dosage, the adverse effects of mixing lithium with excessive amounts of caffeine and various supplements, or a problem with the lithium itself.
>_____________________________
There is no doubt that I gradually sank into
depression, mania and mixed states over 4 months
on this stuff. I knew it was different and
felt so wonderful at first that I examined the
powder - taste, texture; i diluted it, but
i had no chemical instruments. The bad one
compared to a spare old one was less salty
but they looked similar. I guess it may have
been a difference in mixer/drug ratio.Upon switching to the new pharmacy after calling
my doctor, I escaped suicidal psychosis within
24 hours on the new lithium. It was not easy
as I had to play with the dose, opening the
caps, etc. It was scary.__________________________
> Of course, it doesn't really matter to me at this point whether the somewhat adverse feelings of anxiety and agitation that I experienced late into my Wellbutrin-lithium trial were a result of poorly manufactured lithium, because I have no plans to return to take either Wellbutrin or lithium at any point in the future. But I'm just curious as to whether you have any information concerning the possibility that the Able lithium might have been "counterfeit," or faulty in some way.
______________________
Here is one of my letters from my file, at the
beginning:
To Whom It May Concern:I would like to inform you that the generic
version of lithium carbonate capsules (300mg)
of GENERIC type (pink and white cap) are
perceptively milder and have fewer side effects
(thirst, lethargy, head fevers), than the
Patent ones (orange, slightly larger caps, same
dose).I found this out quite by mistake in changing
pharmacies.For me that is a great advantage as my doctor does
not consider it wise to lower my lithium dose.
Thank you/Merci
[Squiggles](taking lithium for almost 25 years (900mg per day)
with Synthroid and Rivotril (got off some 4 yrs. ago).------------
/Squiggles
>
Posted by Tomatheus on January 28, 2006, at 0:39:46
In reply to Re: Forgotten Factor in Counterfeit lithium case, posted by Squiggles on January 25, 2006, at 21:09:56
> Well, first i would like to thank you for
> taking so much time to answer this post.You're welcome, and thanks for the detailed information.
Tomatheus
Posted by Squiggles on January 28, 2006, at 18:28:31
In reply to Re: Forgotten Factor in Counterfeit lithium case » Squiggles, posted by Tomatheus on January 28, 2006, at 0:39:46
> > Well, first i would like to thank you for
> > taking so much time to answer this post.
>
> You're welcome, and thanks for the detailed information.
>
> Tomatheus$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
I hope the information is of value to
anyone doubting the efficacy of lithium
(in its proper form) for "rapid cycling"
"mania" "depression" and "psychotic agitation".
It is a tribute to Drs. Cade and Schou --
when medical scientists worked with integrity,
genius, and compassion.Squiggles
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
Posted by Squiggles on January 30, 2006, at 10:15:00
In reply to Re: Forgotten Factor in Counterfeit lithium case *, posted by Squiggles on January 28, 2006, at 18:28:31
I appreciate the attention to this hard
episode i went through, but I would like
to go back to my initial question. I don't
know if anyone can shed some light.Whether the "bad" lithium batch was old,
low, maybe citrate substrate, or even
counterfeit, the result was that after
4 months (approx.) i became full-flown
bipolar - mania, psychomotor agitation,
rage, suicidal, depression, etc. I was
lucky to get out of it with the fresh
"real" lithium from another pharmacy and
i THINK this proved i am bipolar (my dr.
was never sure). Talk about serendipity.But my question initially was what happened
to the thyroid? If the lithium went down
to say 0 in 4 months, and the thyroxine
drug was kept constant, what would be the
blood level of thyroxine and it psychiatric
effects? Since lithium suppresses the
thyroid, could I have had a case of thyroid
toxicity mimicking bipolar? Would it take
4 months?BTW, the symptoms were almost identical to
what I had BEFORE ever taking lithium or
thyroxine 20 yrs. ago, when i was a "virgin"
patient. Could I have had hyperthyroidism
then, mistaken for bipolar disorder?Is there a way to tell?
Squiggles
This is the end of the thread.
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