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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by becksFLA on August 15, 2007, at 22:42:10
I've come almost completely off it, and I'm not sure if it's too soon to tell but I feel much happier, outgoing, etc. Mood has gone way up. I'm just confused because I thought Lithium if anything, is supposed to have an anti-depressive effect.
Thanks
Posted by Squiggles on August 16, 2007, at 8:07:10
In reply to Did Lithium make me irritable and anti-social?, posted by becksFLA on August 15, 2007, at 22:42:10
> I've come almost completely off it, and I'm not sure if it's too soon to tell but I feel much happier, outgoing, etc. Mood has gone way up. I'm just confused because I thought Lithium if anything, is supposed to have an anti-depressive effect.
>
> ThanksLithium targets the two-sided aspect of bipolar disorder, which is both mania and depression. A unique aspect of this state or disorder is that once one side of the coin is treated, the other one is too. So, if you are bipolar and you are in a manic state, you will soon be in a depressed state. Lithium by targeting the depressed state prevents the manic state from appearing -- that's why it's called a mood *stabilizer*.
You may not have bipolar disorder if you feel better without it. But that is only one possibility. I hope your dr. is experienced in distinguishing one state from another. Don't be surprised if tinkering is required.
Squiggles
Posted by linkadge on August 16, 2007, at 14:05:05
In reply to Re: Did Lithium make me irritable and anti-social? » becksFLA, posted by Squiggles on August 16, 2007, at 8:07:10
Lithium did make me very irratble, but I may not be bipolar. Supposedly lithium is bad for certain "temporal lobe" related disorders??
Linkadge
Posted by Squiggles on August 16, 2007, at 14:56:09
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 16, 2007, at 14:05:05
> Lithium did make me very irratble, but I may not be bipolar. Supposedly lithium is bad for certain "temporal lobe" related disorders??
>
> LinkadgeMaybe it's an aspect of the illness, unmedicated:
Posted by linkadge on August 16, 2007, at 20:01:40
In reply to Re: Did Lithium make me irritable and anti-social? » linkadge, posted by Squiggles on August 16, 2007, at 14:56:09
I'm not so sure. I can get angry like anybody but I don't know if anybody I know would classify me as having any type of anger problem. Generally I am not irritable.
Lithium made me irritable, I know its paradoxical as it is sometimes used for agression.
The only think I can think if is that I am temporal lobe sensitive and that the mildly proconvulsant effect of lithium caused irritability.
Linkadge
Posted by Squiggles on August 16, 2007, at 20:04:24
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 16, 2007, at 20:01:40
> I'm not so sure. I can get angry like anybody but I don't know if anybody I know would classify me as having any type of anger problem. Generally I am not irritable.
>
> Lithium made me irritable, I know its paradoxical as it is sometimes used for agression.
>
> The only think I can think if is that I am temporal lobe sensitive and that the mildly proconvulsant effect of lithium caused irritability.
>
> Linkadge
>
>
>
I have only found irritability upon withdrawal
or playing around with the dose, up and down;
otherwise i would categorize this as The Peace Drug, for me anyway.Squiggles
Posted by linkadge on August 16, 2007, at 20:04:53
In reply to Re: Did Lithium make me irritable and anti-social? » linkadge, posted by Squiggles on August 16, 2007, at 14:56:09
From the link you posted:
"Anticonvulsant medications are the treatment of choice for patients with outbursts of rage and abnormal EEG findings."
Although I have never had an EEG, I do think I might often show abnormal EEG activity if tested.
I have a lot of strange symtpoms that some relate to temporal lobe issues. Never had a seizure although relatives have temporal lobe epilepsy and mother with bipolar.Linkadge
Posted by med_empowered on August 17, 2007, at 15:59:38
In reply to Re: Did Lithium make me irritable and anti-social? » Squiggles, posted by linkadge on August 16, 2007, at 20:04:53
lithium might be causing irritation--that can happen, along with dysphoria and personality blunting. If it sucks, get off of it and have your doc do something else.
Posted by Squiggles on August 17, 2007, at 20:15:43
In reply to Re: Did Lithium make me irritable and anti-social?, posted by med_empowered on August 17, 2007, at 15:59:38
> lithium might be causing irritation--that can happen, along with dysphoria and personality blunting. If it sucks, get off of it and have your doc do something else.
It's highly unlikely that lithium can cause irritation-- unlike just about any other drug except the benzos for example, it may knock you out into lethargy and somnabulence. As for personality blunting, that will happen to a bipolar in a manic state. I have never had the so-called lack of creativity or blunting of emotion on lithium. From the papers i have read and the books, it looks like this is a myth.
BTW, i would be interested to hear from people who have switched from lithium to another mood stabilizer.
Squiggles
Posted by linkadge on August 17, 2007, at 21:12:40
In reply to Re: Did Lithium make me irritable and anti-social? » med_empowered, posted by Squiggles on August 17, 2007, at 20:15:43
>It's highly unlikely that lithium can cause >irritation
I would personally disagree with that. Lithium is sometimes combined with another drug to create an animal model of temporal lobe epilepsy. Lithium can be proconvulsant and is often not a good choice for people with epilepsy and bipolar.
In situations where anger problems are a result of temporal lobe issues, ie abnormal EEG, then it is fully concievable that lithium can exaserbate the irritability just as it can worsen some epilepsy.
I agree that it is not normal, but I would not say that it doesn't exist because it can.
>-- unlike just about any other drug except the >benzos for example, it may knock you out into >lethargy and somnabulence. As for personality >blunting, that will happen to a bipolar in a >manic state. I have never had the so-called lack >of creativity or blunting of emotion on lithium.
Well, it is clear that some people don't get side effects that other people do.
>From the papers i have read and the books, it >looks like this is a myth.
Its not a myth. Lithium can reduce creativity
(IMHO). There are many personal accounts painters, actors, writers, musicians who claim that lithium has reduced their creative capacity.I think Robin Williams admits to reducing his lithium at times when he needed to regain certain aspects of his creativity.
>BTW, i would be interested to hear from people >who have switched from lithium to another mood >stabilizer.
I can say that when I was on lithium I had these rage type reactions that abated completely upon switching to either tegretol or depakote.
Like I had said, I may have temporal lobe issues though.
Linkadge
Posted by Squiggles on August 17, 2007, at 21:19:00
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 17, 2007, at 21:12:40
Can't argue with your experience - that's as
valid as you can get for you. About temporal
lobe issues -- that's a pretty large area we
are speaking of -- any literature on this and
lithium's effect would be appreciated.As for Robin Williams, his genius resulted
from mania when he was at his peak; that he
should lower the li for hypomania does not
mean that he lacks creativiy on lithium; just
that he lacks the euphoric, exceptionally
wild comic genius - in itself a creative
rarity.Squiggles
Posted by linkadge on August 17, 2007, at 21:55:08
In reply to Re: Did Lithium make me irritable and anti-social? » linkadge, posted by Squiggles on August 17, 2007, at 21:19:00
>As for Robin Williams, his genius resulted
>from mania when he was at his peak;Genious does not result from illness.
Sexual dysfunction for instance can be a "side effect" of lithium. Ie, a stable person on lithium can have sexual dysfunction. One could argue (incorrectly) that lithium only decreased the mania, and therby decreased the sexual drive.
If a person on lithium can experience decreased sexual desire when stable on lithium, why is it so inconcievable that they experience decreased creativity?
I can give you one possably explination. Lithium lowers DHEA, a powerful steroid hormone that is involved in differentiation of cells in certain regions of the brain. DHEA acts at sig-1r receptors to increase neurite outgrowth in the presence of nerve growth factor. By decreasing DHEA, lithium would reduce such outgrowth and possably creativity. Of course this is speculative, but a possability nonetheless.
Reduced DHEA is observable in mice reciving lithum with normal DHEA levels. Ie there is evidence that lithium can lower DHEA levels even when they are normal.http://biopsychiatry.com/lithium-dhea.htm
>should lower the li for hypomania does not
>mean that he lacks creativiy on lithium; just
>that he lacks the euphoric, exceptionally
>wild comic genius - in itself a creative
>rarity.If Robin is creative only when he is hypomanic, and the lithium kills the hypomania, than lithium has, by default, has killed his creativity.
To me it seems nonsensicle that somebody would try to dismiss what many lithium users have reported.
Linkadge
Posted by Squiggles on August 17, 2007, at 22:28:06
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 17, 2007, at 21:55:08
> >As for Robin Williams, his genius resulted
> >from mania when he was at his peak;
>
> Genious does not result from illness.It does, and particularly with manic-depression;
>
> Sexual dysfunction for instance can be a "side effect" of lithium. Ie, a stable person on lithium can have sexual dysfunction. One could argue (incorrectly) that lithium only decreased the mania, and therby decreased the sexual drive.Lithium does not affect libido, except when decreasing the hypersexuality during manic states.
>
> If a person on lithium can experience decreased sexual desire when stable on lithium, why is it so inconcievable that they experience decreased creativity?Because creativity involves all the areas of the brain including memory, language, emotion, imagination, motivation, associative functions, etc. Whereas sexual desire is distinctly topical.
>
> I can give you one possably explination. Lithium lowers DHEA, a powerful steroid hormone that is involved in differentiation of cells in certain regions of the brain. DHEA acts at sig-1r receptors to increase neurite outgrowth in the presence of nerve growth factor. By decreasing DHEA, lithium would reduce such outgrowth and possably creativity. Of course this is speculative, but a possability nonetheless.
>
>
> Reduced DHEA is observable in mice reciving lithum with normal DHEA levels. Ie there is evidence that lithium can lower DHEA levels even when they are normal.
>
> http://biopsychiatry.com/lithium-dhea.htmThis DHEA theory is just one among many explanations of how lithium works. The ion transfer is an early one, the glutamate theory, the endocrine theory-- this one has to do with its effect on neurochemistry. But lithium is unique in its ability to allow existing chemicals in the brain to pass through cellular openings. I don't know much about it but it is unique in this way, unlike the drugs which alter neurological states.
Squiggles
>
>
> >should lower the li for hypomania does not
> >mean that he lacks creativiy on lithium; just
> >that he lacks the euphoric, exceptionally
> >wild comic genius - in itself a creative
> >rarity.
>
> If Robin is creative only when he is hypomanic, and the lithium kills the hypomania, than lithium has, by default, has killed his creativity.
>
> To me it seems nonsensicle that somebody would try to dismiss what many lithium users have reported.
>
> Linkadge
>
Posted by linkadge on August 17, 2007, at 22:29:26
In reply to Re: Did Lithium make me irritable and anti-social? » linkadge, posted by Squiggles on August 17, 2007, at 21:19:00
Taken from:
http://www.emedicine.com/med/topic3005.htm
A paradoxical increase of aggressivity during lithium treatment has been described in one patient. This patient had a temporal lobe EEG spike focus. His EEG abnormality and aggressivity increased simultaneously after the start of lithium treatment and then improved after the treatment was stopped.
From:
http://www.psychiatrictimes.com/showArticle.jhtml?articleId=186700416
clinical characteristics of “subictal mood disorders,” including brief euphorias, mixed bipolar episodes, brief severe depressive dips with impulsive suicide attempts, compulsive symptoms, irritability and hostile outbursts, and marked premenstrual worsening. Patients with these disorders may also have paradoxical reactions to lithium and antidepressants, with better response to anticonvulsants.
I have seen this reported many times, that patients with certain EEG abnormalties can experience increases in anger and rage following lithium treatment.Linkadge
Posted by linkadge on August 17, 2007, at 22:48:50
In reply to Re: Did Lithium make me irritable and anti-social? » linkadge, posted by Squiggles on August 17, 2007, at 22:28:06
Genious has to do with the interconnectivity of brain cells, not with how they happen to be firing. Perhaps genious is unleashed during periods of mania, but an individual is a genious regardless of the affective state.
>Lithium does not affect libido, except when >decreasing the hypersexuality during manic >states.
Are you kidding me??? Sexual dysfunction, and decreased libito ***IS*** a possable side effect of lithium.
If you are going to sit here and tell me that sexual dysfunction an **impossable** side effect of lithium, I don't think I can continue with this thread!!
>This DHEA theory is just one among many >explanations of how lithium works. The ion >transfer is an early one, the glutamate theory, >the endocrine theory-- this one has to do with >its effect on neurochemistry. But lithium is >unique in its ability to allow existing >chemicals in the brain to pass through cellular >openings. I don't know much about it but it is >unique in this way, unlike the drugs which alter >neurological states.So, you admit to not completely knowing how it works, and yet completely know how it works??
By saying that it is impossable for a drug to produce a particular side effect, you are saying that you completely know how the drug works.
Linkadge
Posted by linkadge on August 17, 2007, at 23:00:58
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 17, 2007, at 22:48:50
So an inverse agonist would still effectivly work to reverse the effect of an agonist (?)
Linkadge
Posted by linkadge on August 17, 2007, at 23:01:52
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 17, 2007, at 23:00:58
Posted by Squiggles on August 17, 2007, at 23:06:12
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 17, 2007, at 22:48:50
> Genious has to do with the interconnectivity of brain cells, not with how they happen to be firing. Perhaps genious is unleashed during periods of mania, but an individual is a genious regardless of the affective state.
I don't konw about the interconnectivity of brain cells and genius -- are you suggesting that if they are close together the person is smarter, or if they are more numerous, or of a particular chemical nature, or shape? A correlation between cells and genius is really ambitious scientifically, or should i say non-scientifically. I would take a humbler approach and look at the mental states of geniuses who have mental illness and see if there is a higher correlation, than the rest of the population. Another approach might be the gross anatomical structure of brains of highly gifted people in mathematics, or linguistics, or memory, for example.
>
> >Lithium does not affect libido, except when >decreasing the hypersexuality during manic >states.
>
> Are you kidding me??? Sexual dysfunction, and decreased libito ***IS*** a possable side effect of lithium.I never had any problems. Perhaps it's your dose?
>
> If you are going to sit here and tell me that sexual dysfunction an **impossable** side effect of lithium, I don't think I can continue with this thread!!
>
Not impossible, but very unlikely for lithium. I'm sorry if that shocks you-- again, dose?
>
> >This DHEA theory is just one among many >explanations of how lithium works. The ion >transfer is an early one, the glutamate theory, >the endocrine theory-- this one has to do with >its effect on neurochemistry. But lithium is >unique in its ability to allow existing >chemicals in the brain to pass through cellular >openings. I don't know much about it but it is >unique in this way, unlike the drugs which alter >neurological states.
>
> So, you admit to not completely knowing how it works, and yet completely know how it works??Now now.... what i have to do here is drudge up all the research on this topic -- i only recall the general themes. I hope to get back to you tomorrow on this, because it's kind of late now.
>
> By saying that it is impossable for a drug to produce a particular side effect, you are saying that you completely know how the drug works.I certainly did not say that, nor mean it.
I'll get back to this when i have more time. I'm sorry it's late for such an extensive topic now.
Squiggles
Posted by linkadge on August 18, 2007, at 9:38:18
In reply to Re: Did Lithium make me irritable and anti-social? » linkadge, posted by Squiggles on August 17, 2007, at 23:06:12
>I don't konw about the interconnectivity of >brain cells and genius -- are you suggesting >that if they are close together the person is >smarter, or if they are more numerous, or of a >particular chemical nature, or shape? A >correlation between cells and genius is really >ambitious scientifically, or should i say non->scientifically.
Actually, there has been plenty of study on Einstein's brain to indicate that there were significant differences compared to a normal human being, more glia, more grey matter, extra 'flaps' along the parietal lobes etc. Smarter mice have significantly more connections among brain cells, they have thicker, denser, coritices etc.
You can take a dumb individual and mimic a manic episode by giving them cocaine / amphetamines etc, but you will not create a genious, because mania is a biochemical alteration.
>I would take a humbler approach and look at the >mental states of geniuses who have mental >illness and see if there is a higher >correlation, than the rest of the population.
As far as I know, there has been no established link between genious and mental illness.
> Are you kidding me??? Sexual dysfunction, and decreased libito ***IS*** a possable side effect of lithium.>I never had any problems. Perhaps it's your dose?
I am not talking about myself in general. It is illogical to say that sexual dysfunction does not occur simply because you never had that side effect.
>Not impossible, but very unlikely for lithium. >I'm sorry if that shocks you-- again, dose?It all depends on who you talk to. Pro-lithium books will tend to downplay such side effects.
http://www.sexualwholeness.com/isw/resources/7092/SEX%20BUSTERS%20&%20BUSTERS.pdf
"It (lithium) appears to interfere with libido and erection in some males (Aizenberg, et al., 1996) and may effect fertility due to birth defects, and decreased or malformed sperm (Crenshaw &
Goldberg, 1996)."http://www.cancer.gov/cancertopics/pdq/supportivecare/sexuality/HealthProfessional/page4
"Selective serotonin-reuptake inhibitors (SSRIs), tricyclics, monoamine oxidase inhibitors, and lithium have all been associated with sexual dysfunction.[19,20]
http://www.rxlist.com/cgi/generic/lithium_ad.htmRX list notes the side effect of lithium:
"impotence/sexual dysfunction"
http://www.bipolarworld.net/Phelps/ph_2003/ph1013.htm
Case Reports
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=8937790&dopt=AbstractPlus(31.4%) reported sexual dysfunction on at least two items of the sexual function questionnaire. Notable results were reduction in frequency of sexual thoughts and loss of erection during sex in 23 and 20% of patients, respectively.
..
So, I think it is possable
Linkadge
Posted by Squiggles on August 18, 2007, at 10:53:22
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 18, 2007, at 9:38:18
> >I don't konw about the interconnectivity of >brain cells and genius -- are you suggesting >that if they are close together the person is >smarter, or if they are more numerous, or of a >particular chemical nature, or shape? A >correlation between cells and genius is really >ambitious scientifically, or should i say non->scientifically.
>
> Actually, there has been plenty of study on Einstein's brain to indicate that there were significant differences compared to a normal human being, more glia, more grey matter, extra 'flaps' along the parietal lobes etc. Smarter mice have significantly more connections among brain cells, they have thicker, denser, coritices etc.
>
> You can take a dumb individual and mimic a manic episode by giving them cocaine / amphetamines etc, but you will not create a genious, because mania is a biochemical alteration.I will give up the point on the correlation-- there have been many artists, politicians and mathematical and physics geniuses with either depression, or manic-depression, but i agree with you that statistical studies are hard to find. Is it possible that altered states may actually enhance an already very intelligent person to creative thinking that he would not otherwise have access to? Just a suggestion.
>
> >I would take a humbler approach and look at the >mental states of geniuses who have mental >illness and see if there is a higher >correlation, than the rest of the population.
>
> As far as I know, there has been no established link between genious and mental illness.Yes, i have searched and there are many discussions on the perceived link; but no concrete data. One thing to keep in mind is that being mentally ill means thinking in different and possibly insightful ways into some problems or being creative. As for IQ-- that has always been a nebulous concept to define anyway.
>
>
> > Are you kidding me??? Sexual dysfunction, and decreased libito ***IS*** a possable side effect of lithium.
>Pub Med articles on this:
1. In this one, it is the combination of lithium and benzos that create libidinal problems not lithium alone:
2. In this article, sexual satisfation and ability is pretty good, and comparable between taking lithium and not taking lithium:
3. A general overview, including "lowered libido" along with "greyness of life" -- very subjective and complaints that you can have by taking Ibuprofen for that matter:
----------------
PubMed has many articles on this topic, and it seems that according to a) the design of the model for testing, b) the dose and years of taking the drug, and most importantly c) the combination of lithium taken with other drugs, has a greater significance not only on libido strength, but on other motivational aspects of biological phenomena, e.g. lethargy.
> >I never had any problems. Perhaps it's your dose?
>
> I am not talking about myself in general. It is illogical to say that sexual dysfunction does not occur simply because you never had that side effect.Yes, I am sure others have it, but to have any meaningful and practical use in medicine, it must be compared with other drugs, with the dose, with the combination of drugs, and with the original illness for which lithium is given in the first place.
>
> http://www.sexualwholeness.com/isw/resources/7092/SEX%20BUSTERS%20&%20BUSTERS.pdf
>
> "It (lithium) appears to interfere with libido and erection in some males (Aizenberg, et al., 1996) and may effect fertility due to birth defects, and decreased or malformed sperm (Crenshaw &
> Goldberg, 1996)."
>Yeah, i saw that -- as i said there are too many disparate reports to draw a uniform conclusion on this matter. Some things are certain in psychopharmacology-- this is not.
> http://www.cancer.gov/cancertopics/pdq/supportivecare/sexuality/HealthProfessional/page4
>
> "Selective serotonin-reuptake inhibitors (SSRIs), tricyclics, monoamine oxidase inhibitors, and lithium have all been associated with sexual dysfunction.[19,20]
>
Yeah, alcohol too and don't forget someone you don't like sleeping with.>
> http://www.rxlist.com/cgi/generic/lithium_ad.htm
>
> RX list notes the side effect of lithium:
>
> "impotence/sexual dysfunction"
>
> http://www.bipolarworld.net/Phelps/ph_2003/ph1013.htm
>
> Case Reports
>
>
> http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=8937790&dopt=AbstractPlus
>
> (31.4%) reported sexual dysfunction on at least two items of the sexual function questionnaire. Notable results were reduction in frequency of sexual thoughts and loss of erection during sex in 23 and 20% of patients, respectively.
>
> ..
>
> So, I think it is possableI am sure it is possible. There are reports pro and con this assertion about libido and lithium. The fact that there are variations, and that not only lithium but other ADs esp. SSRIs, have effects not only libido but appetites in general and motivational strengths, leaves a lot to be desired in understand and explanation of what exactly is going on?
I just hope that they don't try to treat such finding with Viagra -- because that has nothing to do with libido at all, and may be confused with muscle-vascular changes.
Squiggles
Posted by Maximus on August 18, 2007, at 14:42:28
In reply to Re: Did Lithium make me irritable and anti-social?, posted by linkadge on August 18, 2007, at 9:38:18
Yes lithium can make someone irritable. It's not very common though.
Sexual dysfunction may also be a side effect when used with an SSRI. Also in the long run, lithium decreases testosterone.
A competent psychiatrist will always use a low dose of lithium with an anticonvulsant to manage side effects and get better results.
Posted by Squiggles on August 18, 2007, at 15:32:48
In reply to Re: Did Lithium make me irritable and anti-social?, posted by Maximus on August 18, 2007, at 14:42:28
> Yes lithium can make someone irritable. It's not very common though.
>
> Sexual dysfunction may also be a side effect when used with an SSRI. Also in the long run, lithium decreases testosterone.
>
> A competent psychiatrist will always use a low dose of lithium with an anticonvulsant to manage side effects and get better results.
>
>Hi Maximus,
How do you know that? All the medical books
have the same regulations about dose; including
Dr. Nemeroff Clinical Guide.Squiggles
Posted by Maximus on August 19, 2007, at 15:54:25
In reply to Re: Did Lithium make me irritable and anti-social? » Maximus, posted by Squiggles on August 18, 2007, at 15:32:48
> > Yes lithium can make someone irritable. It's not very common though.
> >
> > Sexual dysfunction may also be a side effect when used with an SSRI. Also in the long run, lithium decreases testosterone.
> >
> > A competent psychiatrist will always use a low dose of lithium with an anticonvulsant to manage side effects and get better results.
> >
> >
>
> Hi Maximus,
>
> How do you know that? All the medical books
> have the same regulations about dose; including
> Dr. Nemeroff Clinical Guide.
>Hi,
Sorry i'm late. I know what you mean. The lithium's "protocol" is excatly the same, everywhere, IF you take it alone for the treatment of bipolar I disorder. I spare you the details, but as you already know the classical goal is to achieve a blood level of approx 0.8 mml/L, and bla bla bla.
Otherwise, if lithium is taken as an add-on for the treatment of bipolar II or for the treatment-resistant depression then the original lithium guidelines is not followed. Often better results are achieved with fewer side effects.
It is based on empirical evidences of new abstracts and the experiences of some "virtual" friends.
M.
Posted by Squiggles on August 19, 2007, at 16:10:38
In reply to Re: Did Lithium make me irritable and anti-social? » Squiggles, posted by Maximus on August 19, 2007, at 15:54:25
> > > Yes lithium can make someone irritable. It's not very common though.
> > >
> > > Sexual dysfunction may also be a side effect when used with an SSRI. Also in the long run, lithium decreases testosterone.
> > >
> > > A competent psychiatrist will always use a low dose of lithium with an anticonvulsant to manage side effects and get better results.
> > >
> > >
> >
> > Hi Maximus,
> >
> > How do you know that? All the medical books
> > have the same regulations about dose; including
> > Dr. Nemeroff Clinical Guide.
> >
>
> Hi,
>
> Sorry i'm late. I know what you mean. The lithium's "protocol" is excatly the same, everywhere, IF you take it alone for the treatment of bipolar I disorder. I spare you the details, but as you already know the classical goal is to achieve a blood level of approx 0.8 mml/L, and bla bla bla.
>
> Otherwise, if lithium is taken as an add-on for the treatment of bipolar II or for the treatment-resistant depression then the original lithium guidelines is not followed. Often better results are achieved with fewer side effects.
>
> It is based on empirical evidences of new abstracts and the experiences of some "virtual" friends.
>
> M.Thanks,
I believe you. Infact, if i were not taking a benzo, it is possible that my li dose would be higher, but i doubt that such fine tinkering is part of general medical policy. If i recall correctly, the benzo was given to me when i started a difficult job just after being prescribed li; and that was because on an interview i said that i was a little nervous and had panic attacks (which are now erratic and less after the thyroxine reduction).
So, maybe i could have done with a lower li dose.
I think that more attention to details is available in the high-tech area, and even marketing of products and tinkering with car engines; i do not mean to show disrespect for the work being done in this area; it is just my impression that tinkering with meds is a very fine and exacting art. I don't think we have the resources for perfection, and those who have been on meds most of their life get to self-monitor details which staff may not. There are worse things than not getting the perfect dose, such as coming into ER with a car head or spine injury.
Squiggles
This is the end of the thread.
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