![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 9 to 33 of 71. Go back in thread:
Posted by Paulie on May 31, 2003, at 10:01:49
In reply to LITHIUM level » paulie, posted by Janelle on May 30, 2003, at 22:29:10
You may be below the therapeutic window on both lithium and depakote. If you cannot tolerate higher doses of lithium due to side effects I would suggest replacing it with lithium orotate. It is a form of lithium that requires no blood tests and side effects are pretty much non-existent. It's non-prescription and is 20 times more bio-active than other forms of lithium so lower doses are just as effective as much higher doses of the prescription forms of lithium. This is the reason for low (or no) side effect profile. Switching over to this may allow to tolerate a higher dose of depakote since you won't be getting the possible side effects from the lithium you're presently on. Standard dose is 2-6 caps per day. Standard lithium level ranges do not apply to lithium orotate so a lithium level test is meaningless. Here's some info about it:
Lithium, like sodium, occurs naturally in a number of different salts. Lithium carbonate and lithium citrate are approved as prescription forms of lithium. The citrate and carbonate salts are only slightly soluble in water, and are poorly absorbed by the cells. Another form of lithium — lithium orotate — is a highly bioavailable form of lithium that is available as an over-the-counter dietary supplement. (24) Because of its superior bioavailability, lower doses of lithium orotate than lithium carbonate (or lithium citrate) may be used to achieve therapeutic brain lithium concentrations and relatively stable serum concentrations. (25)
Lithium orotate has also been demonstrated to be of benefit in the treatment of alcoholics, and proved useful in alleviating alcohol-related symptoms of liver dysfunction, seizure disorders, headaches, hyperthyroidism, affective disorders. Meniere’s syndrome, and liver and lung cancers. (25)
Standard lithium orotate dietary supplements provide 5 mg lithium. This is 1 to 2 percent of the dose provided by prescription forms of lithium.
Safety Issues
Bipolar patients commonly take 200 to 400 mg lithium per day (this is approximately 1,000 to 2,000 mg lithium carbonate). (18) Because the blood levels of lithium citrate or lithium carbonate that have been demonstrated to be therapeutic are only slightly below the level that has been determined to be toxic, patients who take these prescription forms of lithium require regular blood tests to make sure their serum lithium concentrations stay below the toxic range. Adverse side effects and the inconvenience of frequent blood tests cause many patients to discontinue treatment with these prescription drugs.
Paul
Posted by noa on May 31, 2003, at 10:38:18
In reply to Anyone else have THIS KIND of depression ???, posted by Janelle on May 30, 2003, at 19:58:35
Yes, once in a while I get that. It is pretty awful.
Posted by noa on May 31, 2003, at 10:40:38
In reply to Re: LITHIUM level » Janelle, posted by Paulie on May 30, 2003, at 23:03:14
Janelle,
Sounds like you do need that mood stabilizer. But with Lithium, make sure also to monitor your thyroid well (I see that you posted a question about thyroid above, too). Lithium can contribute to hypothyroidism, which can include the kind of lethargy and fatigue that you mention. If you take lithium, you may need help with the thyroid to keep it at a level that helps you feel ok.
Posted by Ron Hill on May 31, 2003, at 15:28:10
In reply to OOPS - didn't state original post quite right! » Paulie, posted by Janelle on May 30, 2003, at 21:41:55
> Oh gosh, I think I did not phrase my post properly! I am on an a-d (Celexa) which knock on wood IS working - what is NOT working is mood stabilization - meaning I swing from hypomanic (lots of energy, anger, impatience, aggressiveness) for quite some time until my body can no longer sustain that kind of prolonged angry energy and I crash into depression where I head to bed and remain there for days. Then the cycle starts again - I have re-energized my battery, go hypomanic for a spell, get depressed, etc. ACCCCCCCK.
--------------------------Hi Janelle,
Sorry to hear that you are cycling. :-(
I can totally relate to the hypersomnia during the depressive phase of the cycle. I believe that the hypersomnia is one of the symptomatic components of atypical depression.
Is it possible that the Celexa is causing (or contributing to) your mood instability? Please read the following information. It is on Dr. Phelps' web site and it discusses the controversy surrounding BP patients taking antidepressants:
http://www.psycheducation.org/bipolar/controversy.htm
Over the years I tried almost all of the SSRI/SNRI's as an add-on to a moodstabilizer for treatment of the atypical depressive side of my BP II. Unfortunately, each and every time the AD eventually left me in worse shape than I was without it.
This put me in a difficult place for several years. I struggled with depression when using just a moodstabilizer, but the situation would become even worse shortly after adding-on an AD. Therefore, I turned my attention to supplements for treatment of my depressive side. About 18 months ago, I had good success using 200 mg/day of SAM-e. However, out of the blue after five months of very good results, SAM-e started to induce severe irritability and I pulled the plug on it.
The good news is that, with the help of others on this board, I have found a medication/supplements combo that is currently working incredibly well. I take 600 mg/day of Lithobid for my hypomania, 2.5 mg twice a week of Enada NADH in conjunction with 250 mg/day of TMG to treat the atypical depressive phase of my BP II disorder, and 250 mg/day of niacin to control my dysphoric mood states (irritability). I think the niacin is also helping my depression, but its main function is to control my irritability which it does exceedingly well.
I'll not bore you by listing all of the vitamins, minerals and supplements that I take since they are numerous. However, the ones I mentioned above are the heavy hitters and they are the main contributors to my current good mental health. Magnesium, fish oil, and phosphatidyl serine, are definitely worth honorable mention.
Janelle, I took the liberty of reproducing some of the above information from one of my previous posts. It's not that I don't care enough about you to draft an original message, but instead it's that I'm cramped for time and I think that what I posted previously may also be applicable to your particular situation.
Specifically, I wonder if supplements could play a more central role in the treatment of your atypical depression and anxiety/irritability. If I were in your shoes, I’d keep and slightly increase the Depakote and lithium. Since SSRIs induce mood instability for so many bipolar patients, I’d slowly discontinue the SSRI and simultaneously try various supplements that might serve to treat the depressive side of your BP. Clearly, I’m biased since this approach has worked so well for me. Further, if I were in your shoes, I’d wean off of the benzo and try to use a supplement(s) to treat the anxiety/irritability.
This approach will require you to do some homework to find the supplements that will work for you. For depression, I recommend that you start your search by considering Enada NADH, TMG, and niacin. Other supplements for possible consideration for depression would include SAM-e and St John’s Wort. For anxiety/irritability, I recommend that you consider niacin, niacinamide, and/or picamilon. Here is a link for the later one:
http://www.smart-drugs.com/picamilon-article.htm
Further, I find that fish oil provides a good mood stabilizing effect and has some antidepressant properties. I take about 20 ml (4 tsps) per day of Carlson’s Fish Oil. I go through three of the 200ml bottles each month and at $19.90 (retail) per bottle it is kind of expensive (about $1.50 per day). Also, magnesium might help you. I take 800 mg/night (400 mg of Mg citrate and 400 mg of Mg malate) at bedtime. It’s a great sleep aid and I’m convinced that it improves my brain chemistry.
Please take what I’ve said with a grain of salt. You know your particular situation way better than I do, of course.
One final note. If I ever find myself in need of a prescription antidepressant in the future, I’ll try an MAOI (e.g.; Nardil) because I’m convinced from what I’ve read that MAOIs work better for bipolar patients than SSRI/SNRIs.
One thing about us bipolars, we sure are opinionated, aren’t we?
I send to you my best wishes, Janelle.
-- Ron
Posted by Janelle on May 31, 2003, at 23:30:13
In reply to Re: Janelle's Medication » Janelle, posted by Ron Hill on May 31, 2003, at 15:28:10
OMG, so much info, so much help, so much support. I will definitely mention the LITHIUM OROTATE to my pdoc this week (he's into natural stuff! Wants to get me off Synthroid onto some natural thyroid booster!). I've also heard that ANYTHING OROTATE is very bio-available; the most bio-available.
Ron's info is too much for me to absorb right now. All I can say is I know that SSRI's can cause mania/hypomania but I'm worse off them than on them. Perhaps I just need to lower the Celexa a notch.
I'll get back to this stuff soon. I'm not feeling well and can't concentrate on it.
Posted by Simcha on June 1, 2003, at 2:58:11
In reply to Anyone else have THIS KIND of depression ???, posted by Janelle on May 30, 2003, at 19:58:35
> Where you LITERALLY stay in bed all day, day after day only getting up to go to the bathroom and maybe eat or probably more likely drink something?
>
> I feel so ALONE in this; but depression manifests itself this way with me - I stay in my bed on and on and on.Janelle,
This sound eerily familiar. During my last major depressive episode I only got out of bet to play video games, drink something, and go to the bathroom. I fed the cat too. I seemed very disinterested in food. This is not my normal way of being in the world. Major depression sucks. There is just no way around that.
Do you think that perhaps this has kicked in as an effect of the withdrawal from the Klonopin? I don't know. I'm not an expert on it. I never did learn why you were coming off of the Klonopin. I did it because my pdoc thought that Neurontin would be better for me. As I was decreasing Klonopin I was increasing Neurontin.
I wish you every blessing and I hope you feel better soon,
Simcha
Posted by McPac on June 1, 2003, at 11:52:44
In reply to LITHIUM level » paulie, posted by Janelle on May 30, 2003, at 22:29:10
Lithium CAN work very well for some at sub-therapeutic levels (I take a puny dose myself and it DOES work).
Posted by McPac on June 1, 2003, at 11:59:28
In reply to Re: LITHIUM OROTATE » Janelle, posted by Paulie on May 31, 2003, at 10:01:49
How would someone know how much lith. orotate to use when switching from lith. carbonate to lith. orotate? Thanks!
Posted by McPac on June 1, 2003, at 12:13:33
In reply to Re: Janelle's Medication » Janelle, posted by Ron Hill on May 31, 2003, at 15:28:10
Hi Ron,
Just wondering, how do you think you would be IF you discontinued your lithium? Thanks
Posted by Paulie on June 1, 2003, at 16:22:49
In reply to Paulie, Re: LITHIUM OROTATE, posted by McPac on June 1, 2003, at 11:59:28
Lithium orotate comes in caps and tabs of 120mg and also tabs of 134mg.
120mg LiOrotate is equivalent to ~500mg lithium carbonate.LiOrotate is ~ 4% elemental Lithium.
LiCarbonate is ~ 20% " " .120mg LiOrotate contains~4.8mg elemental lithium.
500mg LiCarbonate contains ~ 100mg " " .You can see from this the 20x bio-activity of LiOrotate over LiCarbonate.
For bi-polar diorder a starting dose would be 1 cap(tab) 3x/day. If mood doesn't stabilize the dosage can be increased gradually to 6/day.
Even at 6/day your lithium intake is about half that of 1 300mg tab lithium carbonate.
Dietary supplement dose is 1-2/day.It's pretty cheap too. Vitamin Research sells 120mg caps-qty.120 for $11.95. There are other places that sell it for even less.
Here's an interesting article about lithium-
http://vrp.com/art/718.asp?c=1054391658919&g=lithium&k=/srch/lithium.asp&m=/vstyle.cssSo how's it going with the Remeron? Are you still on it? I know you cut down on the dose.
Paul
Posted by Ron Hill on June 1, 2003, at 17:20:46
In reply to Ron, Re: Janelle's Medication, posted by McPac on June 1, 2003, at 12:13:33
Hi McPac,
> Just wondering, how do you think you would be IF you discontinued your lithium? Thanks
I'd become slightly or moderately hypomanic within the first couple of days. For example, my thoughts would go in several directions in a rapid fire fashion (like quickly changing channels on the TV) and, as a result, I'd finish little or nothing. Or, alternatively, I might hyper-focus on a low priority task while ignoring the urgent ones. Further, I act kind of childish and giddy when I'm hypomanic and I tend to be impulsive and socially inappropriate.
Each morning when I wake up I am ever so slightly hypomanic until I take my morning dose of Lithobid. I love the creative ideas I get when I'm hypomanic, but my productivity is low.
If I continued to go for a long period of time without a moodstabilizer (i.e.; lithium), I suspect I would begin to cycle between hypomanic, normal, and depressed mood states.
-- Ron
Posted by Janelle on June 1, 2003, at 18:51:08
In reply to Re: Anyone else have THIS KIND of depression ???, posted by Paulie on May 30, 2003, at 21:20:18
Paulie, I can't begin to thank you for the SIMPLE, PLAIN ENGLISH info and links you have given me about Lithium OROTATE. I have printed out and then made copies for my pdoc of a few of your posts about it and am hoping he will switch me over to it and understand the dosing correspondence.
If he does this, I also hope that he will increase my Depakote. Somewhere in this long thread someone (you?) said that if I switch to Lithium Orotate, I may no longer have problems with a higher dose of Depakote (which is what I think I need!)
Thanks again, Paulie.
Posted by Janelle on June 1, 2003, at 18:57:52
In reply to Re: Anyone else have THIS KIND of depression ??? » Janelle, posted by Simcha on June 1, 2003, at 2:58:11
I can assure you with like 100% confidence level that any depressive episodes I go through have NOT kicked in as a result of withdrawal from Klonopin as I have NOT YET started tapering off it!!
Also, Klonopin is anti-anxiety med, not an antidepressant and does NOTHING for depresion. Also, it does NOTHING for me with my anxiety, it's like a placebo because I've taken it for so long. It's a benzo and your body becomes sed to it and it poops out unless you increase the dose, which I have NO intention of doing. I want OFF the stuff simply because it is NOT helping me; Buspar is. I had tried Neurontin and all it did was make me drowsy all day.
How much Neurontin are you on and how is it working? Also, I am guessing you are OFF the Klonopin - how much had you been on and how long did it take you to get off it? Thanks.
Posted by Simcha on June 1, 2003, at 21:46:59
In reply to SIMCHA: re KLONOPIN and NEURONTIN: » Simcha, posted by Janelle on June 1, 2003, at 18:57:52
Janelle,
My current pdoc told me that Klonopin could have the side effect of depression. It's interesting that you are experiencing depression while on Klonopin. I'm not sure why you think that Klonopin is a placebo.
For me it stopped me from grinding my teeth at night. It also worked with my restless legs. I noticed that it made me feel good while I was being treated with Celexa and Wellbutrin. For me it was a mood lifter.
My pdoc also told me that Klonopin can interrupt sleep patterns. That is, you may not get the right kinds of sleep in one night.
I hope I have not offended you. As I said, I'm not an expert and I'm no pdoc. I'm just a person who has been treated for Major Depressive Disorder and for some time Klonopin provided some relief from bruxism and RLS.
I was only on 1mg of Klonopin per night. That was for over a year.
My current pdoc suggested that I switch the Klonopin for Neurontin since Neurontin could help me by keeping the bruxism and RLS under control without the interruption of the sleep cycle.
Eventually I titrated up to 600mg of Neurontin per night. So here is my combo:
AM Doses:
40mg Celexa
200mg WellbutrinSR
Before Bed:Neurontin 600mg
During the entire year I was on Klonopin, 1mg per night did the trick. I did not need to increase dosage for effectiveness. Many people on the board have been at the same level of Klonopin for years and have had no problems.I was wondering if the depression was partially due to withdrawal from Klonopin because I've read that withdrawal can include depressive symptoms.
I hope I have not confused you or led you to believe that I have more answers than my experience with Klonopin. Please remember that I'm not a doctor or an expert.
Blessings,
Simcha
> I can assure you with like 100% confidence level that any depressive episodes I go through have NOT kicked in as a result of withdrawal from Klonopin as I have NOT YET started tapering off it!!
>
> Also, Klonopin is anti-anxiety med, not an antidepressant and does NOTHING for depresion. Also, it does NOTHING for me with my anxiety, it's like a placebo because I've taken it for so long. It's a benzo and your body becomes sed to it and it poops out unless you increase the dose, which I have NO intention of doing. I want OFF the stuff simply because it is NOT helping me; Buspar is. I had tried Neurontin and all it did was make me drowsy all day.
>
> How much Neurontin are you on and how is it working? Also, I am guessing you are OFF the Klonopin - how much had you been on and how long did it take you to get off it? Thanks.
Posted by Ron Hill on June 1, 2003, at 23:37:58
In reply to , Re: LITHIUM OROTATE » McPac, posted by Paulie on June 1, 2003, at 16:22:49
Larry,
I'd heard about lithium orotate before but I had always dismissed it out-of-hand by saying to myself "a Li ion, is a Li ion, is a Li ion." However, when the topic came up on the board this time around, I looked into it and I'm starting to think that there may be something to this lithium orotate thing after all.
If the sales pitch is true and the lithium orotate does indeed cross the cell membrane more readily than the inorganic Li ion, then an equivalent pharmacological effect might be accomplished with reduced Li blood levels. This in turn would reduce the side effects including possible thyroid damage from long-term use of lithium.
As you know, I take a low dosage (600 mg/day) of Lithobid. I am convinced that lithium provides neuroprotective effects in the brain. However, even at my relatively low Li blood level (0.4 mEq/l) the lithium causes some amount of rash. The bigger issue, however, is the possibility of thyroid damage with long-term lithium use at these blood levels.
Since I am self-insured, the cost of prescription lithium carbonate is comparable to the cost of the lithium orotate supplement product.
Larry, I highly value your opinion and I have learned much from your writings (we are fortunate to have you here). If you have time, could you please read this link and give me your opinion?
Specifically, does Li orotate enter the cells more efficiently than inorganic Li, thereby, facilitating a marked reduction in the dosage required when using the Li orotate product?
Also, although the web page does not specifically say this, I get the impression that the lithium orotate crosses the cell membrane prior to dissociation (i.e.; the Li ion is still bound to the transporter molecule). If this is true, when and where does the Li ion break free from the transporter molecule so that the Li ion can start doing whatever it does as a moodstabilizer?
And finally, Lithobid is a slow-release product. I doubt that the lithium orotate product has a slow-release feature.
Here's the link.
http://www.findserenitynow.com/product_info_4.html
Thank you sooooooooo much.
-- Ron
Posted by Larry Hoover on June 2, 2003, at 8:51:48
In reply to Re: Larry what do you think about lithium orotate?, posted by Ron Hill on June 1, 2003, at 23:37:58
> Larry,
> If the sales pitch is true and the lithium orotate does indeed cross the cell membrane more readily than the inorganic Li ion, then an equivalent pharmacological effect might be accomplished with reduced Li blood levels. This in turn would reduce the side effects including possible thyroid damage from long-term use of lithium.I think that claims such as that require some evidence. I can't find any.
The best theory I've yet seen is that lithium ions interfere with calcium-dependent gene regulation within the cell, effectively down-regulating a number of processes. Yes, that happens inside the cell, but there is so much ion movement in and out of the cell, lithium doesn't just stay there.
> Since I am self-insured, the cost of prescription lithium carbonate is comparable to the cost of the lithium orotate supplement product.
If you want to give it a try, I'd consider it to be an experimental treatment. Lithium orotate was considered for use about 25 years ago, and it was dropped from consideration, for whatever reason.
> Larry, I highly value your opinion and I have learned much from your writings (we are fortunate to have you here). If you have time, could you please read this link and give me your opinion?Thanks, Ron. My pleasure.
> Specifically, does Li orotate enter the cells more efficiently than inorganic Li, thereby, facilitating a marked reduction in the dosage required when using the Li orotate product?Not that I can find evidence for.
> Also, although the web page does not specifically say this, I get the impression that the lithium orotate crosses the cell membrane prior to dissociation (i.e.; the Li ion is still bound to the transporter molecule).That's what they want you to believe.
>If this is true, when and where does the Li ion break free from the transporter molecule so that the Li ion can start doing whatever it does as a moodstabilizer?
Good question. Does the molecule magically know when it has arrived at its destination? I don't know. There are orotic acid transporters, as orotic acid is a precursor to RNA, but why that would be better than the pre-existing Na+/Li+ transporter is beyond me.
> And finally, Lithobid is a slow-release product. I doubt that the lithium orotate product has a slow-release feature.They're suggesting it's inherent, I think.
> Here's the link.
>
> http://www.findserenitynow.com/product_info_4.html
>
> Thank you sooooooooo much.
>
> -- Ron
>Like I said, my pleasure. I like questions, and ones like this one, even more than many others.
I looked at the web-link before I went to Pubmed, etc., and my gut-reaction was a bullshit-detector activation. Here are my thoughts, relevant to quotes from the site.
"Lithium carbonate and lithium citrate are both inorganic salts."
Pardon me? Organic means carbon-based. We have carbonate (CO3--), and citrate (C6H5O7---). Nothing inorganic about those ions.
"Lithium carbonate usually comes in 300mg and 450mg capsules. A common amount that might be prescribed would be 600-1200mg per day. Once ingested; the digestive system will break off the mineral lithium from the lithium compound, allowing the free mineral ion to enter the blood stream."
It doesn't break the lithium off, it dissolves it. Why the semantic twisting? Moreover, we know that lithium readily enters the blood from the gut, so what's the issue?
"In order to have a physiological effect, the lithium mineral ion will have to pass from the blood stream through cell membranes in order to enter the necessary cells."
No shit! They use the Na+/Li+ transporter.
"Lithium carbonate and lithium citrate do not have mineral transport capability..."
At this point, the lithium salts have ceased to exist, so this is a distraction or deception.
"Inorganic lithium compounds are used to insure that the lithium levels in the blood stream are high enough so that enough lithium enters the brain cells to be effective. Unfortunately, lithium in high doses is relatively toxic and blood lithium monitoring is necessary when these inorganic lithium salts are used."
Lithium flux goes both ways. Even if the lithium orotate efficiently transports lithium into neurons, and dissociates in a timely manner, the lithium will then both leak out, and be pumped out. The "high blood concentrations" mentioned are a necessary component of ionic equilibrium. Uptake has to equal release (from a whole cell vs. blood concentration perspective, across the cell membrane) at some point in time, and if there's none in the blood, there will soon be none in the neuron.
"Dr. Nieper developed the organic lithium salt in Serenity."
Ohh? And Dole invented the Internet.
"Serenity has mineral transport capability. Dr. Nieper developed the organic lithium salt in Serenity - which is a lithium mineral transporter. This means that the organic lithium salt in Serenity remains intact through the digestive system so that the entire compound enters the blood stream with most of the lithium still bound to the transporter molecule. Since the mineral transporter in Serenity enables the entire compound to enter the blood stream - the amount of Lithium used can be drastically reduced."
So, how does the orotic acid preferentially target brain neurons? Little maps? Kidney and liver have very high affinities (uptake capacity) for orotic acid. Moreover, calling orotic acid a lithium mineral transporter is deceptive. If it is a mineral transporter, it's not specific to lithium.
"In fact: the organic lithium in Serenity contains about 5 times less elemental lithium per 100mg than lithium carbonate. The amount of lithium that enters the blood stream is significantly lower when lithium mineral transporters are used."
...because you take less in.
"In addition our human cells rapidly absorb the lithium transporters in Serenity, so that the amount that stays in the blood stream is relatively low."
As I said, but most are not in the brain.
"In fact: because of these factors: It is difficult to obtain measurable lithium levels in the blood with the lithium mineral transporter in Serenity."
Equilibrium lies to which side? Brain loses this one.
"It is important to recognize that high doses of any lithium compound will be toxic -- so the lithium mineral transporter in Serenity provides a safety from this toxicity as only low doses of lithium are used."
Proof of efficacy?
"Lithium carbonate contains 18.8mg of elemental lithium per 100mg. With the mineral transporter, it is only necessary for Serenity to contain 3.83mg of elemental lithium per 100mg."
What a distorted way to present the mass ratios of the two salts.
"The effective dose of lithium carbonate usually ranges from 600mg (113mg elemental lithium) to 1200mg (226mg elemental lithium). Dr. Nieper reports: an effective dose of Serenity is between 2-6 120 mg tablets per day. One 120mg tablet of Serenity contains 4.6mg of elemental lithium.
2 tablets of Serenity contains 9.2 mg of elemental lithium.
6 tablets contain 27.6 mg."Nothing in the literature to suggest those are effective doses for lithium orotate.
"Interactions of the inorganic lithium compounds, lithium carbonate & citrate, may occur with: antithyroid pills, diuretics. medications for asthma, bronchitis, cystic fibrosis, emphysema, or sinusitis. Serenity helps to avoid these interactions by keeping the lithium levels in the body very low."
Proof it doesn't work?
"No lithium compounds are habit-forming, however, long-term use of inorganic lithium carbonate and lithium citrate may cause thyroid and kidney problems. Again -- Serenity strongly helps to avoid these problems by keeping the lithium levels low."
Maybe rats aren't representative mammals, but maybe they are.
J Pharm Pharmacol 1979 Mar;31(3):161-3
Kidney function and lithium concentrations of rats given an injection of lithium orotate or lithium carbonate.
Smith DF, Schou M.
A recent study by Kling et al (1978) noted the finding of higher lithium concentrations in serum and brain of rats after an intraperitoneal injection (2 mmol lithium kg-1) of lithium orotate as a slurry than of lithium carbonate in solution. The authors suggested that lithium orotate might offer advantages in the treatment of patients. We repeated the experiments of Kling et al but in addition examined the kidney function of the rats. Glomerular filtration rate and urine flow were markedly lower in rats given lithium orotate than in rats given lithium carbonate, sodium chloride or a sham injection. The renal lithium clearance was significantly lower, the kidney weight and the lithium concentrations in serum, kidney and heart significantly higher after injection of lithium orotate than after injection of lithium carbonate. The higher lithium concentrations could be accounted for by the lower kidney function. It seems inadvisable to use lithium orotate for the treatment of patients.
"It is important not to take any type of lithium (organic or inorganic) during pregnancy as lithium can be counterproductive during these 9 months."
Evidence? Huh?
Ron, I'm biased. Read between my words. I don't like my gut reaction. Are my arguments rational?
Lar
Posted by Larry Hoover on June 2, 2003, at 8:57:47
In reply to Re: LITHIUM OROTATE » Janelle, posted by Paulie on May 31, 2003, at 10:01:49
> You may be below the therapeutic window on both lithium and depakote. If you cannot tolerate higher doses of lithium due to side effects I would suggest replacing it with lithium orotate. It is a form of lithium that requires no blood tests and side effects are pretty much non-existent. It's non-prescription and is 20 times more bio-active than other forms of lithium so lower doses are just as effective as much higher doses of the prescription forms of lithium. This is the reason for low (or no) side effect profile. Switching over to this may allow to tolerate a higher dose of depakote since you won't be getting the possible side effects from the lithium you're presently on. Standard dose is 2-6 caps per day. Standard lithium level ranges do not apply to lithium orotate so a lithium level test is meaningless. Here's some info about it:
>
> Lithium, like sodium, occurs naturally in a number of different salts. (snip)Hey, Paul. Where'd you get the quote? My opinion is that you should include a link with a quote like that, so people can check the references (numbered in the quote, but not included with it).
thanks,
Lar
Posted by Barbara Cat on June 2, 2003, at 11:55:42
In reply to Paulie, Re: LITHIUM OROTATE, posted by McPac on June 1, 2003, at 11:59:28
Hey folks, be real real careful with Lithium Orotate 'replacing' lithium carbonate. The hype that it is a more bioavailable form IS NOT TRUE. At least, not in the amounts given through primarily anecdotal suggestions. Paulie, please take care in recommending someone replace their lithium med with Li orotate. I wonder if Paulie has personal experience in taking it? I have, and started with great hope and a relatively clean slate, having run out of lithium a week prior. I took the conversion doses for two weeks and began feeling good old hypomania surfacing. Increased the dose for another week and had a full blown mixed states depression. Decided lithium orotate is a clever marking ploy for a few internet based companies and not much else. It clearly was ineffective for me. Went back to my lithium carbonate and blessed relief within 3 days. I'm finally a believer. Lithium carbonate is my good friend and nothing else takes it's place.
If you want to experiment with Li orotate, go for it, but don't take as gospel the conversion amounts stated. It may work for you, although from my research, few have found it to be effective on it's own. Don't mess with your current lithium if you need it and definitely don't throw it out the window if you give li orotate a try. I can guess you'll be wanting your old lithium back. With that said, I am taking 1 Li orotate pill mid day as a possible boost, but mainly to use up the 150 pills I still have left. - BarbaraCat
Posted by Paulie on June 2, 2003, at 12:18:12
In reply to Re: LITHIUM OROTATE » Paulie, posted by Larry Hoover on June 2, 2003, at 8:57:47
> >> >
> > Lithium, like sodium, occurs naturally in a number of different salts. (snip)
>
> Hey, Paul. Where'd you get the quote? My opinion is that you should include a link with a quote like that, so people can check the references (numbered in the quote, but not included with it).
>
> thanks,
> LarMy oversight, should have included it with post.
http://vrp.com/art/718.asp?c=1054391658919&g=lithium&k=/srch/lithium.asp&m=/vstyle.css
Paul
Posted by Barbara Cat on June 2, 2003, at 12:19:02
In reply to Re: Larry what do you think about lithium orotate? » Ron Hill, posted by Larry Hoover on June 2, 2003, at 8:51:48
Larry and Ron,
Serenity is the brand I took. Interesting fact is that Serenity costs $39 as opposed to around $10 for the same amount from other sources. Serenity's product of course is 'superior' because it is enterically coated to bypass the deleterious effects of stomach acid. More likely it bypasses the entire digestive system and ends up in the toilet. Or at least, that's what my subjective experience suggests.If anyone is thinking about taking this med, search for another brand. You shouldn't have to pay more than $10 for 1 month's supply (3 per day). Bullshit meter, indeed, Larry. Mine was twanging but I was hoping for a lithium that didn't harm my thyroid more than it already is.
In it's defence, however, I do think the idea of orotates and aspartates as transport mediums offers some interesting theories to consider - IF they actually work in the body as stated. One thing I have learned the hard way is that the benefits of various products, nutrients, etc., are probably true. The problem is that the particular product touting the benefits does not deliver the stated amount, is not bioavailable, does not survive the first liver pass, or whatever. If orotates indeed work the way they're claiming, then how exciting. More likely, the science just isn't there yet to make it work in the body.
Posted by Larry Hoover on June 2, 2003, at 13:22:49
In reply to Re: LITHIUM OROTATE » Larry Hoover, posted by Paulie on June 2, 2003, at 12:18:12
>
> My oversight, should have included it with post.
>
> http://vrp.com/art/718.asp?c=1054391658919&g=lithium&k=/srch/lithium.asp&m=/vstyle.css
>
> PaulThanks. Now, finding the full-text to reference 24, I see claims about lithium action that are unsubstantiated, and promotional arguments by a guy who sells the stuff. Hmmm....
Note the similarity in hyperlink structure.....Hmmm.....same company.....
http://www.vrp.com/art/269.asp?c=1054576876708&g=Ward%20Dean&k=/srch/warddean.asp&m=/vstyle.css
My BS meter is in the red zone.
Lar
Posted by Paulie on June 2, 2003, at 13:28:26
In reply to WHOA on the lithium orotate - be careful!!, posted by Barbara Cat on June 2, 2003, at 11:55:42
What I told Janelle was that if she is unable to increase her dose of lithium because of side effects lithium orotate might be worth a try. She is still cycling between hypomania and depression. I would never suggest to anyone who is stable on any med to discontinue that med. Janelle is bringing the info I have about lithium orotate to her pdoc who will make the decision.
If he decides to not to go with it,to add it to the lithium she's on, or to replace it-that will be his decision.Paul
Posted by Paulie on June 2, 2003, at 14:29:10
In reply to Re: LITHIUM OROTATE » Paulie, posted by Larry Hoover on June 2, 2003, at 13:22:49
>
> >
>>
> Thanks. Now, finding the full-text to reference 24, I see claims about lithium action that are unsubstantiated, and promotional arguments by a guy who sells the stuff. Hmmm....
>
> Note the similarity in hyperlink structure.....Hmmm.....same company.....
>
> http://www.vrp.com/art/269.asp?c=1054576876708&g=Ward%20Dean&k=/srch/warddean.asp&m=/vstyle.css
>
> My BS meter is in the red zone.
>
> LarYes, Dr.Ward Dean is director of research for Vitamin Research Products. Assuming his claims are false on the bio-availibity issue there is a reference to the "Clinical Application of Lithium Orotate" published in 1973 by Dr. HA Nieper.
Superiority of Lithium Orotate
The lithium salt of orotic acid (lithium orotate) improves the specific effects of lithium many-fold by increasing lithium bio-utilization. The orotates transport the lithium to the membranes of mitochondria, lysosomes and the glia cells. Lithium orotate stabilizes the lysosomal membranes and prevents the enzyme reactions that are responsible for the sodium depletion and dehydration effects of other lithium salts. Because of the superior bioavailability of lithium orotate, the therapeutic dosage is much less than prescription forms of lithium. For example, in cases of severe depression, the therapeutic dosage of lithium orotate is 150 mg/day. This is compared to 900-1800 mg of the prescription forms. In this dosage range of lithium orotate, there are no adverse lithium side reactions and no need for monitoring blood serum measurements.17
http://www.vrp.com/art/269.asp?c=1054576876708&g=Ward%20Dean&k=/srch/warddean.asp&m=/vstyle.css
Paul
Posted by Larry Hoover on June 2, 2003, at 14:52:34
In reply to Re: LITHIUM OROTATE » Larry Hoover, posted by Paulie on June 2, 2003, at 14:29:10
> Yes, Dr.Ward Dean is director of research for Vitamin Research Products. Assuming his claims are false on the bio-availibity issue there is a reference to the "Clinical Application of Lithium Orotate" published in 1973 by Dr. HA Nieper.I can't access that paper, so I can't assess it.
I spent years of my life, under contract, looking at other peoples' published work, assessing their methodology, the evidence gathered, the statistical methods employed, the conclusions arising from the data, the relationship of the work in question with the body of evidence already in existence. A single contract might have me analyzing stacks of papers over a meter in height. My reports were 100's of pages long, and the reference lists were often longer than the report itself. I have some experience in this realm.
Just so we're clear, I am looking for independent corroborative evidence.
Without it, referring to papers written by other members of the same private enterprise as supportive evidence is questionable, at best.
If there are only a handful of papers in existence on a subject, and those are 20 or 25 years old, I'm quite skeptical of somebody making current claims about that information. Moreover, in a subject realm as well-studied as lithium prophylaxis of bipolar disorder, the dearth of evidence for the efficacy of lithium orotate is itself damning.
Feel free to form your own conclusions. You have my opinion.
Lar
Posted by Barbara Cat on June 2, 2003, at 15:20:42
In reply to Re: WHOA on the lithium orotate - be careful!! » Barbara Cat, posted by Paulie on June 2, 2003, at 13:28:29
Paul,
Have you personally experienced benefit from lithium orotate? If so, could you give us your subjective experience on how it fares with other lithiums? If you haven't had personal experience, do you know of anyone else who has tried it? Is it perhaps the web material only that you're citing? The research papers sound intriguing, and that's how I was temporarily convinced (snookered is more like it) but I have to agree with Larry's biochemical reasoning and with my own experience. It would be helpful to get some first-hand experience besides my own trial which bordered on dangerous.I think that titrating up on Li Orotate while titrating down on Li carbonate is much safer trial than how I did it. Lithium orotate even at double the dose couldn't prevent or pull me out of a manic depressive state. It really was quite ineffective and the fact that the Serenity folks are making these claims bothers me alot. - BarbaraCat
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