Lithium Update

About two weeks ago my pdoc suggested Lithium to supplement my Lamictal. He thought it would do a good job of handling the rest of my symptoms. He’s suggested Lithium several times in the past, and I’ve turned him down every time. After what I’ve been through the last several months I was ready for some additional relief, so I was receptive this time. I told him of my concerns with Lithium: weight gain, potential kidney and thyroid damage, trembling hands, and the need for regular blood tests to monitor levels. He called the cocktail “Lamithium”, explaining that there is a synergistic effect between Lithium and Lamictal, and that a full dosage is usually not necessary to achieve some benefit in this scenario. He promised we’d monitor the signs to avoid potential problems and side effects. I reluctantly agreed.

Let’s take a moment here to stress that it is critical that you take an active role in your treatment. Ask questions, express your concerns, don’t be afraid to say no to a particular treatment option. Do your research, and arrive for your appointments informed and assertive. The best way to avoid being a victim is to be proactive. But back to the story…

What I find fascinating about Lithium is, in my experience, how few people are critical of the drug. Mention any other drug and you’ve got maybe a 50-50 chance of a positive answer. Bring up Lithium, I've found that 90% of people have positive things to say about it. I find that amazing, and quite hopeful.

I’ve been on Lithium for two weeks now, but I’m not sure I’ll continue. I’ll give it a month and then see how it is. I am very “hyper” and agitated. I’m sleeping very little, and have significant hypomanic symptoms. Now, these symptoms existed prior to beginning Lithium, and perhaps I’d have them anyway. But it seems like I’m MUCH more agitated since beginning this med. I’ve been criticized by some who say “either take a larger dose or don’t take it at all”, and maybe that would reverse the agitation that started when I began the drug. But I’m hoping for that synergistic effect promised by the doc, and hoping to avoid the slight potential for long-term medical issues and get by with less than a typical therapeutic dosage.

Perhaps the agitation I’m feeling is not med related. In the past I had this same thing happen with Risperdal. In fact, it was the same time of year. Every fall I’m looking for a way to temper my moods, and maybe the symptoms are so significant that I’d experience this no matter what. The only way I’ll know is to ride this out a little longer, to a time when past year’s mood charts show my hypomania has typically disappeared. Then I can have an idea of how this is really affecting me. But it does seem like both medications caused an escalation of my symptoms.

I really hope this medication works out. There are so many drugs out there with a tranquilizing effect, and I just can’t bring myself to dull my senses any more. Seroquel, for all the amazing things it has done for me, is not a drug I want to take every day. I’ve done it in the past and work was difficult. If I wasn’t working I wouldn’t hesitate, but I’d rather not right now.