Lithium experience?

[hk1993x]

Hi all. I seen the community psychiatrist today and he's really nice since my big drama with the hospital psychiatrist.

He has advised me that I may be treatment resistant but I'm not beyond help like the hospital psychiatrist said.

He wants to start me on lithium. But I'm on 60mg fluxoetine and he wants me to taper down 10mg every week for 2 weeks until I'm on 20mg before I start lithium. I am absolutely petrified of tapering down and scared of becoming extremely bad with my mental health.

Does anyone have experience with lithium? Did it help their moods/depression/anxiety?

Any advice would be great x

Hi I went on to lithium when I was admitted into a mother and baby unit after having my daughter. At the time I had treatment resistant severe depression and psychosis.

I was already on quetiapine and had tried mirtazapine on its own and with sertraline and citalopram. I had already stopped the citalopram on my own and was on the verge of stopping everything as I was so fed up of nothing working. I had been in this episode for 9 months by this point.
Before starting the lithium I had to have an ECG to check my heart as lithium puts you at risk of prolonged qt syndrome which the quetiapine and mirtazapine also have a risk for and I think they did some general bloods too.
The therapeutic window for lithium is blood levels between 0.4 and 1. It's person dependant and also dependent on your diet and hydration levels so you need to be careful about drinking and eating consistently. I had my dose and bloods taken in hospital every week. Part of the reason for me going into hospital was to allow the dose to be increased quicker as I would get reviewed twice a week rather than 4-6 weeks in the community. The psychosis improved once my blood levels reached 0.6 after 2 weeks but I found I had to have high levels (0.9) for the depression to improve. I did go toxic briefly when a dose increase corresponded with a rise in temperature. I developed a tremor and the hospital quickly arranged an ECG and my levels to be tested. My dose was lowered slightly and I had to drink a lot of water and it then stabilised. I left hospital after 10 weeks no longer severe depressed but still quite low. It allowed me to start interacting with the world. They then added lamotrigine which I don't think ever made any difference but I think time did. The lithium took away the despair which allowed life and therapy to improve my mood. Had it not worked I would have been looking at ect.
The bloods can be a faff but once you are on a stable dose you get them measured every 3 months and once a year you need you kidney and thyroid tested too. You have to take the lithium at 10pm which allows your levels to be test at 10 am.

I have recently come off lithium after 2 and a bit years in order to ttc a second baby. I have noticed a difference, my head is clearer and I used to wake up in the night feeling like I couldn't breathe when I hadn't drunk enough. I had to have a bottle of water by the bed at all times and this quite quickly made it go away. As soon as I dropped my dose from 800mg to 600mg this went so it might have been due to the dose being right at the top of the therapeutic window. Whilst my head feels clearer off it and would never have said it was fuzzy on it either. After being on it for about 3 months I was back at work part time and after 6 months I was doing 4 days a week which is my limit. I'm in a job that requires a lot of focus too.

Lithium has been brought up repeatedly over the last 15 years of my treatment and I have always been very hesitant about trying it. Overall it was a very helpful drug for me. It was the right time to try to come off it but I would consider it again. I have been given the option of restarting it in the 3rd trimester or wait to see if I need it as I would like to have the option of breastfeeding if only in the first weeks. You have to be careful with coming on and off it as one of the quirks of lithium is each time you stop and start it it can be slightly less effective.

I have been on lithium long time. It works really well on my mixed episodes. Not so much for depression or anxiety. I am on sertraline and lamotrigine for that and it works well.

You could always taper more slowly if it feels too rushed - obviously you want to start taking the lithium but you could discuss slowing the process down.
That said, Fluoxetine is among the easiest to come off, certainly in my experience, so hopefully it won't be as bad as you are imagining.

I've been in Lithium for 30 years- excepting when I had my children.

It works excellently for some. Not for all. You just need to make sure you are getting your levels and thyroid/ kidney function monitored regularly.

I haven't had any apparent side effects except I get thirsty more than most. As drugs go it is pretty amazing.

I do still have episodes of illness (mostly mania) but they are much less bad.