ADs don't help, anyone on Lithium for depression?

[Dollymixture17]

Hi, I know Lithium is more for conditions like bi polar, but have been reading up on it as an alternative when anti depressants are not working. I've tried a lot of ADs, I exercise and have had therapy but I am really suffering and have been for 2 years now. I recently was given HRT by Dr to see if that helps but so far it's not, I will give it more time though.
Anyway, i wondered if anyone is taking Lithium as a mood enhancer, if so how are you getting on with it? Thanks

Anyone? 🙏

I have bipolar but lithium never helped me with depression. On the other hand Lamotrigine which is a mood stabiliser helped a lot.

Have you tried a Flow tDCS device? It is pretty new, not much research out, but the first results seem promising.

I’ve been on loads of Ad’s. Struggled with not working/side effects.

Then l found one that worked like magic. I think I’ve been on them all.

I take lithium for BD. Tbh I've found it much more effective as an anti manic agent vs anti depressant. The evidence base reflects that too. It's usually prescribed as an adjunct to an antidepressant in depression.

I wouldn't really describe its effects as 'mood enhancing'. Some ppl find it is calming and for me it does temper irritability somewhat. But I also feel less sharp on it which isn't ideal. You also need to take side effects into account. Tremor is common as is thirst and polyuria. If you are prone to skin problems they will likely worsen. It can also induce hypothyroidism, especially in women. Li accelerates natural kidney decline. For these reasons, in addition to a narrow therapeutic index and risk of toxicity, you will need to have quarterly blood tests. Bear in mind this drug should only be initiated by a psychiatrist.

You really need to weigh up all the risks and benefits. For me at this point it is worth it for manic prophylaxis. I would also take it to prevent very severe/psychotic depression which would otherwise result in hospitalisation + APs + ECT. Maybe not in say less severe episodes/dysthymia/sluggishness. If you are prone to agitation or irritability it might be a better fit.

That's a bit of a screed but it's important to consider. Patients are advised that it can take up to 6 mos to notice benefit and you do need to commit to taking it.

I don’t know a whole lot about lithium, but I’m not sure they’ll go to that after anti depressants, without trying more in between drugs.

if you’ve tried anti depressants from most of the different classes or two of them together, a low dose of aripiprazole is tried I believe. (At least it was a few years ago).

for me I ended up on two antidepressants, didn’t really make much difference. But when I went on haloperidol (for psychosis I should add), my mood came up and was less rock bottom. Not saying you should do that, just my experience.

I am bipolar but mostly have depression. I have been on quetiapine for about 12 years as an antidepressants and mood stabilisers.
I went on to lithium for treatment resistant depression and psychosis after having my daughter. It made a big difference along with time.
I have recently come off the lithium and my mood has lifted and my head is brighter. It gave me my life back though.

What antidepressants have you tried? Sometimes doctors get a bit stuck prescribing lots of SSRIs and don't move on to the other classes.

Apologies everyone, I had no emails to say people had responded. Thanks for your replies I'll read properly later with a brew
@Superscientist The ADS I've tried are:
Citalopram
Sertraline
Mirtazapine
Venlafaxine
Moclobemide
Vortioxetine

Ok that's a good mix of classes. Have you tried multiple antidepressants. I was on mirtazapine plus sertraline and then mirtazapine plus citalopram and very briefly mirtazapine plus venflaxine

I think if I was you I would have a read about quetiapine, olanzapine+fluoxetine, lamotrigine and lithium. For bipolar depression quetiapine is licenced as a monotherapy, olanzapine is licenced for bipolar depression too but along side an antidepressants. Often with fluoxetine as they are made by the same company and I think you can get them as a combined pill. Lamotrigine and lithium are good mood stabilisers which might give a boost to antidepressants. Both have their quirks but can be effective. The main downside to lamotrigine is it's very slow titration up to a therapeutic dose as there is a small risk of a nasty side effect of increased too quickly. With lithium it's a very narrow therapeutic window which varies from person to person so regular blood tests are needed to ensure you are on the right dose. It might be more frequent at first but once on a stable dose it drops to every 3 months

DP took lithium for his bipolar but not for depression. Lithium is not to be taken lightly under any circumstances as regular blood checks are needed to see if there are adverse changes to liver and kidneys. DP stopped taking it as a result but the good thing was his mood swings were helped and he no longer has the extreme highs and lows. He still has depression though and has recently begun to take Prozac again.

OP I take a low dosage of Citalopram and Mirtazapine. My anxiety overall is better but not my depression so like you need to find something that works. So tired of this grey feeling even on a sunny day. 😢

I had tried most of the ones you listed there, OP, and to no avail, but fluoxetine has been life-changer for me. On it I'm "normal" for the first time in my life.

That list doesn’t have any TCA’s in it.

Amitryptiline is meant to be the gold standard. And works when others don’t . Also Chlomiprimine is very potent.

Wrong quote but you get the drift.!

Theres a class of anti depressants you haven’t tried that are good for treatment resistant depression.

I just started lithium last night 400mg, I'm also on 20mg fluoxetine and had to come down from 60mg.

I'm more an anxiety and ocd sufferer that feeds into depression.

I'm hoping to see some results soon 🥹

Lithium is difficult to manage and is toxic at higher doses. I took it for bipolar depression and it was horrific. Turned me into a complete zombi and I was permanently thirsty.

I take the antidepressant Agomelatine. It’s been a miracle drug for me. It’s a completely separate type of AD. I think you’d need to get it prescribed by a psychiatrist. It’s not funded by the NHS in Scotland ( I got special funding, but that’s a long story).

@theferry Is agomelatine still working for you? About to start it.

@Monstermunch37 yes, it very much still works.

I was lucky in that lithium stabilised my mood disorder to “up”. A family member found it had the exact opposite effect, leaving her depressed all the time.

As pp have said, it’s not a medication to be taken lightly. It damaged my thyroid gland, so now I’m on thyroxine. Even getting the dosage right is tricky. The blood tests are a nuisance. I stopped it after four years, with relief, after realising my problems were largely hormonal.

I highly highly doubt any sane ( ha!) psychiatrist would prescribe ( a GP would NOT prescribe lithium) for depression unless your depression runs alongside bipolar or another mood related condition.
Also, it is hard to see a psychiatrist these days on the NHS.
I have BPD, bipolar 2, anxiety and I have depressive episodes as part of the bipolar. I was offered lithium as a very last resort if my lamogatrigine didn't work at max dose and even that was off label psychiatric dose.
Lithium is definitely not a drug given out lightly due to the monitoring needed on it and due to the toxicity it can cause on the body

@theferry that's great!! Hope it works as good for me