Lithium

[Serencwtch]

Any advice or tips on starting lithium.

I have long term schizoaffective/Bipolar 1 & been relatively well for some time on quetiapine.

New psych keeps suggesting lithium. I had a bad experience when I took it age 19 but was very unwell then, repeated sections, horrid inpatient units.

I have to be very careful with any antidepressants as can trigger hypos or worse.

Currently had a mild/moderate depression episode (just mood & no psychosis etc). Muddling through with CBT skills etc but wondering whether lithium is worth another try.

I work just short of full time & worry about having lots of blood test appointments etc but more concerned about destabilizing.

Sorry, no direct experience with lithium, but I wanted to direct you towards the metabolic mind podcast on YouTube. It might interest you if as they have some really interesting episodes on treating bipolar with nutritional interventions.
This is a link to one, if you are interested j

Best of luck and hop you get some more advice re the lithium.

I was prescribed Lithium and the whole drinking all the water and set time for Meds was a pain and then I just felt like a zombie. I had a much better response to olazapene. However now I manage my bipolar 1 without any meds and am relatively stable.

I’ve been on lithium for several years now. Works well for me. I was initially on olazapine for 6 months when had first episode of hypomania. Lithium added a weak after starting olazapine and then slowly reduced olazapine till only on lithium.

I had side effects with olazapine and wouldn’t go back on it if I needed an antipsychotic. Had initial shakes in my thumbs with lithium but that didn’t last long. I find it fine drinking the water and just take it at bedtime which is fairly regular for me so that’s fine. Blood tests reduce to 6 monthly after first year so that manageable.

I have never gone very low in mood and have only had one episode of hypomania. So it works for me and I haven’t needed an antipsychotic or anything more for depression whilst on it. My brain does feel a little slowed down I suppose but that’s exactly what I needed as I was mildly manic most the time I expect as my brain was always racing and over thinking. I didn’t feel myself on olazapine - my friends noticed the same - I was muted somehow. I feel totally myself on lithium.

How these drugs work in terms of success, tolerance etc is very individual. I was told lithium is considered the gold standard treatment bipolar. I’ve read online that it’s good at suppressing the mania which is what I need. It’s a mood stabiliser rather than an antipsychotic so they don’t do quite the same job. Is your consultant suggesting you add it to your current drug?

Thanks for your reply.

Yes I would be taking lithium alongside quetiapine.

I've had some significant mania & psychosis (although not for several years) so that will always be my biggest concern. I don't think I will be able to stop antipsychotics but would like to stay on lowest dose possible.

If you feel confident you can keep your water intake at around 2ltrs a day and can take the medication consistently, it’s a good drug to add. My understanding is that both those things are very important and non compliance is the biggest issue with it working well for people. Don’t worry if you get some finger tremors - mine settled very quickly. It does take a little time to get set on it as you slowly increase the dose until blood level is between 0.4-1.0 (ideally 0.6-0.8).

I remember totally wanting to just been on the least possible drug wise. I now view it as the right dose gives me the best life possible.

All the best. I hope it works for you too.

I have been on lithium twelve years. I don’t really get any side effects apart from tremor sometimes. I don’t really keep eye on how much I drink water. Blood tests every three months is a pain. Oh yeah it did ruin my thyroid so on thyroxine now.

i was prescribed it for psychotic hypomania and really worked like a dream. Later on I got depressed and lithium doesn’t help with that in my case.

Horrific drug for me. Left me like a zombie with no emotions at all. I shook violently all down my left side to the extent of not being able to drink from a cup. Would stumble around and fall over. This was at a very low dose. But I have some quite extreme reactions to medications. I currently take 2750mg of quetiapine (where the usual limit is 800mg) with no side effects, just to be weird.

As I’m sure you are aware, everyone has such different responses to medications.