![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 28 to 52 of 134. Go back in thread:
Posted by katia on December 19, 2003, at 20:33:50
In reply to Re: Quit the Topamax?, posted by kka on December 19, 2003, at 0:02:09
OH, you are funny! I am like that too. I was always the one everyone dared to do something because they knew I would! Did mania influence me? who knows. I think I'm just naturally looney and goofey in a bold daredevilish sort of way. I have a thing for stripping too.....I think I've got in under control now...:-)
AND likewise, I detest my bum! you'd think I'd hide it away in the attic!I think your plan is good - tell your boyfriend that you're going to your sisters and vice versa. Then afterwards just explain you did it b/c you wanted to be alone and you knew that they wouldn't let you!
I saw my pdoc today and I"m starting the Lithium at 450mg - the Eskalith CR form. I'm staying on the Lamictal at 200mg. We'll see what happens. I hope I don't gain weight or get that cognitive dulling/dumbness!
Ciao!
Katia
Posted by fluffy on December 20, 2003, at 11:55:07
In reply to Re: Quit the Topamax?, posted by kka on December 19, 2003, at 0:02:09
Hi Katia--
(and karen). I had an instinct to cruise the babble boards this morning. Katia--sorry I didn't reply to you the other day. I was kind of ignoring all of my e-mails. I'm so sorry you had such a hard time with that nasty mixed state. they are the scariest. the only time i've had a full mixed state was on antidepressants. and I'm really surprised i made it through alive. it's like your head can't think about anything but suicide...just whirling around. i seriously wanted to bang my head into a wall. i thrashed things around and yelled at my cats. if there had been a human around, i'm certain i would have hurt them if provoked. i am so glad you made it out ok. but it's hard to reconcile with your head afterwards.
katia--something keeps striking me about your posts. i think you are coming to terms with the difficulties of all this. having drugs not work or make you feel worse is salt in the wounds. but you have to try them first, and not worry about stuff that may or may not happen.
i may have to go on zyprexa or depakote next, and frankly, i'm having to not care about the possibilities of side effects (pcos, thyroid junk, weight gain, rashes). all drugs carry side effects, and it's important to be aware of them. but if you are feeling miserable, then don't put the cart in front of the horse. just concentrate on if the drug is alleviating your symptoms and actually making you feel better in the short run. you can cross that bridge when you come to it if the drugs seem to be causing long term problems. most problems are reversable.
i'm saying this to you b/c i've been taken off of every drug i've tried due to really bad side effects. if i could achieve mood stability through a drug and be a little chubby or have a thyroid problem, at this point, i probably wouldn't care. as long as i felt like my normal self otherwise. i'm off the trileptal b/c my sodium levels were dropping quickly, and it can result in a coma or death!! so needless to say, it's out of the equation. then when we discontinued the trileptal, i got a rash again. my doctors are freaking out, calling me every 3 days to see if my rash is going away. now my lamictal dose has been cut in half, (i'm at 100mg), and it's the only thing i'm taking. it's not enough. I can't sleep a wink. and i have been hypomanic for 5 days now. my art work is soaring...it's taking off! but i'm having a hard time holding on to my thoughts and concentrating on what people are saying to me. admittedly, i've enjoyed the high, but i know it will end. i keep wondering if i should call my doctor to tell him i'm getting manic, or if i should ride out this enjoyable high. but i just want some long run stability. it's hard to worry about side effects. but i just have to jump in b/c i haven't had typical results to typical drugs.
i hope you will give lithium a try without worrying about the thyroid stuff too much. don't shoot yourself in the foot. you've had a really hard time lately, and if the Li works, then you are on your way. would you ever consider the depakote again? didn't it work for you, but you were afraid about the pcos? just curious.
take care. i really hope you are feeling better, and it continues. i wish you the best of luck with this crap. it's very difficult to say the least!
i care about you,
Katy
Posted by katia on December 20, 2003, at 13:46:08
In reply to Re: lamictal, misery, side effect fears, posted by fluffy on December 20, 2003, at 11:55:07
HI Fluffy old friend!
good to hear from you.
Yes, I started the Lithium yesterday. We'll see about it - I'm not worrried about the hypothyroid thing anymore - I just want to feel better.
I'm envious when I hear of others' hypomania!! Normally if I don't sleep, it goes to a mixed state! I don't have any fun....:-(
I would definitely try Depakote if I were you. Definitely. You're already thin, the Trileptal worked for you minus the s/e so they are somewhat similar. I actually didn't gain weight on it. It didn't quite work for me. I was still cycling.
Thanks for your words!
I'm dashing off so I'll write more later.
your friend,
Katia
Posted by fluffy on December 20, 2003, at 13:53:45
In reply to Re: lamictal, misery, side effect fears » fluffy, posted by katia on December 20, 2003, at 13:46:08
Hey Katia
Good to hear from you, too. i'll admit that the hypomania is sort of fun. but i get really paranoid. i can't keep track of my thoughts...they just whirl around, and i can't really remember much of them later. so mainly, it's kind of annoying after awhile. but at first, wheeeeee!!! I also have to wonder how much i've offended people later. i've been known to tell people off when i'm like this.
later,
katy
Posted by katia on December 20, 2003, at 17:19:32
In reply to Re: lamictal, misery, side effect fears, posted by fluffy on December 20, 2003, at 13:53:45
How much are you sleeping?
Are you taking anything for it?
k
Posted by fluffy on December 21, 2003, at 12:39:32
In reply to Re: lamictal, misery, side effect fears » fluffy, posted by katia on December 20, 2003, at 17:19:32
Hey Katia--
I'm sleeping probably an average of 5-6 hours a night, which isn't the worst it's ever gotten. But even if I take the Temazepam i have for insomnia, i still can't fall asleep very well. i've been getting more and more edgy over the past few days. that's the thing...the fun hypomania part fades rather fast due to lack of sleep, which just catapults me into edgy, irritated, anxious hypomania. I feel like biting peoples' heads off, and I'm starting to cry at the drop of a hat now. I've started to switch into depression over the past day or so. gotta call the doc on monday. this undermedicated business just can't do. we are going to go back to the drawing board anyway. they are just watching and waiting to figure out what to treat with what meds. *sigh*
How are you holding up with the lithium? any weird side effects? what dose are you on? Li carbonate or extended release? i had side effects from the get-go, even on low doses. If you are doing well now side effect wise, then it's a good sign you'll tolerate it well. A little thirst and fatigue is normal. I hope you are doing well,
Katy
Posted by katia on December 21, 2003, at 14:32:28
In reply to Re: lamictal, misery, side effect fears, posted by fluffy on December 21, 2003, at 12:39:32
> Hey Katia--
>
> I'm sleeping probably an average of 5-6 hours a night, which isn't the worst it's ever gotten.Hi katy,
well 5-6 hrs I can relate to. I just can't relate to classic mania - no sleep at all and feel fine for it!But even if I take the Temazepam i have for insomnia, i still can't fall asleep very well. i've been getting more and more edgy over the past few days. that's the thing...the fun hypomania part fades rather fast due to lack of sleep, which just catapults me into edgy, irritated, anxious hypomania. I feel like biting peoples' heads off, and I'm starting to cry at the drop of a hat now.
**Yes, I've been there. It's like just being along for the ride...
>>I've started to switch into depression over the past day or so. gotta call the doc on monday. this undermedicated business just can't do. we are going to go back to the drawing board anyway. they are just watching and waiting to figure out what to treat with what meds. *sigh*
**Has your rash gone away? If it has, then I think you could increase your dose. And I really think Depakote could work for you. Let me know what happens, k?
> How are you holding up with the lithium? any weird side effects? what dose are you on? Li carbonate or extended release?
Well, nothing really has happened yet. I'm going on day three today at 450mg of Eskalith CR (the most extended release). I haven't really noticed any s/e yet. But then again, the first day I took it and went to bed, got up yesterday and was so busy all day into the night as I worked. Then after work, went for a late dinner and had three glasses of vino. And I feel it today. I take it at night, so I haven't taken it yet today. With the holidays here and taking on a second job (dog walking and petsitting), I'm really distracted from myself and I feel it. It doesn't feel healthy - you know like I'm not in tune and I hate that disconnected feeling I have when life gets like this. I need so much solitude and down time. So it's hard to tell really. I guess no news is good news at this point. I'll go to 900mg in 12 days if I see no improvement.
take care and keep in touch.
Katia
Posted by Karen_kay on December 21, 2003, at 18:33:42
In reply to Re: lamictal, misery, side effect fears » fluffy, posted by katia on December 21, 2003, at 14:32:28
Not to discourage you :) but 450 mgs is a relatively low dose. And it will take at least a week (for most people) to begin to see improvements. That dose may work for you. It may not. But, I'm sure that Lithium will work to improve your mood. And I'm so happy that finally you're going to get your moods under control!!! I'm certain things will turn around for you! And I read in a book that there is a thyroid supplement called levothyroxine (Synthroid) in case you need it in the future. (Not saying you will, I'm CERTAIN you won't, but it is available...When I took lithium (plain old Lithobid, the cheap stuff) the only s/e I got was diarrhea and it caused me to be hypomanic at first (which is ODD!!!) But, it didn't make me manic. And it didn't make me crabby or anything, just plain old happy, fun Karen. But, hypomanic just the same. And it was the first day I took it. It lasted for about a week. I guess until the levels stabilized in my blood. But, at first I felt fantastic on Lithium. Kinda makes me wonder why I quit taking it to begin with. Oh yeah, my Pdoc sucked!! Instead of raising lithium when I began to get depressed and suggesting a good therapist, he just put me on a whole bunch of other drugs... I remember now...
One important thing though.. Studies show that if Lithium works for you the first time and you discontinue. If you try to take it a second time it may not work. That's what happened to me... Just food for thought :)
Good luck hun!! Keep me posted... How are the holidays going? Ok aound here. My old man (boyfriend) just got back from Kay Jewelers... That's good news.. He's got wonderful taste.... That's why I love him
Posted by katia on December 22, 2003, at 1:47:59
In reply to Re: lamictal, misery, side effect fears, posted by Karen_kay on December 21, 2003, at 18:33:42
Hiya Karen!
Yes, I know about synthroid and it's counterpart Armour (the natural stuff).Interesting Li. made you hypomanic. Depakote made me manic for sure, esp. mixed with alcohol I went bazeerk! And it was just for the time it was a low dose. the pdoc said that was actually semi-common in bipolars to experience that when the dose is too low. ODD! as you say.
What dose did you start at? And what dose did you end with?
good on ya boyfriend!
did you settle the dilemma?
Katia
Posted by Karen_kay on December 22, 2003, at 9:45:52
In reply to Re: lamictal, misery, side effect fears » Karen_kay, posted by katia on December 22, 2003, at 1:47:59
Hey there girlie girl....
I believe I started with 900 mgs Lithium and tapered up to 1500 mgs a day, taking 600 morning and 900 evening.....I thought I was done with my Christmas shopping and then I talked to my mom and she said "What, you're staying home alone on Christmas? I'll come and get you." I don't really think that's such a great idea, but we'll see what happens. She's having a rough time right now anyway so should be there with her. And I'd love to see my sister. So, now I have to buy her something, my sister and 2 nieces something. Also, I have to get my two other nieces something as well, so I'm not playing favorites. Darn it.... And, my boyfriend is paying, since I'm essentially broke... Poor guy :) He's not too excited. But, I'll pay him back (MAYBE :) How's your shopping going? I spent 10 hours with my boyfriend shopping yesterday, and he only had to get 5 presents.. he is the worst shopper to ever sign a credit card.. I swear. He goes to every shop. Then ends up returning to one of the previous shops to buy a present. It is horrible. Especially since he waits until 3 days before Christmas to go. And, he hasn't called a kennel for our dog. And we have a huskie, so not just any kennel will take him.... What to do???????
Posted by katia on December 22, 2003, at 14:18:07
In reply to Re: lamictal, misery, side effect fears, posted by Karen_kay on December 22, 2003, at 9:45:52
Hi,
In my sleep, I feel incredibly slow and stupid and everything is so hard and frustrating since starting the Lithium. Last night I woke up and had my first hallucination! I saw my friend's head sitting on my desk drinking a beer! I immediately snapped out of it though.wow. that's awfully generous of your boyfriend! It must feel nice to have that sort of security!
Have you ever considered a petsitter? That's one of my parttime jobs.
I'm more or less finished with shopping. didn't have to get much anyway. can't really afford anything!
cheerio-katia
Posted by Karen_kay on December 22, 2003, at 22:30:23
In reply to Re: lamictal, misery, side effect fears » Karen_kay, posted by katia on December 22, 2003, at 14:18:07
Wow!!! Such a strange hallucination.... At least your friend was having a good time??? Maybe you were half way between dream and wakie time? Sounds strange though. I'd say if it continues to let your doctor know.
Sorry that things are feeling slow right now. But, as your body adjusts, things should pick up again.
Yeah my boyfriend's a sweetie! He gave me my present early! It was a beautiful diamond necklace! It is gorgeous!!! I love him :)
I hate being broke :( The holidays suck when you're broke. You want to get everyone everything, but in reality, you can't get crap for anyone.....
Posted by katia on January 3, 2004, at 16:30:13
In reply to Re: lamictal, misery, side effect fears, posted by fluffy on December 21, 2003, at 12:39:32
Hi Katy,
How are you? I'm scared because I just noticed all over my body a red rash. I just paged my doctor and he said not to worry - stop taking it and take an antihistamine. Geezzzz this is SCARY! I've been on Lamictal for so long - why now? I just upped the Lithium to 900mg two days ago so we're not sure what it is. It's everywhere - my thighs, my stomach, my arms, my chest. Looks like Lamictal is out for me - in the best case scenario - the worst case - well....If it's the Lithium then I have to come off of that too. geezzzz I"m sick of this!!!
anyone else out there get a benign rash all OVER your body???? Anyone else out there get a rash with Lithium?
katia
Posted by Karen_kay on January 4, 2004, at 0:21:52
In reply to I got the rash - Lithium or Lamictal? » fluffy, posted by katia on January 3, 2004, at 16:30:13
Hey girlie! Don't panic.... I'd guess it is just from the Lithium. If your dr isn't concerned right now, you shouldn't be either. Or maybe it isn't from lithium either. It could just be a rash. Just wait it out and see what happens. If you can't take lithium, there's still tegretol, or topamax (which I take and I LOVE it!), depakote, there are plenty of options...
How has your mood been lately? With the added mood stabilizer, have you seen a noticable difference?
Keep me updated and let me know!!!
Posted by katia on January 4, 2004, at 1:12:27
In reply to Re: I got the rash - Lithium or Lamictal? » katia, posted by Karen_kay on January 4, 2004, at 0:21:52
But lithium is not known to cause the rash is it? My pdoc is stopping the Lamictal and I'm continuing with the Lithium. The terrible thing if it's the Lithium is I'll keep taking it while I see if the rash was caused by the Lam. that could be days...and then if it is the Li. then I would have to restart the Lam. slowly...I hate this and I'll have the rash for days worrying myself sick if it's the deadly kind. And this rash hurts and it's just about everywhere.
I'm scared. This sucks.
my mood has definitely plummented!
Katia
Posted by fluffy on January 4, 2004, at 12:20:30
In reply to Re: I got the rash - Lithium or Lamictal? » Karen_kay, posted by katia on January 4, 2004, at 1:12:27
Oh no Katia...!!!!
You know, I was just thinking about you last night. I've been pretty shitty myself. I was laying on the couch crying, thinking, "i need the gals right now!" I'm so, so, so, sorry about the rash! It IS scary--WAAAAy scary! I know you probably don't need anyone to alarm you even more, but...having a painful rash all over your body is not very comforting. Like you've said, you'll just have to wait it out and see. Only time will tell. And boy--that doesn't help your mood. Makes you feel helpless about your situation. You just want to feel better, stop cycling, find yourself again, and find the mainstay drug, so you can relax a little and get back to your life. A bump here or there is ok, as long as you know you have a safety belt on--a drug that doesn't kick you in the ass with side effects (esp. rashes!!) I can totally identify lately. (warning...a self-absorbed saga follows in the last paragraph)
In the mean time, though...let's try to be objective about this (the rash itself). You know, when i was on Lithium and Lamictal, i also got a rash. My doctor took me off the Lithium, however, because of the other bad side effects. This past time, when I was pulled off of the Trileptal, I got the very same rash (like excema--not really itchy--just kinda swollen and patchy that later dried up into a scaly patch). It happened in the very same spot--localized to my wrist. My doctor said that when i was on Trileptal, it probably lowered my Lamictal levels, and when i was pulled off it, my Lamictal levels jumped up too fast, causing the rash. Logic tells me the same happened when I was on Lithium (that Lithium raised my Lamictal levels quickly).
Lithium can cause psoriasis. Maybe check on the web what psoriasis feels and looks like. It's possible that it's just a Lithium psoriasis reaction (which isn't life-threatening, just annoying).
A serious Lamictal rash usually involves mouth sores accompanying the body rash. My doctor insisted on looking in my mouth when I showed him my wrist rash. (any mouth stuff? did your doctor ask you about that?) If so, I'd get to an emergency room if I were you.
For me, though, Lamictal has made my skin more sensitive in general. I've had lots more acne. At this point, I'm only on 50mg of Lamictal because my doctor FREAKED about the rash reaction this time. I'm going down to 25mg tomorrow, preparing for a Depakote trial.
I tried Zyprexa--Please don't let any of this deter you from trying it if you need to, or if your doctor thinks it's right for you. I just seem to have very bad luck with medications. I think i'm one of those dreaded "med sensitive" individuals. I was on it for 9 days. (a very low dose--only 2.5mg). At first, it was ok--I was really sleepy, but it started to fade. I had one day of really bad anxiety (I think my neurotransmitters were freaking!). But then I started to even out. BUT THEN....I started having trouble moving my legs and hands when I wanted to. It was like I could walk, but my mind was having to think about it very hard. My hands were so stiff, I could barely type. I was dropping my knitting needles, and my hands felt like big, heavy stiff claws. Needless to say, I'm not on it anymore. I really wish i hadn't had those side effects so early, then i could have seen if the drug would have worked. I'm trying the good ol' depakote before reaching for the neuroleptics again.
But I'm feeling very frustrated and hopeless. I wonder if anything will work on me, or if I'll be forced to be a prisoner in my own rollercoaster moods forever. I've been pretty depressed lately. I'm trying not to think about it, but my options are getting fewer. Pretty soon, we'll be shooting in the dark (if depakote doesn't do it).
I can identify Katia. Tell me how you're doing aside from the rash (if you feel like it!). I'm rooting for you out here. And I do still care and think about you and Barb-cat all the time. I wonder if Barb-cat's ok?
keep in touch, and take care,
Katy
Posted by katia on January 4, 2004, at 15:53:56
In reply to Re: I got the rash - Lithium or Lamictal? (long), posted by fluffy on January 4, 2004, at 12:20:30
**Hi Katy! So good to hear from you. Ditto on the below. Enough is enough!!!!! I just hope I"m alive to try a new drug!
>>You just want to feel better, stop cycling, find yourself again, and find the mainstay drug, so you can relax a little and get back to your life. A bump here or there is ok, as long as you know you have a safety belt on--a drug that doesn't kick you in the ass with side effects (esp. rashes!!)
>> Logic tells me the same happened when I was on Lithium (that Lithium raised my Lamictal levels quickly).
>
> Lithium can cause psoriasis. Maybe check on the web what psoriasis feels and looks like. It's possible that it's just a Lithium psoriasis reaction (which isn't life-threatening, just annoying).**Yes Katy, I've been thinking this is what happened. I just upped my Lithium to 900mg two days before this happened. There has GOT to be a correlation with the Li. since i've been on Lamictal over three months now w/ no rash. Since being on Li. at 450mg the past two weeks, I have also experienced quite a bit of anxiety and panic - outbursts of irritability (I know what's new). But this was different - I felt disassociated as tho' in a dream (depersonalized?) and very anxious and scared. I think maybe the Li. activated the lamictal. I want to page my pdoc again. I wonder if I should stop the Lamictal altogether. He's the boss tho' and when it comes to something like this I'll listen. But I want to tell him my theory and let him know about my derealization thing that's been going on. My rash is the same as yesterday - not worse - not better. I gues that's a good sign? and no sores in my mouth.
**I don't think this is psor. as my rash is itchy and is spanning a quite large area of my body and is warm and in some places small bumps.
> I tried Zyprexa--Please don't let any of this deter you from trying it if you need to, or if your doctor thinks it's right for you. I just seem to have very bad luck with medications.
**I was wondering what was going on with you.>>and my hands felt like big, heavy stiff claws.
**I laughed when I read this! You are funny.Needless to say, I'm not on it anymore. I really wish i hadn't had those side effects so early, then i could have seen if the drug would have worked. I'm trying the good ol' depakote before reaching for the neuroleptics again.
**As I said before, I think Depakote may work for you. When you were on Li. you said you felt stupid? I'm wondering that about myself - but how does a stupid person know they're stupid? It just seems like reality no? How do you have such a clear grasp on what's normal for you and remember that in the midst of hazy heads? I forget and get confused and probably remain needlessly stupid for longer than I have to!
> But I'm feeling very frustrated and hopeless. I wonder if anything will work on me, or if I'll be forced to be a prisoner in my own rollercoaster moods forever. I've been pretty depressed lately. I'm trying not to think about it, but my options are getting fewer. Pretty soon, we'll be shooting in the dark (if depakote doesn't do it).
**I think Depakote will help you. And if not that than add an AD or hypothyroid med (it's known to help rapid cycling regardless if you're hypo or not).>>I wonder if Barb-cat's ok?
Ditto.
take care Katy,
Katia
Posted by fluffy on January 4, 2004, at 17:58:14
In reply to What? Non-flexible talons??? Never! » fluffy, posted by katia on January 4, 2004, at 15:53:56
Hey Katia--
***Good to hear from you, too! I've been just trying to put this whole mess behind me, so I've avoided the PB boards.
Since being on Li. at 450mg the past two weeks, I have also experienced quite a bit of anxiety and panic - outbursts of irritability (I know what's new). But this was different - I felt disassociated as tho' in a dream (depersonalized?) and very anxious and scared. I think maybe the Li. activated the lamictal. I want to page my pdoc again. I wonder if I should stop the Lamictal altogether. He's the boss tho' and when it comes to something like this I'll listen. But I want to tell him my theory and let him know about my derealization thing that's been going on.
***Hmmm. Katia--I don't really know about the derealization stuff. Was it for an extended amount of time? Or was it like a panic attack? Have you ever tried any of the atypical antipsychotics? My experience wasn't great because of the stiffness side effect. But supposedly, they are great for anxiety, derealization, irritability, etc....I think I've read that you take seroquel for sleep? Just curious if you've ever done one for maintenence purposes. I'm not sure how I feel about them at this point.
My rash is the same as yesterday - not worse - not better. I gues that's a good sign? and no sores in my mouth.
>
***Well that's good. No sores is good. Again--I'm sorry about the rash. Keep an eye on it. I really don't know what psoriasis is. But whatever the case, BOTH Lithium AND Lamictal can cause rashes. And certainly together they can! Most of them are not fatal. So try not to worry too much.
>
As I said before, I think Depakote may work for you.***I have very little hope at this point. But i guess I have to raise my hopes a little when trying a new potion. I'm just afraid to hope too much in case my hopes get dashed again!
When you were on Li. you said you felt stupid? I'm wondering that about myself - but how does a stupid person know they're stupid? It just seems like reality no? How do you have such a clear grasp on what's normal for you and remember that in the midst of hazy heads? I forget and get confused and probably remain needlessly stupid for longer than I have to!
***That's quite a whopper of a question, Katia. (from a philosophical standpoint. Very existential!) For me, Lithium made me feel confused and slow. I had a hard time doing things I could normally do. Like, well, finding where I live! I also couldn't write a paragraph, I remember. I just felt trapped in a stupor. You'd know if you were having the "stupid" side effect..promise.
Thanks for your well-wishing, Katia. You take care, too. Keep in touch,
Katy
Posted by Karen_kay on January 4, 2004, at 19:59:34
In reply to Re: I got the rash - Lithium or Lamictal? » Karen_kay, posted by katia on January 4, 2004, at 1:12:27
Lithium doesn't cause the potentially fatal rash that Lamictal does. I can't remember what the particular name of the rash is called (Johnson something). How much Lithium are you taking? And when is the last time you had a blood test? Did he send you in to get your blood drawn? What other symptoms are you having now? I've just been doing a bit of reading and a rash from Lithium could also be a sign of possible Lithium toxicity. Now, you'd know if the levels of Lithium in your system were toxic... Trust me!!! When I took it I was paranoid! To the point that once, over the span of a week, I had my blood drawn every single day. And that gets expensive. But the signs are as follows:
Fine hand tremor, polyuria, and mild thirst may occur during initial therapy for the acute manic phase, and may persist throughout treatment. Transient and mild nausea and general discomfort may also appear during the first few days of lithium administration.
These side effects usually subside with continued treatment or a temporary reduction or cessation of dosage. If persistent, cessation of lithium therapy may be required.
Diarrhea, vomiting, drowsiness, muscular weakness, and lack of coordination may be early signs of lithium intoxication, and can occur at lithium levels below 2.0 mEq./l. At higher levels, ataxia, giddiness, tinnitus, blurred vision, and a large output of dilute urine may be seen. Serum lithium levels above 3.0 mEq./l may produce a complex clinical picture, involving multiple organs and organ systems. Serum lithium levels should not be permitted to exceed 2.0 mEq./l during the acute treatment phase.
The following reactions have been reported and appear to be related to serum lithium levels, including levels within the therapeutic range:
Neuromuscular/Central Nervous System: tremor, muscle hyperirritability (fasciculations, twitching, clonic movements of whole limbs), hypertonicity, ataxia, choreo-athetotic movements, hyperactive deep tendon reflex, extrapyramidal symptoms including acute dystonia, cogwheel rigidity, blackout spells, epileptiform seizures, slurred speech, dizziness, vertigo, downbeat nystagmus, incontinence of urine or feces, somnolence, psychomotor retardation, restlessness, confusion, stupor, coma, tongue movements, tics, tinnitus, hallucinations, poor memory, slowed intellectual functioning, startled response, worsening of organic brain syndromes
Cardiovascular: cardiac arrhythmia, hypotension, peripheral circulatory collapse, bradycardia, sinus node dysfunction with severe bradycardia (which may result in syncope)
Gastrointestinal: anorexia, nausea, vomiting, diarrhea, gastritis, salivary gland swelling, abdominal pain, excessive salivation, flatulence, indigestion
Genitourinary: glycosuria, decreased creatinine clearance, albuminuria, oliguria, and symptoms of nephrogenic diabetes insipidus including polyuria, thirst, and polydipsia
Dermatologic: drying and thinning of hair, alopecia, anesthesia of skin, acne, chronic folliculitis, xerosis cutis, psoriasis or its exacerbation, generalized pruritus with of without rash, cutaneous ulcers, angioedema
Autonomic: blurred vision, dry mouth, impotence/sexual dysfunction
Miscellaneous: fatigue, lethargy, transient scotomata, dehydration, weight loss, leukocytosis, headache, transient hyperglycemia, hypercalcemia, hyperparathyroidism, excessive weight gain, edematous swelling of ankles or wrists, metallic taste, dysgeusia/ taste distortion, salty taste, thirst, swollen lips, tightness in chest, swollen and/or painful joints, fever, polyarthralgia, dental caries.
I suffered from hallucinations, walking into walls, stupor, fatigue, poor coordination and upset stomach (to the point that I couldn't eat or drink). But, even when I had countell blood draws, my Lithium level wasn't high. I believe the therapuetic range is at about 1.0, but don't quote me on that. And I too suffered from derealization as well.
Don't let this freak you out! It's just stuff you have to know about and be aware of. Here's a link to the site where I found this info..
http://www.healthyplace.com/medications/lithium.htm
Take care hun. And call your Pdoc!
Karen
Posted by katia on January 5, 2004, at 15:22:18
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 4, 2004, at 17:58:14
> Hey Katia--
>
> Good to hear from you, too! I've been just trying to put this whole mess behind me, so I've avoided the PB boards.**Yep. me too - nice to take a break but nice to have somewhere to run to for advice when getting rashes!
**I take Seroquel for sleep.
> >Well that's good. No sores is good. Again--I'm sorry about the rash. Keep an eye on it. I really don't know what psoriasis is. But whatever the case, BOTH Lithium AND Lamictal can cause rashes. And certainly together they can! Most of them are not fatal. So try not to worry too much.
**I didn't realize that Lithium causes rashes in people.
**You never know about Depakote! and there's always topamax.> When you were on Li. you said you felt stupid? I'm wondering that about myself - but how does a stupid person know they're stupid? It just seems like reality no? How do you have such a clear grasp on what's normal for you and remember that in the midst of hazy heads? I forget and get confused and probably remain needlessly stupid for longer than I have to!
>
> That's quite a whopper of a question, Katia. (from a philosophical standpoint. Very existential!) For me, Lithium made me feel confused and slow. I had a hard time doing things I could normally do. Like, well, finding where I live! I also couldn't write a paragraph, I remember. I just felt trapped in a stupor. You'd know if you were having the "stupid" side effect..promise.**You know what? This derealization I'm talking about is a stupor. I just couldn't describe it until hearing you talk about it. I feel like anything could happen - I could say anything b/c I'm not that in control - like I"m in the back seat observing it all happening. I feel slow and my brain feels pinned down. The thing that has made it worse was the upping of the Lithium. I was a retard last night at work. And then I got really giddy/silly/giggly and then drank too much. Even during the night customers made jokes about how I was drunk when I hadn't touched a drop. I would set things down on things - judgment off - bump into things. Is this what you experienced?
SHITE! Now w/in two days I find out lam and Li. won't work for me.
Does this not go away? I can't manage like this. I'm writing my thesis!!
-Katia
Posted by katia on January 5, 2004, at 15:40:12
In reply to Re: I got the rash - Lithium or Lamictal? » katia, posted by Karen_kay on January 4, 2004, at 19:59:34
Hi Karen,
Wow! You say so much. I'm cutting and pasting what I wrote in my last post to katy re: my experience. Because I wrote it and then looked at all those symptoms and it was very similar to what i've experienced."**You know what? This derealization I'm talking about is a stupor. I just couldn't describe it until hearing you talk about it. I feel like anything could happen - I could say anything b/c I'm not that in control - like I"m in the back seat observing it all happening. I feel slow and my brain feels pinned down. The thing that has made it worse was the upping of the Lithium. I was a retard last night at work. And then I got really giddy/silly/giggly and then drank too much. Even during the night customers made jokes about how I was drunk when I hadn't touched a drop. I would set things down on things - judgment off - bump into things.""
Karen, I've never had the blood level drawn because we were going to wait until I was at 900mg for twelve days. I've only been at 9 for four days and last night I reduced it to 700mg b/c I am waking up to my stupor (thank god) - yes "trapped in a stupor" is the right way to describe it. You're in such a stupor that you can't scream for help. Give me my brain!!!! and let my be stable as well!!!!Is it too much to ask?
Oh, well. Maybe topamax....
Katia
Posted by katia on January 6, 2004, at 15:24:42
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 4, 2004, at 17:58:14
Hi Katy,
I"m so glad we talked. Sometimes when I'm in a state of consciousness, it takes me a long time to wake up to it. i've definitely been experiencing the Lithium stupor. I've just reduced my mgs back to 450 but I was in a bit of a stupor then too. I don't think Li. will work for me. We're just making the rounds aren't we? Maybe I'll move onto Triletptal. I need my brain back. It's powerful stuff, Lithium. Seee? I just drifted off for a couple of minutes. Ok, where was I? Oh, yeah - sick to death of moods and medications! Do I really need meds? It's been so long with this trial and error roller roaster that I long to be medfree for awhile and try that!
What do you think?
How are you Katy?
Katia
Posted by katia on January 6, 2004, at 15:49:06
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 4, 2004, at 17:58:14
p.s. Didn't you say you felt numb? I feel numb - like the surface of my skin is numb and my brain. I'll go for another few days at 450 and see what happens. Adios Lamictal - Adieau Lithium - hello craziness!
Posted by Karen_kay on January 6, 2004, at 16:13:01
In reply to Lithium stupor » fluffy, posted by katia on January 6, 2004, at 15:24:42
Katia,
Hello! I know it is very dicouraging! OK, now lets talk... I have my book in front of me...*Do you have mixed states, or more of a "pure", euphoric mania?
-Mixed states tend to have a good response to anticonvulsants whereas euphoric manias have a good response to lithium*if you cycle with depression followed by mania, then you should respond better to an anticonvulsant then lithium
*If you have a low or no prevalence of bipolar disorder in your family then you should respond better to an AC then lithium, whereas if you have a high prevalence of BD in your family then lithium should be a better choice
*If you have rapid cycling (4+) x a year, then you *should* respond better to an AC then lithium
**co-occuring anxiety or substance abuse disorders typically respond better to AC then lithium, whereas fewer previous episodes of illness respond better to lithium
----Again, this is JUST according to a book. This isn't individualized according to the person. It is normal to have side effects when you are tirating up on a medication. Then typically go away once your body becomes adjusted to having the foreign substance there. Have you been doing research on your own and really listening to your body. You do know it best. I'm lucky in that I tolerate medications well. And I mean VERY well. And when I started having these side effects, I just KNEW something wasn't right because I had been taking Lithium for quite a while and I didn't raise my dosage. My body told me something was wrong. Do some research to find which type of drug (lithium, anticonvulsant) woudl work for your symptoms best. If you need help, ask me.... Tell ,me your symptoms and I'll give you the web pages to look at. I don't mind. I don't start classes until next week, so I have some free time on my hands and I'm all about learning everything I can about Bipolar Disorder anyway. And I have several books. I WON't Steer you wrong, I promise!! I'd say the best thing you can do at this point is find eVERYTHING you can aobut what medication would be best for you and try to stick it out. When I started topamax, I had some pretty severe side effects. I couldn't remember where I lived. But, I foujnd out that it was normal and i waited it out and now my mood is great. But, I'm NOT at all saying stick it out if it doesn't feel right!!! If your body is telling you that something is not right, then I suggest calling your doctor and getting your blood drawn. DEMAND it if you have to..... My PDOC told my boyfriedn that the best sign of my lithium level being dangerously high is that I begin acting like I'm drunk. And it disturbs me that you acted that way!! He said that if I start acting giddy adn like I'm drunk to page him and get to a hospital to get my blood draw. And there was one occassion where I took my lithium 2 times. That was scary, but still, my levels weren't too high. Give me your symptoms and I'll get to work of finding links for you.....
I understand COMPLETELY if you don't want to give me this info :) I just want to help you babe! That info I gave you should help you get started at least... And a few good pages to look are..
www.healthyplace.com
www.aboutbipolar.comGood luck hun and keep me up to date!!! If you think that lithium can hlep you, give it a shot. Maybe going up slower will make the side effects less prevalent? I'm not sure.. But, listen to your body. I'm thinking about you (it seems I'm thinking about alot of people here :) but I think that finding info about your sympoms and the meds will be a good start for you!!! A strange note, I'm actually the one who suggested topamax to my Pdoc! And I found out about it here. To think, I could still be struggling if it wasn't for Dr. Bob and this place (Thanks you Dr. Bob!!!!!)... My Pdoc still doesn't understand how Topamax works for me, but it does. I worked hard to find info and it payed of for me. It will for you too hun.... My thoughts are with you :)
Posted by katia on January 6, 2004, at 16:31:15
In reply to Re: Lithium stupor » katia, posted by Karen_kay on January 6, 2004, at 16:13:01
Hi Karen Kay,
I always feel slightly drunk/dizzy/numb/stupid on this. I just called pdoc and asked if I could reduce to 225mg rather than 450mg. I was only at 900mg for a few days. He said it takes a number of days for the li. levels to rise. I don't think I'm toxic. I've only been at 450mg. apart from three days at 900. Tonight I'm definitely only taking 225. I have to have my brain. 25pgs of my thesis is due in one week!!!!
thanks for your research. I actually was aware of those things before. The reason i was on Li was b/c I WAS on Lamictal - Li. is good at snergizing meds. I have already tried Depakote and now Lamictal. I guess I could try Trileptal or Topamax. I'm a rapid cycler/II/Mixed mainly depress-o wild woman. Apart from the time in my teens/early twenties, I don't have distinct periods of high and then low. A mixed wave more like it - the up swings being in spring and early fall and the downs being in summer and winter. Too much of anything pushes me over and being at the tip of change (spring and fall) is exciting.
Why did you stop your lithium? I forgot.
Irregardless, if Li. works for me or not - I'll want to add something to it like an AD. I don't think I'd work on something like Li. alone.
You sound in good spirits? hypomania? or just a good healthy line of mood? how was your xmas?
ta ta-
katia
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.