![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by markwell on February 4, 2012, at 15:20:54
I went to my pdoc last week and he put me on lithium. So I am now on lithium and tegretol. He wants me to back off tegretol when my lithium level gets to a therapeutic level. This may help my depression some but I'm not sure about anxiety. Racing thoughts is a huge issue for me. Does anyone have any experience with lithium for helping with racing thoughts? How about something else for racing thoughts?
Mark
Posted by Raisinb on February 4, 2012, at 16:21:30
In reply to lithium, posted by markwell on February 4, 2012, at 15:20:54
Lithium definitely put an end to my racing thoughts and all other anxiety/rumination symptoms.
Posted by markwell on February 4, 2012, at 16:33:27
In reply to Re: lithium, posted by Raisinb on February 4, 2012, at 16:21:30
Was it immediate or did it take awhile?
Mark
Posted by Phillipa on February 4, 2012, at 18:18:29
In reply to Re: lithium, posted by markwell on February 4, 2012, at 16:33:27
Markwell also years ago worked with a pdoc that even wanted me to take very low dose of lithium for PMS as it's anxiety based for me at least it was. Don't have to worry about this any longer.It was take some the few days before so must be rather quickly but if you need levels to build up could be a while? Phillipa
Posted by Raisinb on February 5, 2012, at 9:10:01
In reply to Re: lithium, posted by Raisinb on February 4, 2012, at 16:21:30
Each time I started or the dosage was raised I remember an immediate "smoothing" effect...very pleasant, like a good scotch after a long day. However, almost all meds I've been on, I've responded immediately or not at all, so that might not be typical.
Long term I had terrible side effects and the smoothing out effect got to be too much--I was very anhedonic. It might just have been that the lithium did nothing for my depression, or it may have been that it induced more anhedonia than I would have had normally.
It got rid of anxiety and racing thoughts, but for me, it got rid of just about all mental and emotional activity, period.
Posted by markwell on February 5, 2012, at 10:13:08
In reply to Re: lithium, posted by Raisinb on February 5, 2012, at 9:10:01
Last night was my second full day of lithium. I'm taking 300mgs twice a day. Last night my sleep was horrible. I woke up sweating and clammy at about 12:00 am. and couldn't go back to sleep. I am also anxious with racing thoughts. Can lithium have this type of start-up? Maybe its lithium combined with tegretol? I don't want to give up so early but I don't know what to expect from lithium.
Mark
Posted by ed_uk2010 on February 5, 2012, at 15:29:19
In reply to Re: lithium, posted by Raisinb on February 5, 2012, at 9:10:01
>It got rid of just about all mental and emotional activity, period.
What was your dose and blood level? Perhaps it was much higher than what you required.
Posted by Raisinb on February 6, 2012, at 8:02:15
In reply to Re: lithium » Raisinb, posted by ed_uk2010 on February 5, 2012, at 15:29:19
It was 900/1050 mg per day (pdoc changed it for a couple weeks then went back down). Blood level was point 8. I just don't think it agreed with me.
Posted by Raisinb on February 6, 2012, at 8:03:38
In reply to Re: lithium, posted by markwell on February 5, 2012, at 10:13:08
That doesn't sound like my experience at all, but that is a fairly low dose and you have not been on it that long; I think for most people, it takes a while to have an effect.
Posted by ed_uk2010 on February 6, 2012, at 13:33:10
In reply to Re: lithium, posted by Raisinb on February 6, 2012, at 8:02:15
> It was 900/1050 mg per day (pdoc changed it for a couple weeks then went back down). Blood level was point 8. I just don't think it agreed with me.
0.8 is suitable for mania but a lot for depression. What were you treating?
Posted by Raisinb on February 6, 2012, at 14:16:48
In reply to Re: lithium » Raisinb, posted by ed_uk2010 on February 6, 2012, at 13:33:10
I was just diagnosed with bipolar 2, depressed, in the fall. I was hospitalized for suicidal ideation and they determined that I was bp2. Before that my diagnosis was mdd.
I don't know which to agree with, frankly. I did have a hypomanic reaction to an add, but it was Wellbutrin, and that was the only one. I have had very irritable, angry times in my life but nothing that seems to add up to actual mania or hypomania.
Posted by SLS on February 6, 2012, at 14:28:23
In reply to Re: lithium, posted by Raisinb on February 6, 2012, at 14:16:48
> I was just diagnosed with bipolar 2, depressed, in the fall. I was hospitalized for suicidal ideation and they determined that I was bp2. Before that my diagnosis was mdd.
>
> I don't know which to agree with, frankly. I did have a hypomanic reaction to an add, but it was Wellbutrin, and that was the only one. I have had very irritable, angry times in my life but nothing that seems to add up to actual mania or hypomania.Did the irritability occur when you were an adolescent?
I tend to believe that a manic reaction to an antidepressant indicates bipolarity. Linkadge disagrees with me on this. If your depression looks something like the atypical subtype, but with marked anergia, psychomotor retardation, anhedonia, melancholia, and non-reactive mood, it is probably bipolar.
- Scott
Posted by Phillipa on February 6, 2012, at 19:02:36
In reply to Re: lithium » Raisinb, posted by SLS on February 6, 2012, at 14:28:23
I also reacted to wellbutrin same way. And that was years ago never been manic and anxiety is lessening. So once taken off was fine. Other ad's since then nothing similar. Since anxiety was always problem I for my self disagree nicely I hope. Phillipa
Posted by Raisinb on February 6, 2012, at 20:22:40
In reply to Re: lithium » Raisinb, posted by SLS on February 6, 2012, at 14:28:23
Hi Scott,
Yes, it did, although I have seen a significant resurgence of extreme irritability in the last to years, all due to a job I've had during this time. Don't know if it's circumstances or bp2. I described a time in my early twenties to a pdoc in the hospital--a time when I had obsessive eating/weight issues--couldn't go over 90 lb, had to run at least 50 mi per week--and it subsided pretty much completely in a few years. He said true eating disorders don't really go away; that it sounded more like dyshoric hypomania.I guess since Wellbutrin inhibits dopamine reuptake, I felt it could be a different story than ssri induced mania, and I have never had a hypomanic reaction to an ssri.
My depressions are fairly typical. Total anhedonia, feelings of meaninglessness, worthlessness, culminates in an inability to even talk, because I feel it's so futile. I lose a lot of weight and have insomnia if I don't take Xanax to control it. I'll start stockpiling meds for suicide attempts in fairly short order if it happens. My pdoc says the severity of the depressions alone suggest BP.
It is confusing to me, because I always attached my moods to external circumstances, especially relationship and work issue (had a borderline diagnosis at one time, too, which really seemed to fit), but the bp2 dx makes sense when they explain it, and the conventional wisdom says that border lines do not recover, while I have overcome almost all of my "borderline" behaviors in the past few years. I go back and forth. I guess now I'm in a place where i'll be happy with a combo that works and not worry about pinning down a dx so much.
Posted by littlefamily on February 7, 2012, at 20:50:06
In reply to lithium, posted by markwell on February 4, 2012, at 15:20:54
I am going to try RITINOL for in racing thoughts and for an energy boot. Should start my meds in 1 week, I will update then.
Posted by morgan miller on February 8, 2012, at 0:11:41
In reply to Re: lithium, posted by littlefamily on February 7, 2012, at 20:50:06
I'm wondering why no one has mentioned Depakote. If you try Depakote, make sure to take l carnitine and l methylfolate. If lithium does not work out, Depakote would be the way to go.
I say give lithium some time and see what happens. I believe l methylfolate should also be supplemented when taking lithium, as lithium can deplete folate.
Morgan
Posted by phidippus on February 8, 2012, at 16:45:58
In reply to lithium, posted by markwell on February 4, 2012, at 15:20:54
Lithium is extremely good for 'normalizing' thought, dispelling racing thoughts and the like. I'm so glad you're getting on it.
If yyou still have racing thoughts, it may be due to your anxiety, which you may be able to take Ativan or Conazepam for.
If your racing thoughts are due to the bipolar illness, it would be to your benefit to add an AAP like Seroquel.
Eric
Posted by markwell on February 9, 2012, at 12:11:18
In reply to Re: lithium » markwell, posted by phidippus on February 8, 2012, at 16:45:58
Eric, I'm having a bit of a difficult time on the lithium, I feel very anxious and drugged. I'm going to try to stay with it as I don't have many options. I'm also taking 600 mg of tegretol which might be some of the problem. The thing I'm worried about most is sleep. I tried lithium several years ago and I wasnt able to sleep. I was on it for less than a month. Maybe it needs more time. Sleep is always an issue for me
. I hope this works.
Mark
Posted by phidippus on February 10, 2012, at 12:50:02
In reply to Re: lithium, posted by markwell on February 9, 2012, at 12:11:18
Tegretol+Lithium is going to make you feel drugged. Why not taper off the tegretol?
As far as the anxiety goes, that's a different beast and will have to be treated separately, but not until you're stable on the Lithium.
Ask for something to help you sleep.
Eric
This is the end of the 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.