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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by undopaminergic on January 1, 2023, at 17:37:19
I just read this study:
https://pubmed.ncbi.nlm.nih.gov/25522399/
Title: "Bimodal effect of lithium plasma levels on hippocampal glutamate concentrations in bipolar II depression: a pilot study".
The full article is available.My interpretation is that lower plasma lithium concentrations (< 0.50 mmol/L) are associated with a reduction of glutamate levels in the hippocampus, while higher lithium concentrations (>= 0.50 mmol/L) are associated with an increase. I would not have expected this.
Note that the lithium doses were individualised, and that the changes in glutamate levels were not correlated with the changes in depressive severity. Apparently, some people feel better with a reduction in hippocampal glutamate and others with an increase. This is hardly surprising.
-undopaminergic
Posted by SLS on January 1, 2023, at 20:11:51
In reply to Lithium effects on hippocampal glutamate, posted by undopaminergic on January 1, 2023, at 17:37:19
> I just read this study:
> https://pubmed.ncbi.nlm.nih.gov/25522399/
> Title: "Bimodal effect of lithium plasma levels on hippocampal glutamate concentrations in bipolar II depression: a pilot study".
> The full article is available.
>
> My interpretation is that lower plasma lithium concentrations (< 0.50 mmol/L) are associated with a reduction of glutamate levels in the hippocampus, while higher lithium concentrations (>= 0.50 mmol/L) are associated with an increase. I would not have expected this.
>
> Note that the lithium doses were individualised, and that the changes in glutamate levels were not correlated with the changes in depressive severity. Apparently, some people feel better with a reduction in hippocampal glutamate and others with an increase. This is hardly surprising.
>
> -undopaminergic
>Yup.
- Scott
Posted by SLS on January 2, 2023, at 12:23:43
In reply to Re: Lithium effects on hippocampal glutamate » undopaminergic, posted by SLS on January 1, 2023, at 20:11:51
Hi, UD.
The dosage-response curve extant to my exposure to lithium is biphasic. I have been posting the link you provided for several years now as providing a possible biological rationale for my experience with lithium - which is the bimodal dosage-response curve for glutamate release. Again, my reaction to varying dosages of lithium is biphasic:
This is my biphasic dosage-response reaction to varying dosages of lithium in the treatment of depression:150 mg/day = No improvement.
300 mg/day = 100 % remission.
450 mg/day = 100% relapse.
The generalization most often found in the medical literature is that:Low glutamate = Depression.
High glutamate = ManiaI think it is prudent to use high dosages of lithium whenever there is a history of spontaneous mania or schizoaffective disorder - bipolar-type.
Given that the occurrence of side effects of lithium are dosage-dependent, the low dosages suggested by researchers for treating depression have very little, if any, liability to cause kidney or thyroid damage. I find it hard not to think that low-dosage lithium should be used routinely in treatment-resistant cases.
One caveat: It sometimes happens that the antidepressant activity of lithium is extinguished when it is discontinued and then restarted. This phenomenon was described in 1992 by Robert Post, MD at the National Institute of Mental Health (NIMH) department of the NIH. He named it "Lithium-discontinuation induced lithium-refractoriness".
https://pubmed.ncbi.nlm.nih.gov/1443252/
More citations:
- Scott
Posted by SLS on January 3, 2023, at 6:47:58
In reply to Lithium effects on hippocampal glutamate, posted by undopaminergic on January 1, 2023, at 17:37:19
UD:
* I forgot to acknowledge how very valuable your statements are.> Note that the lithium doses were individualised, and that the changes in glutamate levels were not correlated with the changes in depressive severity.
I missed this.
> Apparently, some people feel better with a reduction in hippocampal glutamate and others with an increase. This is hardly surprising.
I never took this into consideration when I evaluated the article.
I appreciate the precision in your thinking.
- Scott
Posted by undopaminergic on January 3, 2023, at 10:04:31
In reply to Re: Lithium effects on hippocampal glutamate » undopaminergic, posted by SLS on January 3, 2023, at 6:47:58
> UD:
>
>
> * I forgot to acknowledge how very valuable your statements are.
>
> > Note that the lithium doses were individualised, and that the changes in glutamate levels were not correlated with the changes in depressive severity.
>
> I missed this.
>
> > Apparently, some people feel better with a reduction in hippocampal glutamate and others with an increase. This is hardly surprising.
>
> I never took this into consideration when I evaluated the article.
>
> I appreciate the precision in your thinking.
>
>
> - Scott
>Thank you!
-undopaminergic
This is the end of the thread.
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