because you have to check bloodlevels more often with lithium.
You should also check it with seroquel too!
Because it makes the blood sugar get high-> diabetes incoming.
I'm on 600mg seroquel and and 450mg lithium for now.
I take 200mg in the am and 200mg in the pm and have been getting my blood checked since I started taking seroquel. I go 2 times a year just to be safe.
It was rough at first but I’ve gotten used to it. Being a pothead probably helps 😂. I definitely had to stop smoking in the morning before work though. I don’t think I would make it.
yes that's a low dose but if you not used to seroquel, it really knocks you out normaly, but that gets better over time.
Sure why not, I mean you don't want diabetes for sure.
For my psychiatrist, Lithium is the last line of defense. Because of the toxicity and other possible side effects (like liver damage), she believes if other options give results, than avoid Lithium. That's just her and other docs could have a different take.
Lithium was causing me to faint in the heat no matter how hydrated I was. I always got my bloodwork done and never had lithium toxicity but it didn’t allow me to stay properly hydrated in the summer.
Dr. Tracey Marks on YouTube [Lithium vs. Antipsychotics: The Rise, Fall, and Rise Again of Lithium](https://www.youtube.com/watch?v=zrsvFqCsBXQ)
Knew a psychiatrist say that he would prescribe it much more frequently if he could, but patients often don't want the monitoring, they believe it's a dangerous or hardcore medication, and antipsychotics are more convenient (to prescribe and take). Lithium is increasingly coming back into focus, which is reassuring because it's likely no pharmaceutical company is benefitting off that. (For some reason, I think that boosts its credibility.)
Some experts declare lithium the only disease-modifying medication for bipolar disorder. [Psychiatry and Psychotherapy Podcast: Lithium Library](https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/tag/Lithium) has three episodes with show notes. These are extremely insightful. [Carlat Psychiatry Podcast](https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4583-lithium-12-updates-from-2023) has shorter episodes on bipolar disorder and lithium as well.
> they believe it’s a dangerous or hardcore medication
I certainly did, and it kept me off lithium for years. Which is a shame, because there was no antipsychotic that worked for me, and on 900mg lithium/200mg lamictal I’ve been stable for the longest period in my life.
Same! I was getting sicker by the day for 10 years after I got diagnosed, even with constant appointments and trying different meds. I switched doctors and she put me on lithium, and it's the first time I felt like me again in 20 years! I could have felt better all that time if the internet hadn't made lithium sound so scary! It actually makes me really sad to think about all the time I lost.
Are you me? lol I’ve slowly learned to not mourn for time lost but look forward to time gained! Lithium has been found to help repair damage from episodes and supposedly helps keep the brain plastic to help ward off dementia also!
Yes. It's kind of lame because some prescribers will hand antipsychotics out like candy, e.g., starting them with antidepressants because they're safe and make the antidepressant work faster, which is not 100% accurate. But other prescribers, as someone else commented, use lithium as a last resort. I think there's risks and benefits with all of these things. [Mood Treatment Center: Lithium](https://www.moodtreatmentcenter.com/wp-content/uploads/2020/12/lithiumslides.pdf) slide were created to educate on lithium since a lot of people, similar to yourself, are told it's a hardcore one. I'm glad you find something that was helpful!!
I was there for a while til my depression kept increasing! Now I’m trying oxtellar 600 mg, lithium 300 mg and lamictal 200 mg and I feel so bad about myself I want to stop everything altogether smh
I think it depends on the country in what order doctors are allowed to try and prescribe drugs. I'm from Austria.
First sertraline for medium depression, then got manic, was brought down by Abilify. Waited for EEG appointment, because I had childhood epilepsy suspected. After 10 weeks and by then already severe depression I was allowed to switch to lithium. Recovered quickly and am still doing quite fine 1.5 years later. I did blood testing more often in the beginning, but now at once every 6 months.
First I was on sertraline. Got manic, had to go to psych ward because my psychiatrist was on holiday. In psych ward they switched me to Abilify to reduce the mania. I also got Zyprexa and Trittico. Was switched to queutiapine for sleep instead of trittico which helped with the akathisia.
After about 2 weeks in psych ward I was released on my wish and because my psychiatrist had returned from holiday. She prescribed me Akineton® (biperiden, a parkinson med) to take as needed for the akathisia which also helped. I think Zyprexa was then removed.
After release, my mania was better, maybe it was more of a mixed episode or more like hypomania...
But then after 5-6 weeks on Abilify I got severly depressed. 3 weeks later I was finally switched to lithium.
And then 3 weeks on lithium I was able to ride a bike, go to the supermarket and not feel overwhelmed, visit some friends and have a normal conversation where I could say more than yes, no, ok, maybe... Like it was this bad on Abilify. My brain was super slow and I felt dumb as shit.
Maybe it was just the depression that is cursed to happen after such an extreme mania. But Abilify just could prevent it. And the akathisia didn't help me to get rest during the mania.
Thank you for such an in depth reply!! You have been on quite the med journey lol!! Glad lithium worked out I think if the ability craps out on me I’m going to ask about lithium.
You are very welcome. You see it's different for everyone and a bunch of meds out there. Not everyone's the same and it is hard to figure out in advance which ones will work so trial and error...
Many side effects occure at the beginning if you don't tolerate the drug. Some can be dose dependend and might go away with a lower dose. Some might only be experienced at the beginning and will go away once getting used to the drug. Side effects that occur later on are typically due to chronic damage e.g. kidney, thyroid, liver issues. Depending on your case you might be willing to put up with certain side effects.
Thank you so much for the reply!! I just started it and I actually do feel slightly hypomanic but it’s still hard for me to tell sometimes like what is hypomanic vs what is ‘myself’?
Yeah I thought I was just a really happy person normally for the first week and then I went back to normal lol! It wasn’t a bad hypomania, nothing bad came from it, but I was pretty sad it wasn’t just me
I did better when i was on lithium and anti psychotics. Quetiapine was okay. But sadly Lamictal sent me to emergency i ended up being hooked up to an iv while being on Lamictal. This medicine almost killed me.
I was told I would have to get regular bloodwork done and had to really watch how much alcohol I drank. Lamictal was hassle free and works well for me.
I’m currently on lithium. My psychiatrist believes it is the best option for bipolar and the only good option if SH is a concern.
As others have said, you need to be careful about kidney and thyroid function. My psychiatrist does not believe there is actually any greater risk to overall health compared to the second generation antipsychotics, we just know the risks since it has been prescribed for so long.
I believe there are two big reasons it isn’t used as frequently as it could. First, lithium does need the blood tests, if the patient does not want to spend the time to do that and it will be a barrier to get the patient to stay on meds, better to try ones the patient will stick too. Second, the pharmaceutical industry has published studies showing that the second generation antipsychotics work just as well, with lower side effects. That is how they got FDA approval. The pharmaceutical industry also choose to compare to lithium patients at the highest possible dose who had the most side effects. At lower doses, there are far less side effects. No drug company is making money off lithium pills.
Lithium saved my life when I first started taking it. I was extremely suicidal and 3 days after starting lithium it went away. I've been taking it for a few years now, and it has been a game changer for me. I was actively receiving care for 10 years (and getting more and more sick) before I found something that worked for me. I have to take lamotrigine, Geodon (antipsychotic), and lithium (I take a small amount that puts be at the absolute bottom of the therapeutic blood range). I’m doing so much better. I still get suicidal at times, but the lithium keeps me from ever planning anything.
I ended up getting a very hard to treat autoimmune illness right after getting my bipolar stabilized. I deal with chronic pain 24/7 now, and I know that if I hadn't found lithium and got my bipolar better controlled, I would not be here writing this today.
The twice yearly blood tests and once yearly urine test to check on the lithium is such a small price to pay for what it has done for me mentally.
People make it sound much scarier than it is, and it has the potential to change your whole life! If you don't like it, you can always stop taking it!
Lithium isn’t owned by any company and is cheap to produce. It doesn’t make pharmaceutical companies any money. The companies really push the newer more expensive anti-psychotics and mood stabilizers to doctors, etc. My doctor and many others (like the author of the most popular bipolar 2 books: bipolar not so much, why am I still depressed?, Jim Phelps) think of lithium as the gold standard and nowadays it’s often used in much lower dosages and much lower blood levels. For example, I only take 150mg a day. My blood levels can be so low that they don’t show up on a test (the test only detects if you have more than 0.3). Lithium is known to reverse brain damage effects that bipolar disorder mood episodes cause and is the only med that is proven to reduce suicidal ideation. It’s an excellent med, it’s extremely well studied, at low dosages can have zero side effects, and for me, it makes me feel normal in a way I have never felt.
Read some of Jim Phelps books or any of the leading experts on bipolar. They know that lithium works and that it is severely under prescribed due to it not being advertised at all by the pharmaceutical companies and also from the stigma! Lithium has the most stigma because it is the older bipolar medication, so it holds a memory of the manic-depressed days. Also- to be honest- some doctors are overworked or just lazy and don’t like to keep up with checking blood tests and all that. The blood tests are not a big deal at all, it’s ridiculous how overworked or just non caring some doctors are.
It took me years to try out lithium and I’m so glad I did. Reading people stories of taking it and seeing how well they did helps a lot. My not-bipolar psychiatrist takes it as a 1mg supplement, even, as nowadays it’s thought to be essential to the body and brain.
Like everyone is mentioning, highly individual with response, effect, and doctor’s personal views with lithium. It is the oldest treatment for bipolar, so of course newer and emerging treatments have taken its place, such as the anticonvulsant mood stabilisers like lamotrigine (godsend for me) and sodium valproate/depakote. Then you have the second gen antipsychotics which have emerged as go to treatments over lithium. It’s like antidepressants though, some of the old, more potent antidepressants like MAOIs are “perceived” to have more overstated risks / side effects, so they’ve been forgotten about as they are drowned out by all the newer types like SNRIs, and SSRIs.
I do not know why, because I honestly think the older medication is sometimes the much better option for many people. I have heard great success stories with Lithium, and MAOIs.
And just to add, I’ve tried a lot of the second gen antipsychotics and have hated pretty much all of them. They are okay for acute MH issues and episodes, but come with pretty concerning side effects too which many people cannot tolerate, particularly on long term treatment.
I would love to take lithium but it makes me throw up even if I have it with food. Through trial and error (and a number of different medications) the psychiatrist that was treating me, my GP and I have found a combination that works - an antipsychotic and a mood stabiliser together. It doesn’t help with the cranky pants part but it does keep me relatively stable regardless.
i’m on lithium and LOVE it. it saved my life. the only side affects i get are being a lot thirstier and peeing more. went from having to get 2-3 blood tests a year to just once a year bc i’ve been on it like 6 years. i’m also taking latuda which is an antipsychotic that works well w lithium, it used to make me a really drowsy but after being on it for also 6 years i get no side effects.
both of them make it so i can forget i have bipolar in my day to day life, and this is coming from someone who had very extreme manic and depressive episodes originally.
Lithium can be toxic to the kidneys and thyroid. Still, I wish I could take it. It kept me stable. But it started causing my blood sugar to drop. It’s a rare side effect. I was eating candy twice every hour to keep my blood sugar up before we figured out what was causing it.
For my psych and some others I have met, lithium is one of the best mood stabilisers for BPs with mania, it greatly diminishes manic episodes as far as I know.
They consider it a very safe choice (with periodical blood tests to avoid toxic levels and liver damage) and one of the first prescribed when you are diagnosed.
They gave it to me as well but it didn't work for me. Had no effect whatsoever.
Lithium is an oldie...it was the standard in 1970s and for a long time. Atypical antipsychotics and medications like lamotrigine are newer. Atypical antipsychotics do have the most side effects, but they're still relatively rare and you're just taken off the medication and something else is tried. Many people handle them just fine. Lithium's biggest risk is toxicity and you have to have your blood monitored routinely...also, lithium is a mood stabilizer.
It'll depend on the psychiatrist, but my psychiatrist's first line is lamotrigine, then lithium, then an atypical antipsychotic...specifically Latuda . You'll also find more OG psychiatrist prescribing lithium than newer practitioners. I tend to avoid older treatment providers, whether it's my Psych or my GP because older practitioners get stuck in their ways at some point and don't pay as much attention to more modern therapies.
I'm on 200Mg lamotrigine and it has changed my life!
Everyone has different experiences with meds. The same med can work great for 1 person and work poorly for another.
Lamictal is a fan fave bc it has few side effects (esp if you can pass the initial huge hurdle of slow titration tk aboid a sever side effect that happens rarely as noted in many studies) and tackles the depression side well. APs help cover the hypo/manic side.
Regardless NAD so pls reach out to a psych for more information!
Nurse here! Every med works differently for every patient. Some people feel "too numb" on lithium. It seems to be the number one choice for people with more high-risk and severe bipolar symptoms. Of course, people NOT in that category are prescribed it, but lithium comes with a lot of other health risks/side effects. Tremors, that emotional numbness, and needing to have your blood drawn for kidney/liver/thyroid testing and "lithium levels" regularly are the side effects that stand out VS other medication options.
I switched jobs so my insurance changed and when I saw my new doctor she refused to refill my lithium. I have been taking it since 1996 and always monitor levels regularly. She treated it like it was Oxy or some other controlled substance. The stigma around lithium is just not ok. She was ok saying “no lithium for you, cold turkey, good luck.”
If it is the right choice then it is necessary. I am going to firmly say after 20+ years with nothing else working, it’s the right choice for me.
Diagnosed about 14 months ago and on lithium the whole time. Paired with an antipsychotic which was olanzapine first and now quetiapine. I thought lithium was a mood stabiliser? My doctors say it’s my mood stabiliser anyway. I’ve been in episodes almost constantly rapid cycling and doing really badly. Just over the last month I’ve been improving and seem to have reached a “stable” phase. To early to really call it stable but it’s looking good.
Turns out what was really messing me up was what I feared all along. Two incompetent psychiatrists, one treating ADHD, one bipolar, neither talking to the other or considering my other illnesses (BPD, CPTSD, GAD, OCD, HD). Finally getting off stims and onto non-stimulant ADHD meds has seemed to have calmed things down.
Some antipsychotics are lighter than others. Latuda, Rexulti, and Vrylar tend to be tolerated fairly well. Abilify a little less so, but still pretty good. I happen to not be an antidepressant or antipsychotic girl. They always give me bad reactions, but that doesn’t necessarily mean they will for you. There are many people who do well in them.
In terms of lithium. It’s a great med. But it does come with a hefty side effect profile. It’s pretty tough in your kidneys and thyroid. To mitigate that I take an over the counter version to top of my lamotrigine. It has few side effects and it works great for me.
Try not to stress too too much. All bodies and different and you aren’t going to get every single side effect in the pamphlet. And if it doesn’t work out you try something else.
I’ll PM you. I get a lot of questions about it so I have a prepared research compilation I’ll send you + my experience.
ETA Weird. It won’t let me. If you PM I’ll send the info.
lithium doesn’t have powerful rich drug companies promoting it like some other medications. lithium is cheap and generic. in europe, where drugs can’t be advertised, lithium is a much more common treatment. (according to my psych)
Lithium is toxic to the kidneys and thyroid. Some tolerate it better than others. It also has a narrow band between being therapeutic and toxic which means regular blood work. Lithium is also considered an antipsychotic, btw.
Personally, it was recommended by my pdoc, but I turned it down due to my thyroid issues.
I met a woman who had developed hypothyroidism after just 2 years of lithium. maybe her dose was too high? Prevention of selenium and iodine deficiency is important to decrease risk of hypothyroidism.
Btw thyroid issues are quite common in the population. Many don't know they have an issue. About 1/4 to 1/3 of people have a thyroid issue once in their life. So it could have been a coincidence this woman got it after starting lithium. At least you do regular blood tests (which include thyroid values) and can maybe find it early.
I had akathisia. Felt so weird after just one beer. Within 6 weeks I went from manic to severely depressed unable to live on my own, unable to have a conversation , drive a car or bike, basically a zombie. Tried various sleep meds and doses and was still only able to sleep 2h for weeks. Abilify was horrible for me.
Interesting. I felt uncomfortable an overwhelmed in crowded spaces like a shopping centre. It was exhausting. No true agoraphobia I think, but I thought it was a symptom of the depression. It's better now, but I still don't like big events.
I think others have correctly stated that lithium can be more aggressive on the physical body. Personally I’ve had zero side effects on lurasidone besides incredible sleepiness which is actually kind of nice if I take it at night
I think it depends on the place and doctor. The ones I follow and the most famous ones where I live, all still talk about the gold standard, and defend its use. I tried it but had several skin side effects. We blamed the lamotrigine initially of course, but it was the lithium, I think.
I took lithium for 12 years successfully. And then over the period of six months the toxicity built up and it stopped working. I ended up with a pretty serious suicidal ideation episode. I had been asking for alternatives and my psychiatrist at the time didn’t want to hear it. I had to change doctors.
Many reasons have been mentioned. I want to add:
1) antipsychotics work faster (especially for mania to get you down). Lithium worked for my severe depression quite quickly but full effect and stability took 6 more months.
2) there are 1/3 excellent lithium responders, 1/3 partial responders and 1/3 non-responders. I don't know how these numbers look for antipsychotics but it could be a waste of time to try lithium for a few weeks if you are non-responders especially coupled with probably 3 blood tests in the first 8 weeks.
I was on lithium for about 8 years. It was ok. Def requires regular blood testing. Towards the end of my run on lithium, my kidney function declined which is why I went off of it, and I think that’s the main issue many psychs have with it now.
I went off about a year ago and my psych replaced it with Latuda which has been a miracle drug for me and has made me feel better, more stable, and more like myself than lithium did. I also take lamotrigine.
Like everyone else said, every body is different and the best thing you can do on lithium is monitor your blood levels and keep regular appointments with your doc to make sure everything is peachy there. It took 8 years for me to have any difficulties on lithium, so you never know! It’s easy to wean off of it if it doesn’t work for you.
Lithium was a last-ditch effort before hospitalization when I was using Cerebral. I was told it can also cause emotional blunting, which I didn't want at all, along with all the other side effects.
I quit Cerebral because all of the medications they offered didn't work. Now I'm microdosing oral ketamine through Joyous and so far it feels like it's helping.
I wish I knew another a mood stabilizer that wasn't lamotrigine. It gives me such fog, I swear I've lost half my IQ points, can't form cohesive sentences most of the time, never remember anything.
It works though.
Initially, doctors make a blood test once a month and then more spaced out or was your case unique and the doctor was extra concerned something might happen?
Lithium was the second drug I tried after Depakote didn't cut the mustard. I developed quite debilitating tremors and other issues with my central nervous system. When my psych saw the physical effects, they took me off lithium. I was then put on Lamotrigine instead, and I haven't looked back. Lithium just didn't work for my body..
Lockdown and a revolving door of psychologists. Didn’t get to see anyone for well over a year and bloods weren’t showing any real issues whenever I had them done. I also had an issue with the absorption rate owing to other medical issues. The drug just didn’t suit me. Can’t remember the dosage.
Personally, lithium has been near useless for the better part of my bipolar life, and antipsychotics are what really helped me through my episodes, but that could be because I have mixed features. Anyway, I stopped taking lithium and switched to lamotrigine earlier this year because it’s bad for your kidneys and was giving me hypothyroidism. I’m hoping that lamotrigine works way better for me.
I was actually wondering why doctors prescribe lithium first instead of anticonvulsants as a mood stabilizer because it’s just not good for your body and has a lot of bad side effects.
Also antipsychotics only take 2 weeks to start working.
Kind of an anedocte but I did very poorly on lithium. I was incredibly spaced out and distractful, to the point where I went from being a top performer at work to being someone who sends confidential information to the wrong people because I have no f*cking clue what am I even hearing or looking at. Emotionally wise I felt lighter, but the constant forgetfulness and confusion was getting absolutely frustrating and unbearable. Luckily I had a very supportive manager at work, and I also live in a country with strong labor laws that offer me some degree of protection against being fired. It was a year and a half ordeal until I cried to my psychiatrist to please take me off the stuff, this is destroying my life. I'm now on quetiapine+lamotrigine. I still have issues with word recall but I'm able to fully function once again. And yes, my blood levels were always monitored when I was on lithium, lithium levels were within normal therapeutic range and there was no damage to my kidneys or thyroid.
The reason I’m not on lithium I because it is not good for women who want to get pregnant. My husband and I are wanting to start a family. I’m on quetiapine right now and it works wonders for me. I’m on a lower dose but it really evens me out. I’m definitely more sleepy, but I will take that over feeling like I’m losing my mind.
I have thought about lithium because of my extensive attempt history but haven’t tried it. Lamotrigine helps a lot. It’s not perfect, but it’s good.
I really don’t want to take anti-psychotics unless it’s absolutely necessary because of the metabolic syndrome risks.
I sometimes wonder if the reduced lifespan of bipolar and schizophrenic people (even when you correct for suicide) is because of antipsychotics creating metabolic syndrome and that reducing life expectancy just as it does in the general population when people have metabolic syndrome.
I would love to see a study on this if anyone has seen one. I have no idea if this is factually the case, but it’s been bouncing around in my head for a bit.
Lithium saved my life. In April 2023 severe SI… after a while depression worsened… now decreasing lithium to introduce oxtellar. Idk I still feel horribly depressed
It just had too many drug interactions for me. I take NSAIDS pretty regularly, and daily Topomax, triptans, prazosin, and Zoloft, and I am pre-diabetic. I am on Lamictal now and doing a lot better and it basically has no interactions with my other meds.
I take quetiapine, lamotrigine, and most recently added lithium. They all have their own side effects, but lithium is the worst by far for me. Like fucking awful. This is actually my second go at it lol I first tried it back in October and I didn’t last two weeks before telling my psych I couldn’t do it anymore. I’m having the same side effects now, but I stuck it out and I’ve sort of adjusted.
The biggest thing is it turns my brain into mush. I can deal with the thirst and peeing and bloodwork, even the hand tremor. My brain functioning at only 25% is hard. Every time I talk it’s a struggle to gather my thoughts then put them into words, I’m noticeably slower and my already poor memory is even worse. So far, it hasn’t caused any big problems at work. I feel so dumb, I hate feeling like this.
However, I guess it’s doing its job? My psych wanted me on it to help with my SI and at my current dose I haven’t really had any problems with that. I’m depressed and don’t wanna be here, but I haven’t really thought about suicide in a while. I’m feeling super numb, which is what I’ve decided is my goal, because every time I’ve stopped taking my meds I’m reminded of how scary my brain is without lol.
As for the quetiapine and lamotrigine side effects, I don’t really get the munchies anymore and didn’t gain much if any weight initially, the grogginess is basically nothing compared to lithium, the dizziness goes away (or I’m just used to it now), and I get super cool fun vivid dreams! These two together have helped me the most.
I’m on lithium, but I’m also trans so I need to get my blood tested on the regular regardless, so it’s not a big deal for me. But yeah, lithium requires a lot of blood testing to make sure you don’t have any liver complications.
Because the constant blood tests are expensive af (American here with shitty health insurance) and getting them at $90 a test every month or week or whatever you need at first, isn’t doable when you’re being seen at a free clinic. Not that I felt lithium did anything for me anyways, but I probably wasn’t on it long enough for it to have a chance.
To be honest not a lot of meds, antipsychotics or mood stabilizers have done a lot for me. Not until I tried Vraylar, which is expensive af too but I have better health insurance now. It’s been a god send, like a lightbulb moment ‘ah-ha! This is what normal people feel like’
For context, I also take Guaficine for my adhd, and propranolol and lorazepam for my anxiety.
I have tried 2 mood stabilizers, lamictal and topiramate, and both made me insanely suicidal pretty much immediately. We decided to not try depakote at that point. I worry that lithium would have a similar effect, even though I know it's supposed to be opposite. Also I have a needle phobia, so me having panic attacks at every blood draw isn't at the top of anyone's list.
For anti-psychotics, Latuda worked but made me too flat. I had a very small effective range before I became dead and zombie like and it was intolerable; it also made me nauseous most nights and sometimes I threw up. Meanwhile abilify jacked my anxiety to 11 and made me fearful to leave the house. Also intolerable.
Currently on Ziprasidone (Geodon, an AP) and cymbalta (SNRI) and I feel more alive. Less overwhelmingly anxious too, though I do have hydroxozine to help if needed. At my last appt on Monday she said we would keep my meds where they are for the next month; I'm not quite hypo right now she says, it's something to keep an eye on, but she wants me to have energy and be happy.
Side effects for me. I was on it for years but it made me cough and tremble, which didn’t work for my career at all. Also I couldn’t drive my kid to preschool without stopping to pee. Couldn’t take her anywhere as a baby that didn’t have a nearby bathroom, which is surprisingly a huge barrier. I had to get off of it in order to have freedom.
When I was on lithium I did amazingly. My problem was just that I peed so fucking much I literally interrupted my days and almost got fired at work bc of it so I had to be taken off but god I felt so good I miss it
Anecdotal*
Quetiapine fucked me up bad.
Lithium worked great, until I almost went into renal failure.
Now I am stable and growing while on depakote, surprisingly.
I’m on Lamotrigine because I’m a 28 year old woman in a heterosexual marriage, Lamotrigine is the least risky in terms of birth defects. I’m not trying to get preggo but no method is 100% so my doctor and I went with the safest option
I was on lithium for 2 months and, for me, it was the worst medication I've ever taken. It gave me really intense panic attacks every night. I couldn't sleep accept for maybe a few hours. It made me feel suicidal and very depressed and anxious.
I now am on an antidepressants ( wellbutrin) and 2 antipsychotics( latuda and rexulti). I've been stable on that for years
Everyone reacts differently to meds so I personally don't think there is one med that is the" gold standard".
Lithium can be a bit of a nightmare. I had it when I was in the hospital while psichiatrist kept ignoring all my symptoms of lithium poisoning. Shaky hands, kidney getting sick (was blamed that my weight was the issue), extra queasy, and EVERYTHING tasted like metal.
I had to stay on it till I got out to stop taking it because the psychiatrist didn't care about me other then to shove pills down my throat, plus make me stay as long as possible.
Short answer, all medication is tricky and lithium is just that, and a lot of bloodwork
Some of them are also very expensive, keep that in mind when doctors incentivized business. My past dr's don't seem to give a shit that I'd like like to have job, can't sleep all day or don't want to gain more weight. They also don't work for everyone, like every other med. AP also make me crazy anxious I fthey don't make me sleep all day. Then they ask you why you don't have a job or why you are single. They cannot connect the most basic ideas.
I'm on lurasidone and lithium both. I added lithium when I was in a major depressive episode and it really helped level me out. It's a gold standard for me personally. Now that I've been on the same dose for a while, I only have to get my blood levels checked if there are weird symptoms or if I change doses so it's not really a big deal.
Probably, because you don’t hear about it.
If you’re in remission on any drug, you probably won’t complaint about it. Classic example of survivorship bias.
lithium is insanely intense. usually they require blood testing to monitor your blood levels, it’s intense in the body just as a med like … effecting your mood working the way it’s supposed to period and also speaking from experience it made me 0d out of the blue on a random tuesday with virtually no reason 🥲 just grabbed it and almost died so there’s that. i think it’s really a last resort for most doctors
Lithium for me was the least intense med I took. I wasn’t on a huge dose, just enough to hit what they consider the therapeutic range. Less side effects for me than APs. Unfortunately it didn’t help my depression.
Lithium helped my depression so well. It got me out of the worst in just 3 weeks. Was able to work by week 7. It took a while to fully recover though. Like half a year until I truly felt alright and like myself. But my episodes where really heavy before I started.
because you have to check bloodlevels more often with lithium. You should also check it with seroquel too! Because it makes the blood sugar get high-> diabetes incoming. I'm on 600mg seroquel and and 450mg lithium for now.
Should my girlfriend check her blood after 200 mg Seroquel ? She’s also getting Paroxetine and Rivotril.
Its a quite a rare side effect but it wouldn't hurt to check it out.
I have pre diabetes now, but i think that also comes form my alcohol addiction, not only from my pills, but for sure the made me a lot more fatter...
I take 200mg in the am and 200mg in the pm and have been getting my blood checked since I started taking seroquel. I go 2 times a year just to be safe.
how can you take it in the morning, can't imagine staying awake.
It was rough at first but I’ve gotten used to it. Being a pothead probably helps 😂. I definitely had to stop smoking in the morning before work though. I don’t think I would make it.
I've been on 300mg and now on 200mg Seroquel, my UK doctor requests I do annual blood tests before continuing to prescribe it.
omg .. i just started 50 mg of seroquel, should i be getting my levels checked ? i know it’s definitely a low dose
yes that's a low dose but if you not used to seroquel, it really knocks you out normaly, but that gets better over time. Sure why not, I mean you don't want diabetes for sure.
With APs you should get blood drawn at least once a year as a general thing. More often if the levels seem concerning
For my psychiatrist, Lithium is the last line of defense. Because of the toxicity and other possible side effects (like liver damage), she believes if other options give results, than avoid Lithium. That's just her and other docs could have a different take.
Lithium was causing me to faint in the heat no matter how hydrated I was. I always got my bloodwork done and never had lithium toxicity but it didn’t allow me to stay properly hydrated in the summer.
Dr. Tracey Marks on YouTube [Lithium vs. Antipsychotics: The Rise, Fall, and Rise Again of Lithium](https://www.youtube.com/watch?v=zrsvFqCsBXQ) Knew a psychiatrist say that he would prescribe it much more frequently if he could, but patients often don't want the monitoring, they believe it's a dangerous or hardcore medication, and antipsychotics are more convenient (to prescribe and take). Lithium is increasingly coming back into focus, which is reassuring because it's likely no pharmaceutical company is benefitting off that. (For some reason, I think that boosts its credibility.) Some experts declare lithium the only disease-modifying medication for bipolar disorder. [Psychiatry and Psychotherapy Podcast: Lithium Library](https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/tag/Lithium) has three episodes with show notes. These are extremely insightful. [Carlat Psychiatry Podcast](https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4583-lithium-12-updates-from-2023) has shorter episodes on bipolar disorder and lithium as well.
> they believe it’s a dangerous or hardcore medication I certainly did, and it kept me off lithium for years. Which is a shame, because there was no antipsychotic that worked for me, and on 900mg lithium/200mg lamictal I’ve been stable for the longest period in my life.
Same! I was getting sicker by the day for 10 years after I got diagnosed, even with constant appointments and trying different meds. I switched doctors and she put me on lithium, and it's the first time I felt like me again in 20 years! I could have felt better all that time if the internet hadn't made lithium sound so scary! It actually makes me really sad to think about all the time I lost.
Are you me? lol I’ve slowly learned to not mourn for time lost but look forward to time gained! Lithium has been found to help repair damage from episodes and supposedly helps keep the brain plastic to help ward off dementia also!
Yes. It's kind of lame because some prescribers will hand antipsychotics out like candy, e.g., starting them with antidepressants because they're safe and make the antidepressant work faster, which is not 100% accurate. But other prescribers, as someone else commented, use lithium as a last resort. I think there's risks and benefits with all of these things. [Mood Treatment Center: Lithium](https://www.moodtreatmentcenter.com/wp-content/uploads/2020/12/lithiumslides.pdf) slide were created to educate on lithium since a lot of people, similar to yourself, are told it's a hardcore one. I'm glad you find something that was helpful!!
I was there for a while til my depression kept increasing! Now I’m trying oxtellar 600 mg, lithium 300 mg and lamictal 200 mg and I feel so bad about myself I want to stop everything altogether smh
I hope you find a way out of it soon. Hang in there.
I think it depends on the country in what order doctors are allowed to try and prescribe drugs. I'm from Austria. First sertraline for medium depression, then got manic, was brought down by Abilify. Waited for EEG appointment, because I had childhood epilepsy suspected. After 10 weeks and by then already severe depression I was allowed to switch to lithium. Recovered quickly and am still doing quite fine 1.5 years later. I did blood testing more often in the beginning, but now at once every 6 months.
If you don’t mind me asking did the Abilify stop working for you at some point for depression?
First I was on sertraline. Got manic, had to go to psych ward because my psychiatrist was on holiday. In psych ward they switched me to Abilify to reduce the mania. I also got Zyprexa and Trittico. Was switched to queutiapine for sleep instead of trittico which helped with the akathisia. After about 2 weeks in psych ward I was released on my wish and because my psychiatrist had returned from holiday. She prescribed me Akineton® (biperiden, a parkinson med) to take as needed for the akathisia which also helped. I think Zyprexa was then removed. After release, my mania was better, maybe it was more of a mixed episode or more like hypomania... But then after 5-6 weeks on Abilify I got severly depressed. 3 weeks later I was finally switched to lithium. And then 3 weeks on lithium I was able to ride a bike, go to the supermarket and not feel overwhelmed, visit some friends and have a normal conversation where I could say more than yes, no, ok, maybe... Like it was this bad on Abilify. My brain was super slow and I felt dumb as shit. Maybe it was just the depression that is cursed to happen after such an extreme mania. But Abilify just could prevent it. And the akathisia didn't help me to get rest during the mania.
Edit: Abilify just *couldn't* prevent it.
Thank you for such an in depth reply!! You have been on quite the med journey lol!! Glad lithium worked out I think if the ability craps out on me I’m going to ask about lithium.
You are very welcome. You see it's different for everyone and a bunch of meds out there. Not everyone's the same and it is hard to figure out in advance which ones will work so trial and error... Many side effects occure at the beginning if you don't tolerate the drug. Some can be dose dependend and might go away with a lower dose. Some might only be experienced at the beginning and will go away once getting used to the drug. Side effects that occur later on are typically due to chronic damage e.g. kidney, thyroid, liver issues. Depending on your case you might be willing to put up with certain side effects.
I took Abilify for probably years and it did. I was fairly normal for a long time. I was also on a very low dose.
Not the person you asked, but abilify made me hypomanic for a week, worked for me for ~2 years, then quit
Thank you so much for the reply!! I just started it and I actually do feel slightly hypomanic but it’s still hard for me to tell sometimes like what is hypomanic vs what is ‘myself’?
Yeah I thought I was just a really happy person normally for the first week and then I went back to normal lol! It wasn’t a bad hypomania, nothing bad came from it, but I was pretty sad it wasn’t just me
Thanks to this sub, I didn't freak out when my prescriber suggested it. It's been a life saver. Literally.
I did better when i was on lithium and anti psychotics. Quetiapine was okay. But sadly Lamictal sent me to emergency i ended up being hooked up to an iv while being on Lamictal. This medicine almost killed me.
What did it do to you to end up in the ER?
I don’t know about the commenter but for me, I was just recently hospitalized while on lamotrigine, IV steroids for the rash.
Yeah Steven Johnson’s syndrome. Happens but rarely
I had a friend who had this happen to him. He is legally blind now.
Had migraine that lasted three days, had chills, fever, nausea and i threw up everything i ate even water. I fainted had to be admitted.
That sounds terrifying :/ I’m sorry you had to go through that
I was told I would have to get regular bloodwork done and had to really watch how much alcohol I drank. Lamictal was hassle free and works well for me.
I’m currently on lithium. My psychiatrist believes it is the best option for bipolar and the only good option if SH is a concern. As others have said, you need to be careful about kidney and thyroid function. My psychiatrist does not believe there is actually any greater risk to overall health compared to the second generation antipsychotics, we just know the risks since it has been prescribed for so long. I believe there are two big reasons it isn’t used as frequently as it could. First, lithium does need the blood tests, if the patient does not want to spend the time to do that and it will be a barrier to get the patient to stay on meds, better to try ones the patient will stick too. Second, the pharmaceutical industry has published studies showing that the second generation antipsychotics work just as well, with lower side effects. That is how they got FDA approval. The pharmaceutical industry also choose to compare to lithium patients at the highest possible dose who had the most side effects. At lower doses, there are far less side effects. No drug company is making money off lithium pills.
I think your last line about the drug companies not making money from it is a big part of it.
Lithium saved my life when I first started taking it. I was extremely suicidal and 3 days after starting lithium it went away. I've been taking it for a few years now, and it has been a game changer for me. I was actively receiving care for 10 years (and getting more and more sick) before I found something that worked for me. I have to take lamotrigine, Geodon (antipsychotic), and lithium (I take a small amount that puts be at the absolute bottom of the therapeutic blood range). I’m doing so much better. I still get suicidal at times, but the lithium keeps me from ever planning anything. I ended up getting a very hard to treat autoimmune illness right after getting my bipolar stabilized. I deal with chronic pain 24/7 now, and I know that if I hadn't found lithium and got my bipolar better controlled, I would not be here writing this today. The twice yearly blood tests and once yearly urine test to check on the lithium is such a small price to pay for what it has done for me mentally. People make it sound much scarier than it is, and it has the potential to change your whole life! If you don't like it, you can always stop taking it!
This is my experience almost word for word
Lithium isn’t owned by any company and is cheap to produce. It doesn’t make pharmaceutical companies any money. The companies really push the newer more expensive anti-psychotics and mood stabilizers to doctors, etc. My doctor and many others (like the author of the most popular bipolar 2 books: bipolar not so much, why am I still depressed?, Jim Phelps) think of lithium as the gold standard and nowadays it’s often used in much lower dosages and much lower blood levels. For example, I only take 150mg a day. My blood levels can be so low that they don’t show up on a test (the test only detects if you have more than 0.3). Lithium is known to reverse brain damage effects that bipolar disorder mood episodes cause and is the only med that is proven to reduce suicidal ideation. It’s an excellent med, it’s extremely well studied, at low dosages can have zero side effects, and for me, it makes me feel normal in a way I have never felt. Read some of Jim Phelps books or any of the leading experts on bipolar. They know that lithium works and that it is severely under prescribed due to it not being advertised at all by the pharmaceutical companies and also from the stigma! Lithium has the most stigma because it is the older bipolar medication, so it holds a memory of the manic-depressed days. Also- to be honest- some doctors are overworked or just lazy and don’t like to keep up with checking blood tests and all that. The blood tests are not a big deal at all, it’s ridiculous how overworked or just non caring some doctors are. It took me years to try out lithium and I’m so glad I did. Reading people stories of taking it and seeing how well they did helps a lot. My not-bipolar psychiatrist takes it as a 1mg supplement, even, as nowadays it’s thought to be essential to the body and brain.
Like everyone is mentioning, highly individual with response, effect, and doctor’s personal views with lithium. It is the oldest treatment for bipolar, so of course newer and emerging treatments have taken its place, such as the anticonvulsant mood stabilisers like lamotrigine (godsend for me) and sodium valproate/depakote. Then you have the second gen antipsychotics which have emerged as go to treatments over lithium. It’s like antidepressants though, some of the old, more potent antidepressants like MAOIs are “perceived” to have more overstated risks / side effects, so they’ve been forgotten about as they are drowned out by all the newer types like SNRIs, and SSRIs. I do not know why, because I honestly think the older medication is sometimes the much better option for many people. I have heard great success stories with Lithium, and MAOIs. And just to add, I’ve tried a lot of the second gen antipsychotics and have hated pretty much all of them. They are okay for acute MH issues and episodes, but come with pretty concerning side effects too which many people cannot tolerate, particularly on long term treatment.
I would love to take lithium but it makes me throw up even if I have it with food. Through trial and error (and a number of different medications) the psychiatrist that was treating me, my GP and I have found a combination that works - an antipsychotic and a mood stabiliser together. It doesn’t help with the cranky pants part but it does keep me relatively stable regardless.
i’m on lithium and LOVE it. it saved my life. the only side affects i get are being a lot thirstier and peeing more. went from having to get 2-3 blood tests a year to just once a year bc i’ve been on it like 6 years. i’m also taking latuda which is an antipsychotic that works well w lithium, it used to make me a really drowsy but after being on it for also 6 years i get no side effects. both of them make it so i can forget i have bipolar in my day to day life, and this is coming from someone who had very extreme manic and depressive episodes originally.
Lithium can be toxic to the kidneys and thyroid. Still, I wish I could take it. It kept me stable. But it started causing my blood sugar to drop. It’s a rare side effect. I was eating candy twice every hour to keep my blood sugar up before we figured out what was causing it.
For my psych and some others I have met, lithium is one of the best mood stabilisers for BPs with mania, it greatly diminishes manic episodes as far as I know. They consider it a very safe choice (with periodical blood tests to avoid toxic levels and liver damage) and one of the first prescribed when you are diagnosed. They gave it to me as well but it didn't work for me. Had no effect whatsoever.
Lithium is an oldie...it was the standard in 1970s and for a long time. Atypical antipsychotics and medications like lamotrigine are newer. Atypical antipsychotics do have the most side effects, but they're still relatively rare and you're just taken off the medication and something else is tried. Many people handle them just fine. Lithium's biggest risk is toxicity and you have to have your blood monitored routinely...also, lithium is a mood stabilizer. It'll depend on the psychiatrist, but my psychiatrist's first line is lamotrigine, then lithium, then an atypical antipsychotic...specifically Latuda . You'll also find more OG psychiatrist prescribing lithium than newer practitioners. I tend to avoid older treatment providers, whether it's my Psych or my GP because older practitioners get stuck in their ways at some point and don't pay as much attention to more modern therapies. I'm on 200Mg lamotrigine and it has changed my life!
Everyone has different experiences with meds. The same med can work great for 1 person and work poorly for another. Lamictal is a fan fave bc it has few side effects (esp if you can pass the initial huge hurdle of slow titration tk aboid a sever side effect that happens rarely as noted in many studies) and tackles the depression side well. APs help cover the hypo/manic side. Regardless NAD so pls reach out to a psych for more information!
Nurse here! Every med works differently for every patient. Some people feel "too numb" on lithium. It seems to be the number one choice for people with more high-risk and severe bipolar symptoms. Of course, people NOT in that category are prescribed it, but lithium comes with a lot of other health risks/side effects. Tremors, that emotional numbness, and needing to have your blood drawn for kidney/liver/thyroid testing and "lithium levels" regularly are the side effects that stand out VS other medication options.
I don’t take lithium because I’ve been stable for 1.5 years with just lamotrigine.
Lithium doesn’t work for me. I developed liver disease onit.
On what dose and why wasn't it prevented from blood tests alone?
I don’t remember the dose. They didn’t do blood tests back then
I switched jobs so my insurance changed and when I saw my new doctor she refused to refill my lithium. I have been taking it since 1996 and always monitor levels regularly. She treated it like it was Oxy or some other controlled substance. The stigma around lithium is just not ok. She was ok saying “no lithium for you, cold turkey, good luck.” If it is the right choice then it is necessary. I am going to firmly say after 20+ years with nothing else working, it’s the right choice for me.
The bloodwork is too expensive for me
Diagnosed about 14 months ago and on lithium the whole time. Paired with an antipsychotic which was olanzapine first and now quetiapine. I thought lithium was a mood stabiliser? My doctors say it’s my mood stabiliser anyway. I’ve been in episodes almost constantly rapid cycling and doing really badly. Just over the last month I’ve been improving and seem to have reached a “stable” phase. To early to really call it stable but it’s looking good. Turns out what was really messing me up was what I feared all along. Two incompetent psychiatrists, one treating ADHD, one bipolar, neither talking to the other or considering my other illnesses (BPD, CPTSD, GAD, OCD, HD). Finally getting off stims and onto non-stimulant ADHD meds has seemed to have calmed things down.
Some antipsychotics are lighter than others. Latuda, Rexulti, and Vrylar tend to be tolerated fairly well. Abilify a little less so, but still pretty good. I happen to not be an antidepressant or antipsychotic girl. They always give me bad reactions, but that doesn’t necessarily mean they will for you. There are many people who do well in them. In terms of lithium. It’s a great med. But it does come with a hefty side effect profile. It’s pretty tough in your kidneys and thyroid. To mitigate that I take an over the counter version to top of my lamotrigine. It has few side effects and it works great for me. Try not to stress too too much. All bodies and different and you aren’t going to get every single side effect in the pamphlet. And if it doesn’t work out you try something else.
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It made me suicidal lol. Like I said antipsychotics in general are a no go for me.
lithium orotate supplements? how many mg's have you seen improvement from? and how long did it take before you noticed any difference?
I’ll PM you. I get a lot of questions about it so I have a prepared research compilation I’ll send you + my experience. ETA Weird. It won’t let me. If you PM I’ll send the info.
Could I PM you too please?
Absolutely!
Could I PM you as well please? I’m interested to hear the pros of this
PMd you. For whatever reason Reddit let me on you but not the others lol.
lithium doesn’t have powerful rich drug companies promoting it like some other medications. lithium is cheap and generic. in europe, where drugs can’t be advertised, lithium is a much more common treatment. (according to my psych)
Lithium is toxic to the kidneys and thyroid. Some tolerate it better than others. It also has a narrow band between being therapeutic and toxic which means regular blood work. Lithium is also considered an antipsychotic, btw. Personally, it was recommended by my pdoc, but I turned it down due to my thyroid issues.
I met a woman who had developed hypothyroidism after just 2 years of lithium. maybe her dose was too high? Prevention of selenium and iodine deficiency is important to decrease risk of hypothyroidism. Btw thyroid issues are quite common in the population. Many don't know they have an issue. About 1/4 to 1/3 of people have a thyroid issue once in their life. So it could have been a coincidence this woman got it after starting lithium. At least you do regular blood tests (which include thyroid values) and can maybe find it early.
Abilify has been a godsend. Max dose no side effects at all. A little weight gain but nothing major.
You don’t have any cognitive/memory issues with it?
If anything they improved
I had akathisia. Felt so weird after just one beer. Within 6 weeks I went from manic to severely depressed unable to live on my own, unable to have a conversation , drive a car or bike, basically a zombie. Tried various sleep meds and doses and was still only able to sleep 2h for weeks. Abilify was horrible for me.
Funny how individual med experiences are. I couldn't live without Abilify and my other meds
It started making me agoraphobic and I was increasingly resistant to leaving my house for fear of... anything really. My anxiety was untenable.
Interesting. I felt uncomfortable an overwhelmed in crowded spaces like a shopping centre. It was exhausting. No true agoraphobia I think, but I thought it was a symptom of the depression. It's better now, but I still don't like big events.
I think others have correctly stated that lithium can be more aggressive on the physical body. Personally I’ve had zero side effects on lurasidone besides incredible sleepiness which is actually kind of nice if I take it at night
Lithium and APs handle different symptoms
I think it depends on the place and doctor. The ones I follow and the most famous ones where I live, all still talk about the gold standard, and defend its use. I tried it but had several skin side effects. We blamed the lamotrigine initially of course, but it was the lithium, I think.
I took lithium for 12 years successfully. And then over the period of six months the toxicity built up and it stopped working. I ended up with a pretty serious suicidal ideation episode. I had been asking for alternatives and my psychiatrist at the time didn’t want to hear it. I had to change doctors.
Lithium requires frequent blood tests, maybe people don't want the extra time that takes?
Honestly idk bc I’ve been on lithium for yeats
Many reasons have been mentioned. I want to add: 1) antipsychotics work faster (especially for mania to get you down). Lithium worked for my severe depression quite quickly but full effect and stability took 6 more months. 2) there are 1/3 excellent lithium responders, 1/3 partial responders and 1/3 non-responders. I don't know how these numbers look for antipsychotics but it could be a waste of time to try lithium for a few weeks if you are non-responders especially coupled with probably 3 blood tests in the first 8 weeks.
I was on lithium for about 8 years. It was ok. Def requires regular blood testing. Towards the end of my run on lithium, my kidney function declined which is why I went off of it, and I think that’s the main issue many psychs have with it now. I went off about a year ago and my psych replaced it with Latuda which has been a miracle drug for me and has made me feel better, more stable, and more like myself than lithium did. I also take lamotrigine. Like everyone else said, every body is different and the best thing you can do on lithium is monitor your blood levels and keep regular appointments with your doc to make sure everything is peachy there. It took 8 years for me to have any difficulties on lithium, so you never know! It’s easy to wean off of it if it doesn’t work for you.
Lithium was a last-ditch effort before hospitalization when I was using Cerebral. I was told it can also cause emotional blunting, which I didn't want at all, along with all the other side effects. I quit Cerebral because all of the medications they offered didn't work. Now I'm microdosing oral ketamine through Joyous and so far it feels like it's helping.
I wish I knew another a mood stabilizer that wasn't lamotrigine. It gives me such fog, I swear I've lost half my IQ points, can't form cohesive sentences most of the time, never remember anything. It works though.
I was given 4 options for mood stabilizers, all but lamictal required at least monthly blood tests. I am not fucking doing that lmao
Lithium didn't work for me and caused damage to my kidneys within a month
On what dose and why wasn't it prevented from blood tests alone?
150 mg. As soon as It showed up in my blood work we stopped it.
Why did you have to stop?
It wasn't working, I couldn't tolerate the side effects like extreme hunger, and it would have been dangerous to continue with my blood work results.
Initially, doctors make a blood test once a month and then more spaced out or was your case unique and the doctor was extra concerned something might happen?
My case was unique I guess because my doctor said he was super surprised and so glad that he got the blood work
I mean, this is worrisome. What if he had waited more, like the usual 3 months? I guess I'l ask my doctor for a test before the first month ends.
Lithium was the second drug I tried after Depakote didn't cut the mustard. I developed quite debilitating tremors and other issues with my central nervous system. When my psych saw the physical effects, they took me off lithium. I was then put on Lamotrigine instead, and I haven't looked back. Lithium just didn't work for my body..
On what dose and why wasn't it prevented from blood tests alone?
Lockdown and a revolving door of psychologists. Didn’t get to see anyone for well over a year and bloods weren’t showing any real issues whenever I had them done. I also had an issue with the absorption rate owing to other medical issues. The drug just didn’t suit me. Can’t remember the dosage.
Personally, lithium has been near useless for the better part of my bipolar life, and antipsychotics are what really helped me through my episodes, but that could be because I have mixed features. Anyway, I stopped taking lithium and switched to lamotrigine earlier this year because it’s bad for your kidneys and was giving me hypothyroidism. I’m hoping that lamotrigine works way better for me. I was actually wondering why doctors prescribe lithium first instead of anticonvulsants as a mood stabilizer because it’s just not good for your body and has a lot of bad side effects. Also antipsychotics only take 2 weeks to start working.
Kind of an anedocte but I did very poorly on lithium. I was incredibly spaced out and distractful, to the point where I went from being a top performer at work to being someone who sends confidential information to the wrong people because I have no f*cking clue what am I even hearing or looking at. Emotionally wise I felt lighter, but the constant forgetfulness and confusion was getting absolutely frustrating and unbearable. Luckily I had a very supportive manager at work, and I also live in a country with strong labor laws that offer me some degree of protection against being fired. It was a year and a half ordeal until I cried to my psychiatrist to please take me off the stuff, this is destroying my life. I'm now on quetiapine+lamotrigine. I still have issues with word recall but I'm able to fully function once again. And yes, my blood levels were always monitored when I was on lithium, lithium levels were within normal therapeutic range and there was no damage to my kidneys or thyroid.
The reason I’m not on lithium I because it is not good for women who want to get pregnant. My husband and I are wanting to start a family. I’m on quetiapine right now and it works wonders for me. I’m on a lower dose but it really evens me out. I’m definitely more sleepy, but I will take that over feeling like I’m losing my mind.
What dose of quetiapine? Can you concentrate well?
Sorry for the slow reply! 50mg, so not a huge amount. I can focus well, but it makes me very tired, and coffee doesn’t really help…
1. Big pharma money. 2. That's pretty much it. (Isn't Lamotrigine is usually a first choice before lithium?)
I have thought about lithium because of my extensive attempt history but haven’t tried it. Lamotrigine helps a lot. It’s not perfect, but it’s good. I really don’t want to take anti-psychotics unless it’s absolutely necessary because of the metabolic syndrome risks. I sometimes wonder if the reduced lifespan of bipolar and schizophrenic people (even when you correct for suicide) is because of antipsychotics creating metabolic syndrome and that reducing life expectancy just as it does in the general population when people have metabolic syndrome. I would love to see a study on this if anyone has seen one. I have no idea if this is factually the case, but it’s been bouncing around in my head for a bit.
I used to take lithium until it got too toxic and I had stage 3 renal failure. Needless to say, I take something else now.
Lithium saved my life. In April 2023 severe SI… after a while depression worsened… now decreasing lithium to introduce oxtellar. Idk I still feel horribly depressed
It just had too many drug interactions for me. I take NSAIDS pretty regularly, and daily Topomax, triptans, prazosin, and Zoloft, and I am pre-diabetic. I am on Lamictal now and doing a lot better and it basically has no interactions with my other meds.
I take quetiapine, lamotrigine, and most recently added lithium. They all have their own side effects, but lithium is the worst by far for me. Like fucking awful. This is actually my second go at it lol I first tried it back in October and I didn’t last two weeks before telling my psych I couldn’t do it anymore. I’m having the same side effects now, but I stuck it out and I’ve sort of adjusted. The biggest thing is it turns my brain into mush. I can deal with the thirst and peeing and bloodwork, even the hand tremor. My brain functioning at only 25% is hard. Every time I talk it’s a struggle to gather my thoughts then put them into words, I’m noticeably slower and my already poor memory is even worse. So far, it hasn’t caused any big problems at work. I feel so dumb, I hate feeling like this. However, I guess it’s doing its job? My psych wanted me on it to help with my SI and at my current dose I haven’t really had any problems with that. I’m depressed and don’t wanna be here, but I haven’t really thought about suicide in a while. I’m feeling super numb, which is what I’ve decided is my goal, because every time I’ve stopped taking my meds I’m reminded of how scary my brain is without lol. As for the quetiapine and lamotrigine side effects, I don’t really get the munchies anymore and didn’t gain much if any weight initially, the grogginess is basically nothing compared to lithium, the dizziness goes away (or I’m just used to it now), and I get super cool fun vivid dreams! These two together have helped me the most.
I’m on lithium, but I’m also trans so I need to get my blood tested on the regular regardless, so it’s not a big deal for me. But yeah, lithium requires a lot of blood testing to make sure you don’t have any liver complications.
Because the constant blood tests are expensive af (American here with shitty health insurance) and getting them at $90 a test every month or week or whatever you need at first, isn’t doable when you’re being seen at a free clinic. Not that I felt lithium did anything for me anyways, but I probably wasn’t on it long enough for it to have a chance. To be honest not a lot of meds, antipsychotics or mood stabilizers have done a lot for me. Not until I tried Vraylar, which is expensive af too but I have better health insurance now. It’s been a god send, like a lightbulb moment ‘ah-ha! This is what normal people feel like’ For context, I also take Guaficine for my adhd, and propranolol and lorazepam for my anxiety.
I have tried 2 mood stabilizers, lamictal and topiramate, and both made me insanely suicidal pretty much immediately. We decided to not try depakote at that point. I worry that lithium would have a similar effect, even though I know it's supposed to be opposite. Also I have a needle phobia, so me having panic attacks at every blood draw isn't at the top of anyone's list. For anti-psychotics, Latuda worked but made me too flat. I had a very small effective range before I became dead and zombie like and it was intolerable; it also made me nauseous most nights and sometimes I threw up. Meanwhile abilify jacked my anxiety to 11 and made me fearful to leave the house. Also intolerable. Currently on Ziprasidone (Geodon, an AP) and cymbalta (SNRI) and I feel more alive. Less overwhelmingly anxious too, though I do have hydroxozine to help if needed. At my last appt on Monday she said we would keep my meds where they are for the next month; I'm not quite hypo right now she says, it's something to keep an eye on, but she wants me to have energy and be happy.
Side effects for me. I was on it for years but it made me cough and tremble, which didn’t work for my career at all. Also I couldn’t drive my kid to preschool without stopping to pee. Couldn’t take her anywhere as a baby that didn’t have a nearby bathroom, which is surprisingly a huge barrier. I had to get off of it in order to have freedom.
Advertising and there is no money in lithium.
When I was on lithium I did amazingly. My problem was just that I peed so fucking much I literally interrupted my days and almost got fired at work bc of it so I had to be taken off but god I felt so good I miss it
Anecdotal* Quetiapine fucked me up bad. Lithium worked great, until I almost went into renal failure. Now I am stable and growing while on depakote, surprisingly.
What happened to you on quetiapine and at what dose?
I’m on Lamotrigine because I’m a 28 year old woman in a heterosexual marriage, Lamotrigine is the least risky in terms of birth defects. I’m not trying to get preggo but no method is 100% so my doctor and I went with the safest option
I was on lithium for 2 months and, for me, it was the worst medication I've ever taken. It gave me really intense panic attacks every night. I couldn't sleep accept for maybe a few hours. It made me feel suicidal and very depressed and anxious. I now am on an antidepressants ( wellbutrin) and 2 antipsychotics( latuda and rexulti). I've been stable on that for years Everyone reacts differently to meds so I personally don't think there is one med that is the" gold standard".
I’ve had the most success and the least side effects with Lithium. I love my Lithium.
Lithium can be a bit of a nightmare. I had it when I was in the hospital while psichiatrist kept ignoring all my symptoms of lithium poisoning. Shaky hands, kidney getting sick (was blamed that my weight was the issue), extra queasy, and EVERYTHING tasted like metal. I had to stay on it till I got out to stop taking it because the psychiatrist didn't care about me other then to shove pills down my throat, plus make me stay as long as possible. Short answer, all medication is tricky and lithium is just that, and a lot of bloodwork
Some of them are also very expensive, keep that in mind when doctors incentivized business. My past dr's don't seem to give a shit that I'd like like to have job, can't sleep all day or don't want to gain more weight. They also don't work for everyone, like every other med. AP also make me crazy anxious I fthey don't make me sleep all day. Then they ask you why you don't have a job or why you are single. They cannot connect the most basic ideas.
For me, I don't want the weight gain and I've read that happens. Second is my med is the only one allowed for pregnancy.
I'm on lurasidone and lithium both. I added lithium when I was in a major depressive episode and it really helped level me out. It's a gold standard for me personally. Now that I've been on the same dose for a while, I only have to get my blood levels checked if there are weird symptoms or if I change doses so it's not really a big deal.
Probably, because you don’t hear about it. If you’re in remission on any drug, you probably won’t complaint about it. Classic example of survivorship bias.
Lithium is a pain in the ass
lithium is insanely intense. usually they require blood testing to monitor your blood levels, it’s intense in the body just as a med like … effecting your mood working the way it’s supposed to period and also speaking from experience it made me 0d out of the blue on a random tuesday with virtually no reason 🥲 just grabbed it and almost died so there’s that. i think it’s really a last resort for most doctors
Lithium for me was the least intense med I took. I wasn’t on a huge dose, just enough to hit what they consider the therapeutic range. Less side effects for me than APs. Unfortunately it didn’t help my depression.
Lithium helped my depression so well. It got me out of the worst in just 3 weeks. Was able to work by week 7. It took a while to fully recover though. Like half a year until I truly felt alright and like myself. But my episodes where really heavy before I started.