Posted by Scott L. Schofield on January 26, 2000, at 10:44:19
In reply to Re: dysthymia & meds-my combo, posted by S. Suggs on January 24, 2000, at 6:04:22
> Lithium has a reputation of losing its effectiveness when stopping and quitting. So, along my journey of med searches, I kept taking it.
You are very fortunate that you discovered this information early enough to make decisions base upon it.
A friend of mine who suffers from bipolar II (and probably dysthymia) remained symptom-free for over three years while receiving lithium monotherapy. During this time, she experienced no side-effects, and her thyroid and renal tests were normal. When she relocated, her new doctor decided that she had been taking lithium for long enough, and that it was about time to discontinue it. She weaned off of it gradually over the course of a month or two. I think she relapsed into severe depression within three months. Of course, the doctor decided to restart the lithium. Fifteen years worth of therapeutic drug trials have passed since.
> I honestly cannot tell you if it is responsible for the excellent response I've received from Parnate.
Not that I've performed any kind of extensive survey or anything, but I seem to remember hearing or reading about quite a few success stories involving lithium augmentation to Parnate. I don't recall coming across as many with Nardil. However, this may reflect a tendency for many doctors to try Parnate before Nardil when treating depression in bipolar disorder, a scenario that may frequently include an ongoing regime using lithium.
- Scott
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Am J Psychiatry 1992 Dec;149(12):1727-9Lithium-discontinuation-induced refractoriness: preliminary observations.
Post RM, Leverich GS, Altshuler L, Mikalauskas K
Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.The authors used a systematic life-chart methodology to observe four patients with bipolar disorder in whom long periods (6-15 years) of effective lithium prophylaxis were followed by relapses on lithium discontinuation. Once the drug was reinstituted, it was no longer effective. The incidence, predictors, and mechanisms underlying this phenomenon all require further systematic study. The current preliminary observations suggest an additional reason for caution when lithium discontinuation in the well-maintained patient is considered.
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poster:Scott L. Schofield
thread:19212
URL: http://www.dr-bob.org/babble/20000112/msgs/19728.html