Posted by Sunnely on May 16, 2001, at 21:22:00
In reply to so tired, posted by cellocarly on May 16, 2001, at 16:37:37
Hi Colleen,
Here's my own 2 cents.
How's your lithium levels been? Although 1200 mg/day of Lithium is an average dose for most healthy people, some are more sensitive than the others with regard to the side effects such as tiredness, easy fatigability, even lethargy. If you exercise and sweat considerably, your lithium level may increase. Also, if you restrict your salt intake, your lithium level may rise. You should also be aware that there are several drugs that can interact with lithium leading to an increase in lithium level. Notorius are the diuretics, the ACE inhibitors (for high blood pressure such as Vasotec, Zestril, etc.) and the NSAIDs (e.g., ibuprofen, naproxen, piroxicam, etc.). Incidentally, caffeine intake will lead to a decrease in lithium level which can lead to manic relapse. On the other hand, if you have been consuming caffeine regularly with a stable lithium level then decide to stop caffeine, your lithium level will rise.
There have been case reports of lithium toxicity in combination with the SSRIs (especially Prozac). The exact mechanism is unknown but may have something to do with the SSRIs' effect on the kidneys. In your case, I'm not sure if the Effexor may be causing your lithium level to rise. Nonetheless, it's clinically prudent to have a periodic lithium levels while on these antidepressants.
How's your thyroid doing? Lithium can induce hypothyroidism which can be manifested as tiredness and lack of energy or motivation. While on lithium, thyroid function tests should be performed every 6-12 months.
How's your parathyroid gland doing? There have been case reports of lithium causing parathyroid tumor leading to such symptoms as tiredness, lack of energy, and even depression. If it occurs, it usually occurs after a few years of lithium therapy. If your calcium level is high (which should also be checked periodically while on lithium), this may indicate that your parathyroid is affected. A parathyroid hormone level (parathorhome) should then be checked.
Finally, "therapeutic" lithium levels are merely guidelines. They are not etched in stone. The clinical picture remains the best parameter as to whether one is experiencing lithium side effects or toxicity. One person may not have an iota of side effects with a lithium level ranging from 0.8 - 1.2 while another individual, of similar age and health profile, may already feel lethargic at this range.
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> I cannot get my psychiatrist or GP to listen to me when I say how incredibly tired I have been the past few years. I excercise on a regular basis and eat a healthy vegan diet and am under 30 yrs of age. I am on lithium (1200 mg/day) and effesor sr (300 mg/day.
> I am just so tired - how can I get them, especially my psychiatrist to take me seriously and listen to me when I say the meds must be causing it.
> Does anyone else have problems with being ridiculously tired? I am ready to start taking caffeine pills so that I can function for a full day. This has been going on for so long and I thought these side effects would go away or lessen. Any thoughts would be appreciated.
> colleen
poster:Sunnely
thread:63252
URL: http://www.dr-bob.org/babble/20010515/msgs/63296.html