Posted by Ritch on October 11, 2002, at 23:23:31
In reply to Lithium and mood stability question « Peter, posted by Dr. Bob on October 9, 2002, at 1:33:30
> [Posted by Peter on October 7, 2002, at 1:50:36]
>
> > Hello all:
> > Over the years , my doctor has changed my diagnosis numerous times. In a nut shell, I get into periods where I become very depressed, isolated,impulsive, irritable, unmotivated, antisocial, and generally miserable. This has been occuring for years, though he's had me on mood stabilizers, benzos, AD's, dopamine agonists, beta blockers, stimulants, and sleeping pills. He believes that I have comorbid 'mild' bipolar/'possible' ADD/SP tendencies. Right now, I take 750mg depakote, 75mg zoloft, 2.5mg klonopin, 45-50mg adderall, and 5-10mg ambien. Though I was on this combo for a while, I began to get more emotionally volatile and my moods were more extreme than usual. My pdoc thus recommended that I try Lithium (Eskalith), reduce depakote after finding the right Lithium levels, and perhaps further reduce zoloft, as he thinks that might be causing overactivation. As we all know, this is not an exact science, but the fact that my pdoc, who I've been seeing since '97, is just so carefree about chucking new drugs my way without really being sure of what, if any, disorder I have, causes me to have to sometimes try to figure it out on my own. So, if possible, I'd like to use this Lithium triaI as a test; I believe that it is quite possible that the adderall might be the culprit in my recent mood instability, since it has more of a up/down kind of action than any of the other drugs I'm taking. I asked him the possibility of that, and he sort of brushed it aside. IF ANYONE KNOWS ANYTHING ABOUT LITHIUM, I REALLY NEED THE FOLLOWING INFO: If someone is experiencing what seem like bipolar symptoms, but they are really side-effects of another medication, will Lithium nonetheless balance those mood swings? Or ,does Lithium only balance mood swings tied to the specific chemical dynamics of genuine bipolar disorder? I have started the Lithium a few days ago. If the answer is that Lithium only helps real bipolar symptoms, then that can be a telling sign that my recent mood instability has in fact been due to a real bipolar disorder. On the other hand, if Lithium evens out your mood no matter what the source of its instability is, even if its drug-induced, then even if it is effective, I will not know if I'm taking any or all of these meds because I need them, or because they are just each cancelling out the negative effects of one another (which would really suck, since I'm taking a lot of stuff). Thank you all for your help, advice, and input.
> > Peter
>
>Peter,
Wow, this sounds SO familiar. My suggestion is to SUBTRACT meds (one at a time), that you think may be causing you more problems than they solve, then see how you feel. If you THINK that the Adderall is causing the worst instability-then that would be the first one to give a shot at tapering/stopping, and then see how you feel. Trust your feelings. My suggestion is to back off the Adderall slowly over a few weeks and leave everything else the same. It is possible you might find that 5-10mg works fine without all of this trouble. Just an opinion-but I think your pdoc is asking you too make way too many changes too quickly. I would keep everything the same and just taper down the Adderall first. Then evaluate the situation next (before you throw lithium/change depakote, etc. etc.)
Mitch
poster:Ritch
thread:122865
URL: http://www.dr-bob.org/babble/20021006/msgs/123310.html