![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 10 to 34 of 59. Go back in thread:
Posted by ed_uk on March 21, 2005, at 20:25:04
In reply to Re: Dysphoric Mania » ed_uk, posted by barbaracat on March 21, 2005, at 20:15:59
Hi B!
> I've done that 3 times so far and learned that I simply can't live without it.
Just out of curiosity, what lithium level is best for you?
Ed.
Posted by barbaracat on March 22, 2005, at 8:20:34
In reply to Re: Dysphoric Mania » barbaracat, posted by ed_uk on March 21, 2005, at 20:25:04
>
> Just out of curiosity, what lithium level is best for you?**I do best on 600mg Li Carbonate. Went up to 750mg and it was fine. 900 and up and I start getting tremors and thirst. I try to keep it down to where I don't put on more weight and don't get a flattened emotional affect. There are times of extra stress when I could and should probably take more, but I try to keep my thyroid levels steady becuase hypothyroidism is quite depressing in it's own right.
It also has to be Li Carbonate. Tried Li Orotate twice, believing the hype and hoping to lessen some of the thyroid problems Li was exacerbating. But no go. It took a little longer with Li Orotate, but I hit a mania anyway. I also take a very small amount of Cymbalta (12 pellelts of SNRI), fish oil and many nutrients, and keep on top of all my other hormones, but it's the lithium that keeps me sane.
Posted by ed_uk on March 22, 2005, at 9:00:48
In reply to Re: Dysphoric Mania » ed_uk, posted by barbaracat on March 22, 2005, at 8:20:34
Hi!
>I do best on 600mg Li Carbonate. Went up to 750mg and it was fine.
That's a fairly low dose- sounds good to me. I get the impression that a quite a lot of people take doses of Li which are too high. Do you agree?
Ed.
Posted by CareBear04 on March 22, 2005, at 11:45:59
In reply to Re: Dysphoric Mania » barbaracat, posted by ed_uk on March 22, 2005, at 9:00:48
it's funny, ed, because i used to think i only responded to high doses of lithium. looking back, 1800mg of lithium is an awful lot for a girl of 100 pounds. right now, i'm on a teeny dose of 450mg, and i feel fine. part of the change has to do with my body's ability to metabolize lithium-- 450mg now brings a much higher level than it used to. but more than that, i think it's just impossible to isolate what the lithium is doing when one takes a cocktail of drugs. i thought it was the lithium keeping me afloat when i was at a high dose, but who knows, maybe it was something altogether different? but overall, the less lithium the better. taking it always makes me remember why i hate it.
Posted by barbaracat on March 22, 2005, at 12:23:38
In reply to Re: Dysphoric Mania » barbaracat, posted by ed_uk on March 22, 2005, at 9:00:48
**Well, my experience with bipolar meds is that I need much less than what the the party-line dictates. At higher doses (1200) of Li I had tremors and flatness of affect, greasy hair and nausea. Gave it 3 weeks and then titrated down until I reached a stable mood without sx at 600mg and have stayed there.
I'm having a conversation about just this topic with Cache-Monkey on another thread. He felt good at 900mg but his doctor is insisting on increasing until he reaches the 'therapeutic window'. Now that he's having very uncomfortable sx and polyurea, his doc wants him to quit. So unfortunate because this can be a very good med but at near toxic levels is stops being a good med.
New research is showing that the therapeutic level of lithium may be too high and have lowered the bottom end to .4 instead .6. My levels aren't even in the ballpark, but I dug in my heels with my pdoc and luckily, he reluctantly agreed that a non-therpeutic dose seemed to be working. Those levels are based upon the range of a generic male population and I have always been sensitive to many meds. Ten pellets out of a Cymbalta capsule have been working beautifully as an AD for about 5 weeks now, whereas the standard starting dose of 30mg almost sent me into orbit.
The only negative for me with Li has been an exacerbation of my hypothyroidism, but I'm managing that with Synthroid and Cytomel and feeling good. In fact, all my hormones were flatlining and getting them in order with bioidentical sublinqual hormones has made a huge difference.
It's my theory that mood disorders can be helped greatly by rebalancing the endocrine system. But sadly, few mainstream docs know how to correctly test for hormones or what to do about the results. Few people know how important estrogen/progesterone/testosterone is in men and women - they're precursors to the 3 neurohormones, GABA, and involved in thyroxine synthesis.
So yes, from what I've seen on this board and others, I'd have to agree with you that Li doses do not need to be so high. I'm beginning to suspect that most med doses are too high, especially for us tweaky bipolars.
>
> >I do best on 600mg Li Carbonate. Went up to 750mg and it was fine.
>
> That's a fairly low dose- sounds good to me. I get the impression that a quite a lot of people take doses of Li which are too high. Do you agree?
>
> Ed.
Posted by barbaracat on March 22, 2005, at 12:31:01
In reply to Re: Dysphoric Mania » ed_uk, posted by CareBear04 on March 22, 2005, at 11:45:59
Hey, I'm with you CareBear. A handful on this board have reported the same thing with 450mg working just fine. You mentioned your body being able to better metabolize Li. Are you doing anything in particular to bring this about?
I have to think that all this rampant polypharmacy at high doses is confusing the living heck out of our livers and the enzymes needed to break the meds down. One thing I appreciate about Lithium is that it bypasses liver metabolism and is excreted directly in the kidneys - but huge doses put a huge burden on the kidneys and that ain't right. I've opted for less is better in all my meds and haven't suffered any bad consequences. In fact, I've noticed that just a sliver of a benzo will sometimes affect me stronger than the whole pill.
> it's funny, ed, because i used to think i only responded to high doses of lithium. looking back, 1800mg of lithium is an awful lot for a girl of 100 pounds. right now, i'm on a teeny dose of 450mg, and i feel fine. part of the change has to do with my body's ability to metabolize lithium-- 450mg now brings a much higher level than it used to. but more than that, i think it's just impossible to isolate what the lithium is doing when one takes a cocktail of drugs. i thought it was the lithium keeping me afloat when i was at a high dose, but who knows, maybe it was something altogether different? but overall, the less lithium the better. taking it always makes me remember why i hate it.
Posted by CareBear04 on March 22, 2005, at 12:44:45
In reply to Re: Dysphoric Mania » CareBear04, posted by barbaracat on March 22, 2005, at 12:31:01
thanks barbaracat. i don't know if my body is better or less able to metabolize lithium. i think i'm definitely more sensitive to it because a dose like 450mg now is .5, whereas a year ago, it would be like .2. there doesn't appear to be anything wrong with my kidneys, so it's just an unexplained change. once i got over the fear that i needed 1800mg to function, i like the lower dose better.
you mentioned dropping the therapeutic range down to include 0.4. do you happen to know what the therapeutic range used to be? i remember reading in kay jamison's _an unquiet mind_ that the therapeutic doses were much higher then, and that she was often toxic from her prescribed dose. i'm very glad i wasn't treated with lithium during that time, but i'm curious what dose people were prescribed if it made them sick so often?
thanks!
Posted by ed_uk on March 22, 2005, at 13:25:17
In reply to Re: Dysphoric Mania » ed_uk, posted by barbaracat on March 22, 2005, at 12:23:38
Hello!
>New research is showing that the therapeutic level of lithium may be too high and have lowered the bottom end to .4 instead .6.
That's interesting, I think it's 'always' been 0.4 in the UK. I just looked in a book from 12 years ago, it was 0.4 then!
> He felt good at 900mg but his doctor is insisting on increasing until he reaches the 'therapeutic window'.
IMHO, every patient has their own individual therapeutic window.
>My levels aren't even in the ballpark, but I dug in my heels with my pdoc and luckily, he reluctantly agreed that a non-therpeutic dose seemed to be working.
What's your level? Maybe 0.3? Just a random guess!
>I'd have to agree with you that Li doses do not need to be so high.
My friend's pdoc wanted him at a minimum of 0.8 for unipolar depression w/ prominent fatigue! This was despite the fact that his depression got worse at 1200mg (0.7), she wanted to increase to 1500mg- he refused! I don't think he'd even be able to get out of bed if he was on 1500mg.
Ed.
Posted by barbaracat on March 22, 2005, at 14:51:11
In reply to Re: Dysphoric Mania » barbaracat, posted by CareBear04 on March 22, 2005, at 12:44:45
i don't know if my body is better or less able to metabolize lithium. i think i'm definitely more sensitive to it because a dose like 450mg now is .5, whereas a year ago, it would be like .2. there doesn't appear to be anything wrong with my kidneys, so it's just an unexplained change. once i got over the fear that i needed 1800mg to function, i like the lower dose better.
**Yes, it feels much better to not be drooling, eh? You know, there are many substances that interact w/lithium such as coffee, fiber (psyllium, flax), ibuprofen, even milk. Maybe something in your diet or med combo has changed - so hard to pinpoint these variables. Very important to get extra salt in the diet, like a good sea salt. I always put a pinch in my water which prevents the bloat I get from drinking alot of water because of lithium making me thirsty.
>
> you mentioned dropping the therapeutic range down to include 0.4. do you happen to know what the therapeutic range used to be? i remember reading in kay jamison's _an unquiet mind_ that the therapeutic doses were much higher then, and that she was often toxic from her prescribed dose.**I believe it was around .8-2.0 or .9-2.0(2.0 and above is now believed to be toxic). People used to regularly be given 1,500-1,800mg. A Babble Bud I'm communicating with's pdoc insists anything under .6 is worthless. I disagree. You have to go by individual results.
Posted by ed_uk on March 22, 2005, at 15:33:54
In reply to Re: Dysphoric Mania » CareBear04, posted by barbaracat on March 22, 2005, at 14:51:11
PS.
In the UK, the usual range is 0.4-1.
Ed.
Posted by barbaracat on March 22, 2005, at 15:44:25
In reply to Lithium: to barbara and carebear, posted by ed_uk on March 22, 2005, at 13:25:17
>
> What's your level? Maybe 0.3? Just a random guess!**You're right on. My levels have consistently been .3 on 600mg.
>
> My friend's pdoc wanted him at a minimum of 0.8 for unipolar depression w/ prominent fatigue! This was despite the fact that his depression got worse at 1200mg (0.7), she wanted to increase to 1500mg- he refused! I don't think he'd even be able to get out of bed if he was on 1500mg.
>
**That's criminal! What on earth would a unipolar depressive be doing on that much lithium?My friend on another thread, Cache Monkey, just got word from his pdoc to stop lithium immediately because of concerns of diabetes incipidus. He was having polyuria and excessive thirst. It's my partial understanding that he was doing ok on 900mg but not in the therapeutic range, so his doc pushed the dose until he felt miserable. Sigh. We just want to get better. Why can't pdocs have patience and monitor the response at a less than 'therapeutic range'? For some people, this range is proving to be toxic. For me, .3 is just fine, but even I was having some concerns from metabolites in my urine that pointed to lithium induced diabetes - which it turns out I don't have. But still, we need to be careful with this stuff and be provided with a long list of the many drugs and foods that interact with it.
Posted by barbaracat on March 22, 2005, at 15:47:30
In reply to Re: Dysphoric Mania, posted by ed_uk on March 22, 2005, at 15:33:54
> In the UK, the usual range is 0.4-1.
>
**Here, it's .5-2 or .6-2, recently dropped to .4-2.
Posted by ed_uk on March 22, 2005, at 15:57:53
In reply to Re: Lithium: to barbara and carebear » ed_uk, posted by barbaracat on March 22, 2005, at 15:44:25
Hi!
>That's criminal! What on earth would a unipolar depressive be doing on that much lithium?
His pdoc appeared to be following the guidelines for the treatment of mania!
>Why can't pdocs have patience and monitor the response at a less than 'therapeutic range'?
I don't know, they seem to work by a 'one size fits all' strategy eg. everyone should be on 20mg Prozac etc.
>0.3
Do you think your 'requirements' have decreased with time as you've been on the Li??
Ed.
Posted by ed_uk on March 22, 2005, at 16:33:10
In reply to Re: Dysphoric Mania » ed_uk, posted by barbaracat on March 22, 2005, at 15:47:30
Hi B!
I thought the 'standard' upper limit was 1.2 in the US?
Here, we usually say >1.5 is toxic and >2.0 requires emergency treatment!
Kind regards,
Ed.
Posted by CareBear04 on March 22, 2005, at 16:50:40
In reply to Re: Dysphoric Mania » barbaracat, posted by ed_uk on March 22, 2005, at 16:33:10
thanks both for your posts.
i'm pretty sure 1.2 is the upper level of therapeutic in the U.S. definitely anything above 1.5 is now treated as toxic. i think my former pdoc fell into the mentality of your friend's dr you described. of course, i told him that i felt better with more lithium-- and i did feel like my thoughts were slower and i was sleeping better, though i was really sluggish-- but he didn't think anything below 0.6 was worth taking. for me, we aimed between 0.8 and 1.2, and 1800mg put me at 1.12. it's funny b/c he's otherwise a very liberal, free-thinking pdoc. he's a psychoanalyst and doesn't even prescribe drugs to most of his patients. but on the matter of lithium, he was very old-school in his belief that more is better and his convinction that lithium, when it works, is elegant and unmatchable. i think i've been brainwashed as well. when i'm on lithium, especially higher levels, i hate it and want to go off. when i'm not on it, i start to feel racy and feel like i need to be back on lithium. what a drug! thanks for your thoughts.
Posted by barbaracat on March 22, 2005, at 17:30:06
In reply to thanks barbaracat and ed! » ed_uk, posted by CareBear04 on March 22, 2005, at 16:50:40
I have some fairly recent lab results that show the range as .5-2.0. I agree that even 1.5 is getting way too high. If I stop lithium I'm a mess. Mixed states, racing thoughts, total fracture. There's a happy medium, however, and it's not 'too much', it's 'just right'.
>
> i'm pretty sure 1.2 is the upper level of therapeutic in the U.S. definitely anything above 1.5 is now treated as toxic. i think my former pdoc fell into the mentality of your friend's dr you described. of course, i told him that i felt better with more lithium-- and i did feel like my thoughts were slower and i was sleeping better, though i was really sluggish-- but he didn't think anything below 0.6 was worth taking. for me, we aimed between 0.8 and 1.2, and 1800mg put me at 1.12. it's funny b/c he's otherwise a very liberal, free-thinking pdoc. he's a psychoanalyst and doesn't even prescribe drugs to most of his patients. but on the matter of lithium, he was very old-school in his belief that more is better and his convinction that lithium, when it works, is elegant and unmatchable. i think i've been brainwashed as well. when i'm on lithium, especially higher levels, i hate it and want to go off. when i'm not on it, i start to feel racy and feel like i need to be back on lithium. what a drug! thanks for your thoughts.
Posted by barbaracat on March 22, 2005, at 17:45:19
In reply to Re: Dysphoric Mania » barbaracat, posted by ed_uk on March 22, 2005, at 16:33:10
Not according to some recent lab work I have in front of me showing .5 - 2.0 as the range, with anything over 2 as toxic. But this is only one lab's opinion, albeit from one of the largest HMO's in the US. However, in doing a web search, typical ranges are .6 - 1.2 to 1.5. Recently, lower range of .4 are recommended.
> I thought the 'standard' upper limit was 1.2 in the US?
>
> Here, we usually say >1.5 is toxic and >2.0 requires emergency treatment!
>
> Kind regards,
> Ed.
Posted by ed_uk on March 22, 2005, at 17:55:53
In reply to Re: Dysphoric Mania, posted by barbaracat on March 22, 2005, at 17:45:19
Hi B!
0.5 - 2.0
>1.2 sounds extreme!
Ed.
Posted by barbaracat on March 22, 2005, at 18:17:16
In reply to Re: Lithium: to barbara and carebear » barbaracat, posted by ed_uk on March 22, 2005, at 15:57:53
>
> His pdoc appeared to be following the guidelines for the treatment of mania!**Ummm, unipolar/bipolar, depression/mania - pretty clear difference to me...
>
> >Why can't pdocs have patience and monitor the response at a less than 'therapeutic range'?
>
> I don't know, they seem to work by a 'one size fits all' strategy eg. everyone should be on 20mg Prozac etc.
>
**Less work for them, I guess. I find the same cookie cutter approach to conventional women's hormone therapy. I came down with a precancerous uterine condition because in my case, the cookie was too heavy with the estrogen ingredients.
>
> Do you think your 'requirements' have decreased with time as you've been on the Li??
>
**Good question. I don't know if the length of time (2 years) is a factor, but I am taking other things that are purported to be mood stabilizers, i.e., the amino acid L-taurine and 12 grams fish oil, so these could be potentiating things. I also take myo-inositol ocassionally which some say helps bipolars, others say is not good. I'm not sure it's doing anything one way or the other.It's possible I'm not even true bipolar, that something else is going on and lithium is calming an inflamed brain and I don't need as much as a 'true bipolar' would. But whoo boy, some of those manias were corkers and seem like classic BP-1 to me. More fun by far than the mixed states hells. Sigh. If only I had half the money now that I spent on those grand schemes and expensive projects...
Lithium is such an amazing substance. At the correct dose it's being prommoted as an alzheimer's treatment! It apparently inhibits the enzyme that contributes to amyloid plaque, it also increased brain derived neurotropic factor which increases dendrite growth. I haven't found anything definitive that states what dosages are recommended for neuroprotection as opposed to mania, but much less, I'm sure. Why can't we treat the mania, but reduce to neuroprotective maintenance levels afterwards?
I'm almost considering dropping my dose down no lower than 300mg 'just to see'. There are reports all over the web of bipolars benefitting from this small maintenance dose, but definitely not stopping altogether and raising it as needed. I like the idea of this. Something to carefully consider, given my hell with mixed states, but something to consider if it will work as well but without those toxicity issues. - Barbara
Posted by ed_uk on March 22, 2005, at 18:35:52
In reply to Re: Lithium: to barbara and carebear » ed_uk, posted by barbaracat on March 22, 2005, at 18:17:16
Hi B!
>cookie cutter approach
LOL I've never heard that one before, I like it!
> But whoo boy, some of those manias were corkers and seem like classic BP-1 to me.
Yes, I've read your posts where you describe your manias, it certainly seems like classic BP-I to me too.
>I'm almost considering dropping my dose down no lower than 300mg 'just to see'.
Are you sure you want to take the risk? I wouldn't want you to get ill again. It could be worth it if you've got some major side effects though.
Ed.
Posted by barbaracat on March 22, 2005, at 21:23:50
In reply to Re: Lithium » barbaracat, posted by ed_uk on March 22, 2005, at 18:35:52
>
> Yes, I've read your posts where you describe your manias, it certainly seems like classic BP-I to me too.**I've never been sure if I had BP-II or I but what's in a name? The treatment is the same.
>
> >I'm almost considering dropping my dose down no lower than 300mg 'just to see'.
>
> Are you sure you want to take the risk? I wouldn't want you to get ill again. It could be worth it if you've got some major side effects though.**No, no obvious side effects except that my thyroid has a hard time remaining stable. I also had some metabolites in my urine that concerned my doctor - said diabetes incipidus showed those metabolites, an condition unfortunately induced by lithium. I don't have it, luckily, but it did scare me.
But you're so right. There's nothing that would make me want to bring on a worsening of my condition. I just got out of the hospital 6 weeks ago because of a stressful event that was too much for lithium or any med. Life gets like that sometimes.
We forget so easily how bad it was when things start improving. Perhaps it's too soon to start tinkering because I'm just starting to feel stable physically and mentally for the first time in years - good in fact. Why would I want to fix something (lithium dose) if it ain't broke? But at some point I may inch on downward and see if things hold. I've never gone down lower than 600mg so who knows? The fact that 10 pellets out of a Cymbalta capsule is working so well still amazes me. My newest soapbox is my growing suspicion that we take too many meds at too high a dose. But I'll leave that lithium experiment for when I'm reallllly stable for a good long time. Thanks for your encouraging words of wisdom, Ed.
Are you a health professional, BTW, a fellow sufferer - or both? if you don't mind my asking. - Barbara
>
Posted by ed_uk on March 23, 2005, at 6:32:44
In reply to Re: Lithium » ed_uk, posted by barbaracat on March 22, 2005, at 21:23:50
Hi B!
>I've never been sure if I had BP-II or I but what's in a name?
In the European ICD-10 we just call it bipolar affective disorder, there is no I or II :-)
>my thyroid has a hard time remaining stable...
I wonder if a dose reduction would help this? - Especially since your level is only 0.3. Has your thyroid condition become easier to manage when you've reduced the dose previously?
>Why would I want to fix something (lithium dose) if it ain't broke?
Good point!
>But at some point I may inch on downward and see if things hold.
Perhaps you could reduce the dose gradually in very small steps- with careful monitoring for relapse. I think it would be useful to see your pdoc very regularly if you were doing this, depression can feel very much like reality if you know what I mean. If you relapse you could immediately go back up to 0.3.
>But I'll leave that lithium experiment for when I'm reallllly stable for a good long time.
I think that's a good idea. Don't rush into anything, your current stability is precious- hang on to it!
>Are you a health professional?
No, I'm a pharmacy student atm.
>a fellow sufferer...
Yes: anxiety, OCD, depression etc.
Kind regards,
Ed.
Posted by barbaracat on March 23, 2005, at 11:59:17
In reply to Re: Lithium » barbaracat, posted by ed_uk on March 23, 2005, at 6:32:44
>
> In the European ICD-10 we just call it bipolar affective disorder, there is no I or II :-)**I think we're up to Bipolar V in the US. Seems like splitting hairs but it does seem useful to distinguish cases that of mania that were brought on primarily by SSRIs (I think that's BP-IV) from genetic or other biochemistry.
> >my thyroid has a hard time remaining stable...
>
> I wonder if a dose reduction would help this? - Especially since your level is only 0.3. Has your thyroid condition become easier to manage when you've reduced the dose previously?**I'm not sure about 'easier to manage' but my TSH is affected by lowering/increasing the dose. At this point, I assume that my thyroid is toast anyway, has been problematic for a long time. Reducing or eliminating lithium is not going to restore healthy thyroid function and I'm resigned to needing thyroid hormone forever.
What is interesting is that I had some tests done late last year and earlier in this year that showed my TSH to be hovering around 8.0 and my reproductive hormones to be almost nil. I was seeing a clueless 'holistic' doctor who basically took tests but did nothing about them. I hit a wall of stressful events early February and crashed and had to be hospitalized for 10 days in the psych unit.
Since then, I've seen a very savvy OB/GYN who specializes in hormones and has increased my thyroid and changed it from the natural one I was taking to Synthroid and Cytomel. I resisted because I was brainwashed on the 'natural is better', but the synthetic T4/T3 is more consistent with less jaggy T3/T2 spiking.
She's put me on SUBLINGUAL bioidentical sex hormones and it has made all the difference. I had been on bioidentical hormones all the time but they were apparently not being adequately absorbed (transdermally). She said my cortisol levels were quite low indicating my adrenal function was exhausted.
This hormonal support has been crucial to all the other things working and getting in sync. My digestion and elimination has improved (thyroid). My fibromyalgia symptoms (fatigue, muscle pain, insomnia) have cleared up (fibro symptoms are EXACTLY the same as hypothyroid symptoms and some schools of thought believe it's an malfunction in cellular mitochondria and an inability to uptake T3). Thyroid has been the big player, but the total endocrine hormonal balance is necessary and all interrelated. Menopause can be a bitch, but doesn't have to be. And it doesn't matter what age or sex you are. Hormonal imbalance happens.
My new doc said "I can't believe you're up and walking about with levels like these". No wonder everything was so difficult. I was depleted. I try to stress on this board how important it is to get a baseline full hormone panel and go from there. So few doctors test for this - a thyroid panel is about as far as they go and you're lucky if you get that. Vitamin D deficienty is another one that's receiving alot of attention for mood disorders. I'm awaiting my prescription for high dose Vitamin D and looking forward to seeing how it goes.
So once my cellular sparkplugs are firing like they should and my energy and stamina and ability to manage stress are in good shape, I may be able to reduce the lithium. Lithium augments the other neurotransmitters and smooths electrical impulses - but so do the endocrine hormones! Lithium may have been keeping me together while my other hormones were non-functioning.
Why all the hormonal malfunction is what I ask myself and what to do about it. Stress, of course, early life stress damage to the HPA-axis. So that's my focus now - what heals, supports limbic structures. Can the hippocampus be regenerated? Is that really the problem?
>> >Are you a health professional?
>
> No, I'm a pharmacy student atm.
>
> >a fellow sufferer...
>
> Yes: anxiety, OCD, depression etc.
>
**Pharmacy - how interesting! Right there on the cutting edge of new developments. It's poignant how so many of us are in these specialized fields because of the need to understand our own condition. I go to the my pharmacies and usually look into the eyes of the pharmacist and sure enough, I recognize someone who's been through it.If you don't mind my asking, is there anything that's helping you with your symptoms? I realize that that combo of OCD, anxiety and depression are tricky to manage. How are you doing with it? - Barbara
Posted by Spriggy on March 23, 2005, at 15:21:24
In reply to Re: Lithium: to barbara and carebear » ed_uk, posted by barbaracat on March 22, 2005, at 18:17:16
Whoever that was up there that described their state when they are dysphoric, that is exactly how i feel as well.
I suppose the only difference is that I've never done that on my own; only when given an anti depressent.
Lexapro was the worst- it got me stuck in that HORRIBLE, HORRIFIC place of internal restless, hell, agitated, crawling out of my skin, racing thoughts, suicidal, and every other bad and dark thing of the mind you can think of.
But then, in a split second, I would go from that experience, and swing waaaaaaay over and feel almost euphoric (which only lasted 10 minutes at the most).
It was horrible.
Now, I'm dealing mostly with cycling from feeling "normal", to anxious, to semi depressed (but not that deep, dark depression).
The brain is so weird. Our bodies are just so complex. God's design was so intricate and when it gets messed up in the least bit, we go nuts and haywire.
I really appreciated this post on dysphoric mania because it really described in words how I felt on Lexapro (and the weeks after discontinuing) in ways I could not explain.
Posted by ed_uk on March 23, 2005, at 16:23:18
In reply to Re: Lithium » ed_uk, posted by barbaracat on March 23, 2005, at 11:59:17
Hi Barbaracat!
>She's put me on SUBLINGUAL bioidentical sex hormones and it has made all the difference.
That's interesting, there aren't any sublingual hormones on the market here, we do have hormones in the form of a nasal spray though! (Aerodiol)
>Synthroid and Cytomel.
Have you ever taken Synthroid on its own? In your experience, is it more effective to take Synthroid and Cytomel in combination?
When I've worked in pharmacies in the UK, we get trillions of prescriptions for T4 every day. I've never once seen a prescription for T3 though!
>How are you doing with it?
>.....is there anything that's helping you with your symptoms?I'm not doing too badly at the moment thank you, I don't have any severe symptoms right now.
I'm just on lofepramine 140mg. It's quite similar to desipramine- which isn't marketed here. I often taken an SSRI for my OCD, not at the moment though. My symptoms come in 'episodes,' they always have done. I don't have OCD atm but I may do in the future. If so, I'll need to go back on an SSRI, probably citalopram. I've never tried sertraline though, I might try that next time. SSRIs don't do much for my depression, if I get really depressed in future I'd like to try an MAOI. Lofepramine is ok for my depression but not great.
Regards,
Ed.
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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