Posted by SLS on May 8, 2013, at 7:55:59
In reply to Lou's warning-anecdotal, posted by Lou Pilder on May 8, 2013, at 5:48:27
One of the most important functions of Psycho-Babble is to provide a forum for the sharing of personal experiences (anecdotes). People can glean information about treatments in real-life that is not readily available elsewhere. This includes miracles and catastrophes that may not be reported in the medical literature, despite well-scrutinized scientific observations. The value of anecdotal data is recognized by medicine as case reports (anecdotes) are ubiquitous in medical literature. These help with the often serendipitous discovery of new uses for old drugs. Testing hypotheses in proof-of-concept studies is often the motivation for more structured studies. Without the recognition and evaluation of anecdotal data, progress in medicine throughout history would have been stymied.
Regarding lithium, you fail to present statistics portraying the rate of incidence of the events you describe. Acetaminophen causes ruminant liver failure. However, this reaction is quite rare when the drug is taken as prescribed. Almost all of the cases of liver failure are due to overdose. Unfortunately, with lithium use, kidney and thyroid damage are adverse events that occur often enough to require frequent screenings to monitor for changes in function. However, the incidence of reduced kidney function is only 1.2% - 3.7%. Full renal failure occurs even less often.
http://www.ncbi.nlm.nih.gov/pubmed/19940841
http://www.ncbi.nlm.nih.gov/pubmed/8376615
What are the consequences of discontinuing lithium? Sometimes, it is death.
"In conclusion, our biopsy-based study in a selected population of lithium-treated patients is not inconsistent with the consensus opinion that only a minority of patients receiving lithium will develop mild renal insufficiency due to lithium-associated CTIN. Furthermore, the importance of lithium for patients with affective disorders is underscored by the fact that one patient (patient 2) who discontinued lithium subsequently committed suicide."
http://jasn.asnjournals.org/content/11/8/1439.full
Thyroid abnormalities occur more often than renal impairments, particularly in middle-aged women. Clinical hypothyroidism might occur in as much at 10% of people taking lithium. However, this can easily be treated with T4 thyroid hormone.
The incidence of kidney and thyroid side-effects are dose-dependent and a function of the duration of treatment. It is therefore important to monitor for changes in function and establish the lowest effective dose. The incidence of death due to lithium toxicity is rare (< 1.0%), and is usually the result of intentional overdose.
Please redirect any further discussion of clinical matters to the Medication board. Thank you.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1042981
URL: http://www.dr-bob.org/babble/admin/20130109/msgs/1043387.html