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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by TomG on May 21, 2002, at 1:05:58
I have recently been diagnosed with bipolar type II disorder. My deprsession, agitation, and terrible irritability plague me more than some of the hypomanias that I have experienced through my 26 years. It took four psychiatrists before I found a competent one who I believe has finally correctly diagnosed me. I have taken a slough of AD before my current diagnosis. None of them seemed to do the trick by themselves. My current drug therapy started with lithium 900mg/day. By day 14 the "switch" I hear so many talk about finally flicked in my head. The fog lifted and feelings of normalcy came over me like nothing I've ever felt. Definately not hypomania. After five days this went away. Too good to be true. My blood test showed my levels to be a bit low (.57mmol/lt) so my doctor raised my dose to 1200mg/day. This dosage drove me up the wall with extreme agitation. I had this pressure in my brain like something was building up. I guess like I was literally going blow my lid. Felt like I needed to scream. I dropped my dosage to 600mg and added Nardil 45mg. I've been on Nardil for 24 days total but only 14 days at 45mgs. Four days ago I added 2.5 Zyprexa. I feel as though some of the problems are lifting, but it doesn't fell as natural as the lithium. Has anyone had this experience with lithim. Is that normal. What is a typical effective Nardil dose? I really don't know which medicines are working. I think I should have given the Nardil longer without adding the Zyprexa. I'd appreciate if anyone has similar experiences with biplolar II or especially lithium to write. The medicine game is all too confusing.
Posted by rainbowlight on May 21, 2002, at 1:46:48
In reply to That Bitch Bipolar II, posted by TomG on May 21, 2002, at 1:05:58
I have taken Lithium in the past. I didn't care for it, made me feel like a zombie. Alot of Bipolars are having great results with Lamictal, a mood stabilizer, (myself included). It evens out my moods and really help me with my irratibility.
Posted by Squiggles on May 21, 2002, at 8:27:34
In reply to That Bitch Bipolar II, posted by TomG on May 21, 2002, at 1:05:58
Hi,
I'm sorry you have so much trouble getting
the right kind and dose of medication; at
least the dx seems to be certain.I know what you mean about the "switch" - I
experienced it with li and I call it the
On/Off button (i.e. computer);
1200 mg li is what is typically given the first
3 months of initiation into the drug; that's what
i got; but after that once they measure your blood
level and stabilization is attained, it is lowered
to 900mg - maybe even lower for some people.Many factors can influence the dose, e.g. the
state of your thyroid, which I assume must have
been checked.And yes, lithium feels natural. I hope some
kind of combo can work out for you. Drug treatment
for mental states is new so I guess they just
don't know a lot of things.cheers,
Squiggles
Posted by TomG on May 21, 2002, at 11:56:03
In reply to Re: That Bitch Bipolar II, posted by Squiggles on May 21, 2002, at 8:27:34
> Hi,
>
> I'm sorry you have so much trouble getting
> the right kind and dose of medication; at
> least the dx seems to be certain.
>
> I know what you mean about the "switch" - I
> experienced it with li and I call it the
> On/Off button (i.e. computer);
>
> 1200 mg li is what is typically given the first
> 3 months of initiation into the drug; that's what
> i got; but after that once they measure your blood
> level and stabilization is attained, it is lowered
> to 900mg - maybe even lower for some people.
>
> Many factors can influence the dose, e.g. the
> state of your thyroid, which I assume must have
> been checked.
>
> And yes, lithium feels natural. I hope some
> kind of combo can work out for you. Drug treatment
> for mental states is new so I guess they just
> don't know a lot of things.
>
> cheers,
>
> Squiggles
Thanks for the reply Squiggles,
Did you have any bad side effects like I mentioned on the lithium? I thought maybe if I rode it out the agitation and pressured feeling might go away. I couldn't take it anymore though. Has your sucess with lithium lasted? I thought maybe if I stopped all medication and started lithium it would work again and hopefully stick.Tom
Posted by Squiggles on May 21, 2002, at 13:04:53
In reply to Re: That Bitch Bipolar II, posted by TomG on May 21, 2002, at 11:56:03
I confess that I have gone through so many
adverse reactions because of the number of
drugs, I am on, that it is hard to be truthful
about what you ask.But yes, I have experience the pressure you
speak of - it feels like your head is swelling;
infact, I did have a stroke/seizure episode in
Aug. for which i blame w/d from K. But it could
have been lithium going up.I am in the middle of an experiment about the
lithium level. As since my Synthroid dose
was reduced by about 45% and the li level kept
the same, I suspect, that maybe this balance is
what gives me all these symptoms: swollen ankles,
head pressure, weight gain, great fatigue, and
the peripheral neuropathy.But I may be wrong.
I will let you know.
Suqiggles
P.S. I wish we had li-detectors - anyone out there
in an enterpristing spirit and technically adept
want to make some money?:-)
Posted by TomG on May 21, 2002, at 13:43:35
In reply to Re: That Bitch Bipolar II, posted by Squiggles on May 21, 2002, at 13:04:53
> I confess that I have gone through so many
> adverse reactions because of the number of
> drugs, I am on, that it is hard to be truthful
> about what you ask.
>
> But yes, I have experience the pressure you
> speak of - it feels like your head is swelling;
> infact, I did have a stroke/seizure episode in
> Aug. for which i blame w/d from K. But it could
> have been lithium going up.
>
> I am in the middle of an experiment about the
> lithium level. As since my Synthroid dose
> was reduced by about 45% and the li level kept
> the same, I suspect, that maybe this balance is
> what gives me all these symptoms: swollen ankles,
> head pressure, weight gain, great fatigue, and
> the peripheral neuropathy.
>
> But I may be wrong.
>
> I will let you know.
>
> Suqiggles
>
> P.S. I wish we had li-detectors - anyone out there
> in an enterpristing spirit and technically adept
> want to make some money?
>
> :-)Thanks again,
I'm curious to know what you've been diagnosed with Squiggles. Has the lithium helped with or have side effects of lithium been curbed with the lithium combined with Synthroid. If my next drug of choice Lamictal fails to do what the lithium did solo I'm going to add a combination of T4 and T3 (T4 being Synthroid). My thyroid hormones are normal, but I believe that adding these to a current drug regimen has yeilded some impressive results in some people. I have mental illness on my fathers side of the family all throughout the 1900's. I've been able to count 10 suicides and several hospitilizations (mainly the earlier cases where there was no diagnosis). I'm about 85% convinced I have bipolarII. However, my father, who has had no diagnosis of bipolar has undergone psychiatric problems caused by a hyperparathyroid. He was treated with thyroid medication and radiation to treat tumors on his thyroid initially. His thoughts are that the medication and radiation caused tumors on his parathyroid which caused psychotic mania. The problem was finally resolved after five years of hell and two failed suicide attempts at Menningers Clinc in Topeka, KS(the legendary psychiatric hospital. His calcium and phosphorous balance was all screwed up. He has been normal for over thirty years. He takes Synthroid and Depakote in case of any more psychosis. I sometimes wonder if this plays any role in my condition. Even though there is really no history of thyroid disorders in my family and my father's problem was not genetic but reactive to medication and radiation, I wonder whether my father's DNA was mutated in some way to cause this in me. I have no psychotic episodes. I was born right in the middle of all his problems. Would love to hear from anyone with knowledge or similar experiences.Tom
Posted by Squiggles on May 21, 2002, at 14:08:41
In reply to Thyroid or Bipolar II, posted by TomG on May 21, 2002, at 13:43:35
HI Tom,
I was dx'd with manic-depression (1980-82 circa);
before that with depression but imipramine made me
really sick. At the time i had a breakdown I was
under great academic stress doing my doctorate.I was prescribed lithium which was great and then
later given K and X and then when the thyroid was
affected by the lithium, given Synthroid.The lithium was miraculous in treating severe
depression preceded by weird mood swings - however,
there is the factor that i was taking Valium and
I am still not sure if that was not the originating
problem in the first place.I am very sorry your father went through thyroid
hell. I sympathize because when I became hypothyroidic
and then "adjusted", I think it was the worst 6 months
of my life. If i were asked to go through that again
i would choose death.The thyroid seems to be very important in affective
disorders. I have read some articles by two doctors
(Jaffe is one) at McMaster University who are working
in this area.And yes, I do have mental illness in my family,
though I confess, it may have been something like
post partum depression unrecognized.Psychiatry is full of the most tragic and
horrible tales in human sufferring.Squiggles
Posted by Chloe on May 21, 2002, at 18:53:01
In reply to That Bitch Bipolar II, posted by TomG on May 21, 2002, at 1:05:58
> I have recently been diagnosed with bipolar type II disorder. My deprsession, agitation, and terrible irritability plague me more than some of the hypomanias that I have experienced through my 26 years. It took four psychiatrists before I found a competent one who I believe has finally correctly diagnosed me. I have taken a slough of AD before my current diagnosis. None of them seemed to do the trick by themselves. My current drug therapy started with lithium 900mg/day. By day 14 the "switch" I hear so many talk about finally flicked in my head. The fog lifted and feelings of normalcy came over me like nothing I've ever felt. Definately not hypomania. After five days this went away. Too good to be true. My blood test showed my levels to be a bit low (.57mmol/lt) so my doctor raised my dose to 1200mg/day. This dosage drove me up the wall with extreme agitation. I had this pressure in my brain like something was building up. I guess like I was literally going blow my lid. Felt like I needed to scream. I dropped my dosage to 600mg and added Nardil 45mg. I've been on Nardil for 24 days total but only 14 days at 45mgs. Four days ago I added 2.5 Zyprexa. I feel as though some of the problems are lifting, but it doesn't fell as natural as the lithium. Has anyone had this experience with lithim. Is that normal. What is a typical effective Nardil dose? I really don't know which medicines are working. I think I should have given the Nardil longer without adding the Zyprexa. I'd appreciate if anyone has similar experiences with biplolar II or especially lithium to write. The medicine game is all too confusing.
When I read your post, I thought, who cares about the # or blood level if you are feeling well and stable. BP2 is a different diagnosis than BP1, and the blood levels are much more subjective and "should" be based on what the patient can tolerate and comply with.
I too, took Li. I was on 600 mgs, .4 level. I was feeling well, not cycling, but my pdoc pushed my dose up to 900 mgs. I had the most uncomfortable feeling inside. I was shaky on the inside, sleepy but restless and just felt so blah and yucky. So I got my level up to .7 but I felt like hell. Then I developed a rash, and had to come off the li completely. I was really disappointed. So now I am on Li 225 mgs(most I can take without a rash), 250 mgs depakote and 600 mgs of Neurontin, plus a little celexa and diazapam...
My point is, if something is working, and the patient is reporting stability, and the patient knows the signs to look for when hypo or mania is coming, I think a lower end level is ok. Ie, I could have stayed on 600 mgs of li and not had to bother with the side effects and expense of two other mood stabilizers...Sorry for the rant, I guess I can relate to some of what you are experiencing.
Take care,
Chloe
Posted by jay on May 22, 2002, at 2:30:37
In reply to Thyroid or Bipolar II, posted by TomG on May 21, 2002, at 13:43:35
Hi Tom:
There seems to be some *really* good success with using two mood stabalizers, and possibly adding then thyroid or a small dose of an a.d. I am BP II, and am still trying to find my right med doses. Lithium by itself was too activating, and I am now trying a combo of Tegretol and Zyprexa.
I really, with confidence, would say two mood stabalizers is a good choice in BPII, and possibly addition of an a.d. or Thyroid when/if needed. It's really such more of an art then science, but you are doing a *great* service to yourself and others when you demand optimal treatment. I'd say BPII is becoming much more treatable with the new anticonvulsants and atypical antipsychotics. Keep up the fight..I'd say you/we are on the right track. :-)Best wishes...
Jay
Posted by BarbaraCat on May 23, 2002, at 22:26:39
In reply to That Bitch Bipolar II, posted by TomG on May 21, 2002, at 1:05:58
Tom,
What kind of lithium were you taking? Chloe has alot of great experience in this area and I'm convinced that different formulations have different effects. I've been taking generic Lithonate, or plain old lithium carbonate since February. It has been a miracle and I bless the periodic table every day. In fact, I recently ran out and was without for 10 days and boy oh boy, was I glad to get back on. I'm on 600 mg. along with Remeron 70 mg. Even though my blood levels are lower than the therapeutic range I don't want to raise my dosage since it seems to be doing the trick for me. However, I have to stress that for me I also need the Remeron for the awful depressions. One does not work without the other. I also take 2 grains of Armour thyroid for hypothyroidism which was present before starting lithium. I sure hope it works for you. Barbara
Posted by TomG on May 23, 2002, at 23:21:55
In reply to What kind of lithium? » TomG, posted by BarbaraCat on May 23, 2002, at 22:26:39
Thanks for replying Barbara,
I'm taking lithium carbonate also, but I will discuss with my doctor about different kinds. For me lithium worked alone at 900mgs for five days. How do you distinguish the effects of the lithium from the effects of the Remeron? I took Remeron alone about three years ago and it caused some weird side effects (extremely vivid dreams and it turned me into an obsessive workhorse--- cleaning out closets organizing drawers etc. etc.) but really no antidepressant effects. If you have any other lithium knowledge please tell. Also, were your blood tests normal to indicate you had hypo-thyroid or was it obvious that it was under-producing?Tom
Posted by BarbaraCat on May 24, 2002, at 0:32:46
In reply to Re: What kind of lithium?, posted by TomG on May 23, 2002, at 23:21:55
Good questions, Tom. I've taken just about every other AD on the market and ended up with Remeron. It worked great for two months - the best of all of them and then pooped. The lithium seems to create a synergistic effect. One doesn't work without the other, however, whether or not another Serotonin uptake med would work just as well isn't clear. I've increased the Remeron slowly and am now up to 72.5 mg and the NE effects have definitely kicked in -- much more activating, but still not speedy or wired like, say, Prozac made me feel. I'd like some of that cleaning closets oomph! But come to think of it, I've been kinda obsessively getting back into my dance routine after 3 years of nothing. Can't hurt, since the Remeron has added a fair bit of pudge.
As far as hypothyroid, I've been on thyroid hormone since the early 80's cause it showed up in blood tests and I was feeling it's symptoms. A few years ago on the advice of a naturopath I tapered off and was not taking any for about a year. His rationale was that I perhaps didn't really need it and this was the best way to find out. I really needed it. It took another 6 months to get my levels back and feel warm again.
Currently, I take my blood tests every couple of months because of the lithium. The TSH values are good, under 2.0. I increased my dose from 1.5 grains to 2 grains (Armour thyroid - I can't take synthroid) just for the heck of it when I started lithium and TSH has remained pretty consistent. I just had a test today, so we'll see. I don't feel any hypothyroid symptoms at all now and my energy level is better than it's been in many years. I also have fibromyalgia which causes extreme fatigue and musle aches, so this is very good news for me. When I was feeling hypothyroid it felt like I had a cold furnace at my core. Felt like my joints and muscles were seizing up and aching deep inside, foggy brain, bone-weary tired, sluggish, dry hair, constipation.
Oh, also, just today my pdoc recommended taking all my lithium in one dose. For me this is at bedtime. He said some recent evidence suggests that this avoids alot of the side effects for some reason I don't quite understand.
- Barbara> Thanks for replying Barbara,
> I'm taking lithium carbonate also, but I will discuss with my doctor about different kinds. For me lithium worked alone at 900mgs for five days. How do you distinguish the effects of the lithium from the effects of the Remeron? I took Remeron alone about three years ago and it caused some weird side effects (extremely vivid dreams and it turned me into an obsessive workhorse--- cleaning out closets organizing drawers etc. etc.) but really no antidepressant effects. If you have any other lithium knowledge please tell. Also, were your blood tests normal to indicate you had hypo-thyroid or was it obvious that it was under-producing?
>
> Tom
Posted by kpo2002 on May 26, 2002, at 16:51:02
In reply to Re: Thyroid or Bipolar II » TomG, posted by jay on May 22, 2002, at 2:30:37
I can't believe that I am finding people that are taking high doses of Remeron. I am taking 75 mg. at night for neuropathic pain. I had a hard time convincing a few doctors that I needed this much. the recommended dosage is 45 mg. and that is the highest dosage that the company ever tested. the last time that I was in the hospital everyone questioned the amount even the pharmacist. I think we should all save a few hundred dollars and meet eachother on a beach in Florida with a sleeping bag, a few cans of tuna and a loaf of bread. That would surely help my depression and I wouldn't have to spend all my time reading and writing. Oh by the way TOM G--I have been sick for years and my house is a wreck. You can come over anytime you're having an uncontrollable cleaning spell.
Posted by BarbaraCat on May 26, 2002, at 19:14:25
In reply to Re: Thyroid or Bipolar II, posted by kpo2002 on May 26, 2002, at 16:51:02
There's not too many of us maxiRems, as far as I can tell. Did you know that in Europe they regularly start them out at 30 mg and the typical dose is 90mg? I'm very glad I had the intuitive hit to increase my dosage from 45 to 75mg. It is an entirely different drug than the dopey half baked response I was getting at lower dosages. I think Remeron is wonderful and wish the US psych community would get a clue as to it's effective dosages.
The Florida trip sounds like a great idea, but can't we do a little better in the cuisine department than canned tuna and bread? Hey, I'm a great cook! As long as you catch me in a hypomanic swing I'll handle the munchies. Speaking of which, did you find your weight problems/appetite change with a higher dose? - Barbara
> I can't believe that I am finding people that are taking high doses of Remeron. I am taking 75 mg. at night for neuropathic pain. I had a hard time convincing a few doctors that I needed this much. the recommended dosage is 45 mg. and that is the highest dosage that the company ever tested. the last time that I was in the hospital everyone questioned the amount even the pharmacist. I think we should all save a few hundred dollars and meet eachother on a beach in Florida with a sleeping bag, a few cans of tuna and a loaf of bread. That would surely help my depression and I wouldn't have to spend all my time reading and writing. Oh by the way TOM G--I have been sick for years and my house is a wreck. You can come over anytime you're having an uncontrollable cleaning spell.
Posted by TomG on May 29, 2002, at 21:16:17
In reply to Re: What kind of lithium?, posted by BarbaraCat on May 24, 2002, at 0:32:46
Thanks for the reply Barbara. Are you saying that different solutions of lithium can actually work when others did not? I'm thinking of washing out all medications that I'm on now and starting over since I had a partial response to Lithonate. It worked for five days and then it was all bad side effects. Totally intolerable. Curious to know.
Tom
Posted by BarbaraCat on May 30, 2002, at 0:24:15
In reply to Re: What kind of lithium?, posted by TomG on May 29, 2002, at 21:16:17
Hi Tom,
Chloe has some great info and experience with different kinds of lithium. I've only been on generic Lithonate since Feb. You might try asking her for advice. - Barbara> Thanks for the reply Barbara. Are you saying that different solutions of lithium can actually work when others did not? I'm thinking of washing out all medications that I'm on now and starting over since I had a partial response to Lithonate. It worked for five days and then it was all bad side effects. Totally intolerable. Curious to know.
> Tom
Posted by TomG on May 30, 2002, at 9:50:14
In reply to Re: That Bitch Bipolar II » TomG, posted by Chloe on May 21, 2002, at 18:53:01
Thanks for all the information Chloe. I originally wrote this message to Barbara, but she said you had more information. Are you saying that different solutions of lithium can actually work when others did not? I'm thinking of washing out all medications that I'm on now and starting over since I had a partial response to Lithonate. It worked for five days and then it was all bad side effects- totally intolerable. If you were me which solution would you try first? Curious to know.
> Tom
Posted by Chloe on May 31, 2002, at 18:51:50
In reply to Re: What Kind of Lithium?, posted by TomG on May 30, 2002, at 9:50:14
> Thanks for all the information Chloe. I originally wrote this message to Barbara, but she said you had more information. Are you saying that different solutions of lithium can actually work when others did not? I'm thinking of washing out all medications that I'm on now and starting over since I had a partial response to Lithonate. It worked for five days and then it was all bad side effects- totally intolerable. If you were me which solution would you try first? Curious to know.
> > TomTom,
As you know, BP2 is not very easy to treat. And treatment usually consists of at least one mood stabilizer, but possibly more, and often and small amount of an antidepressant, etc.If you had an initial, but partial response lithonate, you may benefit from lithium as one of the players in your cocktail. Lithium does have some nice antidepressant as well as stabilizing properities. So at lower doses, I am a big fan of lithium augmentation. BUT, you said, after 5 days, the side effects were intolerable. What side effects? What was so bothersome that made you stop?
There are different preparations of li, called extented release, or controlled release. These slower release pills tend to decrease the typical side effects, but I don't know what you were suffering from. These brands are described in detail in a post to Barbara at:http://www.dr-bob.org/babble/20020517/msgs/107335.html
I would not wash out all meds! I think you will a bad, unpredictable reaction. I think you need to sit down with a pdoc, and plan a stagedy of what a good cocktail would be for you. You need to discuss:
What are the meds that you have tolerated ok and have give you decent or partial response?What is working for you now?, etc, etc,
As you said it, "that bitch bp2", this is not an easy one to treat. Changing to a long acting form of Li may reduce some side effects, or perhaps you were on too high a dose. It takes about 5-7 days to get a steady blool level of lithium at a steady dose...
Sorry I can't be more help without more info. If you have more questions, fire away.
Chloe
Posted by TomG on June 1, 2002, at 0:00:22
In reply to Re: What Kind of Lithium? » TomG, posted by Chloe on May 31, 2002, at 18:51:50
Sorry Chloe. I guess I was a little vague on my last post. I was just diagnosed bpII in March. The only mood stabilizer I have tried is lithium. I am now on 600mg lithium, 7.5mg zyprexa, and 60mg Nardil. This combination doesn't seem to be doing much. I can notice my anxiety and agitation are not as bad as when I was taking lithium alone, but I wouldn't consider my overall mood better. I attribute this to the zyprexa. I feel drowsy everday and just generally dopey. When I first took the lithium I was able to get up to 900mg by day 14. It worked unbelievably well for only five days and quit. It was definately not hypomania. My doctor says he can't call it a response whereas I think it was. I said in my earlier post that my level was .57mmol/lt at this point with 900mg. My doctor raised dose to 1200mg. When the lithium stopped working I felt bad, but when the dose went to 1200mg it was intolerable. I had this sick internal pressure in my head (not really like a headache) but pressure. Also, my agitation and irritability went went way up. I lowered to 600mg and still felt a little twinge of bad side effects, but it was tolerable. Somehow the lithium worked on me and then stopped working. Something unknown happened. This is where I wonder if another solution of lithium might work for me. What do you think? If one brand fails to work or partially work could another solution work? I can't feel anything on 600mg. I would love to just take lithium, but I think this is a little rare with bipolarII. When I said "wash out" my current medications I of course meant tapering. I've been on the lithium since March 14th, the Nardil since April 26th, and Zyprexa since May 17th. I think I've given all this adequate time. My doctor wants to try Lamictal next. What do you think about trying another solution? Would trying another solution not be practical based on the horrible side effects I got when the lithium stopped working on day 19. Would trying a new solution be more justifed with having more typical side effects of lithium? Tom
Posted by Chloe on June 1, 2002, at 9:19:54
In reply to Re: What Kind of Lithium?, posted by TomG on June 1, 2002, at 0:00:22
> Sorry Chloe. I guess I was a little vague on my last post. I was just diagnosed bpII in March. The only mood stabilizer I have tried is lithium. I am now on 600mg lithium, 7.5mg zyprexa, and 60mg Nardil. This combination doesn't seem to be doing much. I can notice my anxiety and agitation are not as bad as when I was taking lithium alone, but I wouldn't consider my overall mood better. I attribute this to the zyprexa. I feel drowsy everday and just generally dopey. When I first took the lithium I was able to get up to 900mg by day 14. It worked unbelievably well for only five days and quit. It was definately not hypomania. My doctor says he can't call it a response whereas I think it was. I said in my earlier post that my level was .57mmol/lt at this point with 900mg. My doctor raised dose to 1200mg. When the lithium stopped working I felt bad, but when the dose went to 1200mg it was intolerable. I had this sick internal pressure in my head (not really like a headache) but pressure. Also, my agitation and irritability went went way up. I lowered to 600mg and still felt a little twinge of bad side effects, but it was tolerable. Somehow the lithium worked on me and then stopped working. Something unknown happened. This is where I wonder if another solution of lithium might work for me. What do you think? If one brand fails to work or partially work could another solution work? I can't feel anything on 600mg. I would love to just take lithium, but I think this is a little rare with bipolarII. When I said "wash out" my current medications I of course meant tapering. I've been on the lithium since March 14th, the Nardil since April 26th, and Zyprexa since May 17th. I think I've given all this adequate time. My doctor wants to try Lamictal next. What do you think about trying another solution? Would trying another solution not be practical based on the horrible side effects I got when the lithium stopped working on day 19. Would trying a new solution be more justifed with having more typical side effects of lithium?
Tom,
I don't think that changing brands will help much with the "intolerable" side effects you describe. When someone is very nauseated, has a very bad hand tremor, or diarrhea, a long acting preparation (not solution, because a solution is a liquid!) can ease these side effects by keeping the blood level more constant between doses.It does sound to me, like li is useful to you. But IMHO, your body can only tolerable about 600mgs without feeling uncomfortable or yucky. This is good information to have. You can work on adding and subtraction meds from there.
You said you feel dopey. Maybe the Zyprexa dose is too high with the high end dose of Nardil and your Li? Zyprexa can make peoplel feel very hung over and knocked out even during the day. Maybe adding Lamictal to your mix would perk you up a bit, as it can be activatiing with some AD properties, and you could decrease the Nardil a smidge. This is all guess work, and takes a great deal of time and patience to find the right mixture of meds. Don't give up!
Now that I think about it, I would push for a switch to Lithobid, a long acting lithium preparation. It might ease some discomfort, but it will not prevent the pressure in the head and the internal edgy feeling. (I have that awful, jiittery feeling when my level is over 0.5 or so. So I added Depakote and Neurontin to my mix.) You seem to know the dose that makes you feel ok without feeling worse. And again, I think you may have gone up on the Li too fast if you got to 900 mg in 14 days. It seems to me that you may have shot past a "therapeutic window" of lithium for your body.
Keep us posted
Chloe
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