Lithium facts

[AJ]

I just can't see it in yn.

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[uni]

Much better AJ!

[paul m]

Hello Tracey. In regards to lithium use and kidney damage it can and does happen. However it usually happens over a very long time. I'm talking decades and provided you are tested regualarly you will recieve a lot of advance warning and be able to quit in time before anything major happens.

I am sure there are exceptions, but I have been taking lithium for about 15 yrs+/_ and large doses too. Some of my kidney functions are starting to change, but nothing serious(I can't notice them, just the readings are higher now)

The worse side effects that will never go away, as long as you take lithium, for most people: mild to medium tremor in your hands( I cannot thread a small needle for example, but I can a large needle). Thirst and dry mouth can be a problem. Lithium tends to make a few people constipated, but most people taking large doses have the opposite problem. Between drinking lots of water and having loose stool, I always need to know where the nearest washroom is, whole trips are planned around availability of rest stops.

Dental problems are also common, not from the lithium, but from the dry mouth that may be a side affect. Dry mouth causes a better medium for bacteria and decay to flourish in, causing more cavities. Dentists and pharmicists can offer suggestions on this .(I can too if anyone needs info).

There are some people who suffer from really rare side effects of lithium so read your product information sheet carefully, but not fearfully. Take Care. paul m

[Atlantis]

My anxiety level has increased since my last episode and has not yet returned to its previous level, and I'm not even sure if it will...I can not sleep with out sleeping pills (1 1/2 years now) and of course I need mood stabilizers...

Is this what my life will be like from now on, taking clonanepam 3 times a day to help me relax because i can not handle even small amounts of stress, taking sleeping pills because it is impossible to just lay down after a long day and peacefully fall a sleep, and taking large doses of pills to keep my emotions from swinging wildy out of control and to keep suicidal thoughts out of my head

With all these drugs and as the illness progresses, I hardly know myself anymore...Does anyone else feel this way?

Maybe I will have to get to know the new me, accept the new me and come to love the new me...But it won't be easy.

p.s. I feel scared...I just wanted to tell you that, I don't have anyone to tell this too...Thanks for listening

[paul m]

Hello Karen. First, it's natural to be scared, this is pretty scarey stuff. The ironic part for me, that while I was pretty scared for a long time, it's now my wife who worries that my illness may come back with the same vengance as before. She worries because she has no control over my illness, whereas I have at least learned some control over it.

Will you have to take pills forever? Probably, but as you learn to live with your illness you may be able to cut down or adjust your medicine regime so that they do not affect your life so much.

Do I know myself? Yes, but for a long time I didn't. The things I did while really ill were absolutely abhorrent to my basic social values. It took me a long time to realize that I was the same person, different capabilities, but the same good person I had always been. The illness just masked that for a while.

You have a serious and chronic illness with a high rate of premature deaths. Any other illness that also fits those criteria also takes a long time to recover from. Bipolar is no different.

I won't lie and say it will be easy to get better, you will have to work very hard at getting better. But it certainally is possible to love life and yourself again. Ask me, I know, but it's certainally been the hardest thing I've ever done by far. Take Care. paul m

[AJ]

If I wasn't taking Clozaril, I wouldn't sleep at all. It's aweful to feel 'dependent' on a drug just to sleep. I take it, the consequences of not getting any sleep are too high. Sucks though!

With each episode I seem to have more anxiety than before. I don't take anything specifically for the anxiety although the Abilify seems to help somewhat.

Honestly for me, feels like whenever I have an episode, I never get back to the level of functioning (or at least it's more of a challenge) than it was before.

'Maybe I will have to get to know the new me, accept the new me and come to love the new me...But it won't be easy.'


That's a life long project for me. The new me keeps changing. I don't think it's easy at all. In fact I think it's one of those hard lessons to learn. Then when we've learnt it, we need to remind ourselves continually about what we've learned.

I'm afraid too. I'm afraid of how this will all play out. I think it's normal to be afraid of what we don't know Karen. Hang in there. You are not alone.

[uni]

Hello Karen With nobody else to tell your fears to, I'm so glad you've chosen to share them here. That's what it's all about.

My mind goes to some scary places sometimes too. More questions than answers. And wondering "Who am I, and what have you done with the Uni I know and love?" Well guess what, she's still in there. Finding her voice, finding her own way, growing at her own pace.

The pills help. But maybe even more, what helps is to learn as I go, getting smarter about it all (some might say becoming a smart*ss) and taking it a day at a time. Oh, and very, very important, sharing about it with those I trust. I need people. Crap. I don't want to, but I do.

Hmm, writing this has probably helped me more than you Karen. But please take whatever may be helpful and make it your own.

I have a feeling we'll all pick our way through the land mines alright as long as we stick together. And use our smarts, hopefully without becoming smart*sses.

[gtchamp]

Karen - I feel like you on many days, escpecially when I am down. You are not alone. Trade in the anxiety pills for epileptic ones and I am the same as you. Just know you aren't alone, as you have read (and so have I, thank goodness) we aren't alone. Our thoughts aren't out of the ordinary. Thank goodness for our friends here on the forum!

Uni - Thanks for thinking of me. I'm with AJ though, I can't see the crossed fingers?

Paul - Thanks for the info on Lithium re:Kidneys and other stuff. I'll read the article Karen attached when I have more time. I was wondering, do you know why they say you should not cut down on your salt intake? I thought Lithium was a salt based drug? Just curious.

Karen....I just want to send out a hug for you . I have had some of those days recently and it is really hard. Keep writing to us. You have helped me.

Tracey

[Atlantis]

I am overwhelmed by the support and kindness shown by my friends here on the forum .
I felt such relief reading the post that tears came to my eyes.

Paul, by simply stating sums up the reason behind my fear and now I can face it. Thank-you.

You have a serious and chronic illness with a high rate of premature deaths. Any other illness that also fits those criteria also takes a long time to recover from. Bipolar is no different.

AJ, thank-you for comforting me by sharing that you share some of the same fears as me.

I'm afraid too. I'm afraid of how this will all play out. I think it's normal to be afraid of what we don't know Karen

UNI, thank-you for making me laugh, how did you know I was a smart as* too . And, I need people also, I can't do this alone either, so lets all face this illness together

The pills help. But maybe even more, what helps is to learn as I go, getting smarter about it all (some might say becoming a smart*ss) and taking it a day at a time. Oh, and very, very important, sharing about it with those I trust. I need people

Tracey, Thanks so much for the hug and thank-you for saying that I have helped you, that was very nice of you to say that, sometimes it feels like I am the one who needs all the help it is nice to know that I have helped someone else.

Karen....I just want to send out a hug for you . I have had some of those days recently and it is really hard. Keep writing to us. You have helped me.

[paul m]

Hello Tracey. You asked about lithium being a salt and cutting down on your salt intake. First, Karen may know more than I do as I believe her field is geology, so if I explain it poorly, perhaps she can help me out with a better explaination.

Lithium is actually a metal which is very unstable and forms a chemical salt readily.

This is a different type of salt than table salt(sodium chloride), so it does not affect our sodium levels because it is classed as a salt. (sodium is what may be bad for us in large quanities)

However, just to confuse matters more, lithium does interfere with the kidneys ability to regulate salt in the body. The kidneys tend to retain less salt than is good for us when lithium is present. So low salt or salt free diets are not a good idea if you take lithium.

I know that is not a great explaination and if anyone has a better or simpiler one, please post it. I get asked this question all of the time and I never have an easy to understand answer. Take Care. paul m

[gtchamp]

I appreciate the answer Paul and I am getting a better picture. I shouldn't cut salt out of my diet. I only asked because I don't use salt in anything. I don't even cook with it and most of the time I leave it out of recipes. I just found that salt made me retain water. I'm getting the feeling things will be a bit different now.

Gee, so much to learn! I don't know how anyone can get their head wrapped around all this stuff.

I haven't made this big a change to my meds in so long, this is going to be a bit of a journey. Hope I am ready for the ride.

Tracey

[paul m]

Hello Tracey. I haven't used salt on my food (except for french fries) or in cooking for a long time. However the normal Cdn food has a fair bit of salt in it anyways(doesn't everyone eat popcorn and peanuts).

There is a lot to learn and unfortunately there isn't any one reference spot that explains it all in easy to understand language. Even pdocs are not always reliable.

My pharmacist is pretty good, but he gives me a headache trying to asborb everything he tells me.

Of course mood disorders are pretty complicated illnesses. My list of favorite websites is so long that I forget that I even have half of them, much less remember what is in them all.

How are your kids doing? Take Care. paul m

[Atlantis]

Hi Guys,
First I'd like to say I thought you answer about salt and Lithium was excellent Paul .

I found a website that had some good info on the topic

http://www.fortunecity.com/campus/psychology/781/lithium.htm

Here is what is said about lithium and sodium.

Lithium is excreted from the body almost entirely by the kidneys. If, for some reason, the kidneys are unable to get rid of the proper amount of lithium, the drug may accumulate to dangerous levels in the body. The excretion of lithium in the kidneys is closely linked to that of sodium.

The less sodium, or salt, in the body, the less lithium is excreted, and the greater chance of lithium buildup to toxic levels. Diuretics cause the kidneys to excrete sodium; as a result, lithium levels rise.

The reason that many illnesses can increase lithium levels is that increased sweating, fever, a low salt diet, vomiting, and diarrhea all result in less sodium present in the body, thus producing higher levels of lithium.

I hope this helps.

I went to see my pdoc the other day and unfortunately he told me slow (extended) release lithium is no longer available in Canada

I got my blood work back and my lithium level is 0.8. so we are going to stay at that level for now and see how things go...I'm still not sure if I will continue with the lamictal, it's to early to tell yet but that mood stablizer has worked really well so i would be nervous to go off that. But we will have to try and lose atleast one of the 6 meds I'm on

My doc doesn't make any hasty decisions, which i am really starting to like this trait in him

p.s. Maybe next time I'll talk a little about Lithiums Geology, if anyones interested, I know I love Geology but thats just because I'm a big nerd

[uni]

Neat website Atlantis. And knock yourself out (figuratively of course) explaining the geology, it's always good to learn new stuff.

I was on lithium a long time ago and liked it. Can't remember why I went off it, maybe it quit working very well. Or maybe I just plain went off meds, which I've done a few times over the years.

In any case, I don't think blood testing is a bad thing; in fact I sometimes wish there were blood tests for the other meds floating around in my body. It's such an inexact science, medications of any sort. Said the guinea pig.

[paul m]

Hello Karen. That was a pretty good site. Thx for posting the info, it is now in my favorites file.

In one place it explains how it is important to tell the Nurse taking the blood when your last dose was. I don't agree that it has to be exactly 12 hrs, but consistentcy is important. If you ususally take your last dose at 11pm and usually have your blood work done at 10am always do it that way. Also always tell the nurse when your last dose was. They don't always ask(why I don't know!!!).

The site does a good job of pointing out that lithium works best as a long term preventitive and that patient doctor interaction is of utmost importance. Unlike say lorazepam or seroquel which produce very quick results and any fool doc can predict the short term results.(if they inject you with 4mg of lorazepam you will calm right down).

I would love to have you talk about lithiums geology. When I talk about it I am using memories drawn from my days as a chemistry major(looong ago) and I am sure that some of my info is less than 100% complete. Thx again and Take Care. paul m