Lithium facts

[Atlantis]

Whether I took lithium or not, insufficent fluid intake will cause muscle cramps, especially when exercising in hot weather, even mild exercise.

I already knew all of this, so that was my really dumb move for the week. Take Care. paul m

Yeah, but you made up for it, you shared it with us so we wouldn't make the same mistake, that was smart ...Thanks.

[Atlantis]

I often read people's posts on the forum and they talk about taking lithium several times a day, I take all my dose right before I go to bed...I asked the doc about this and he said I would sleep through the worst of the side effects. I would think I am also sleeping through the highest lithium levels in my blood, although I'm not sure I'm just guessing...I will do some research but I just thought i would bring this topic up in this thread...

As I am still relatively new to the drug, i still find it quite sedating, so for example my dose is 1200 mg, I wouldn't want to take 600 mg in the am and then 600 mg in the pm because I would be tired going to work in the am but maybe if I spaced out the 300 mg pills that would work better...I think Lithium also comes in 150mg...

[paul m]

Hello Karen. When I took duralith (slow release) I took my lithium 2X per day and I tolerated it very well(with or without food). I know try and take it 3X per day. I would take it 4 or 5 times a day, but I find it better when I eat.

I have found that taking it a number of times a day helps reduce the following: irritable stomach, loose stool and my over all feeling of wellness. ie, my head seems a little clearer.

I have found it doesn't help dry mouth, the shakes or thirst.

Perhaps you could try Starting on a Friday morning and take 300mg , 300, mg at lunch, 300 at supper and 300 mg at bedtime and continue on Saturday and Sunday and see if it leaves you less sedated. Or 300 am 300 supper and 600 at night.

If I was to take 1200 mg at night on an empty stomach(like that ever happens) I would never get out of the house in the morning due to loose bowels.

Lithium can really upset my digestive system in large quanities and when taken without food. Take Care. paul m

[gtchamp]

I take my pills twice a day. 300mg in the am and 600mg in the pm. I think it is working ok. I do find I am tired though. Could that morning pill be the problem? Who knows. Either way I hope you find a fix to your problem Karen.

I have a question....is Lithium good for depression too? I have heard that it is very good for mania but does it help with the lows too? I only ask because I may try to go off my Epival (with doctors advice) and that would leave me with just Lithium to control my disorder.

PS. Thanks Paul for the info on muscle cramps. I am suffering from them and it just helps knowing where it is coming from.

[paul m]

Hello Tracey. I found that while lithium helps some with depression it wasn't the total answer.

Lithium does offer me some control over my life and is the biggest stabilizing influence I have, but I still take other meds and sometimes when my mania starts to roar or I really start to sink into depression I have to add still more.

Prior to my taking lithium, my life was a mixture of rapid cycling and mixed states that changed my moods quickly and I would experience really manic highs and great depression. For me, lithium slowed all of that down more than any other med except antipsychotics (and I have trouble with basic functioning when I take them in large doses), but did not control my moods totally.

But everyone is different. I know some people who only take lithium and it works well for them. Take Care. paul m

[gtchamp]

Thanks Paul for answering my question. I think you may have changed my mind a bit in regards to going off the Epival and that is all good.

[Atlantis]

Hi,
I just started to get cramps in my calf muscles over the weekend...I thought I was drinking lots of water, but I guess I'll have to add another couple of glasses...The cup of coffee I have in morning cancels out some of the water, so that might be effecting the daily amount too.

Hopefully I am going to try wellbutrin for depression and ADH but I need to get to 300 mg, I am on 150 mg now, I have an appt tomorrow with my pdoc, I'll let you know if he thinks increasing it is o.k. now that I am stablized on Lithium. 150 mg is not enough and if he won't increase, we will discontinue the med.

I'm trying the "spacing" out the lithium throughout the day this week to see how that works...I'll let you know

[gtchamp]

Hi Karen. Just thought I would drop a quick line in regards to your cramps. I was talking to my pdoc's nurse about them and she recommended that I take the following vitamins.....Calcium, magnesium and Vitamin D. I am to take double the recommended dose. I have not tried it yet but I plan to. I'll let you know if it relieves the cramps.
Good luck with your meds.
Tracey

[Atlantis]

Thanks Tracey...It will be interesting to see if the vitamins help with the cramps...
The vitamins would be good to take even if we didn't have muscle cramps
But the thoughts of taking more pills...Yukky

[Atlantis]

I saw my pdoc today...The only change in my meds is a slight decrease in topiramate because I can't find my words...sigh

But I have had a peaceful couple of days...My mind is rather quiet, not completely quiet, but still it's nice, soothing, calming...I am moving at a slower pace, yet I don't feel blah or yukky or black and white...I have only felt like this yesterday and today, so I don't want to get too excited but 2 days of calmness...I'll gladly take that for now...

I feel hopeful for the first time in a long time, maybe it is possible to get my mind to stop thinking...I think all the time...For 48 hours now I have had brief periods where my mind was totally relaxed...i couldn't ask for more

Me and Lithium may become good buddies afterall.

[uni]

That's such good news Karen. I hope the trend continues .

[Atlantis]

Thanks Uni

Here is a link to a book preview and there is a section titled "Therapeutic Monitoring", in which the effects on theraputic levels are discussed in divided daily dosing versus once daily dosing of Lithium.

http://books.google.ca/books?id=1bv0cvkxklsC&pg=PA218&lpg=PA218&dq=lithium+once+daily+dosing+versus+divided+doses&source=bl&ots=vKqa3R8iVw&sig=ofA8W7JDxnMwv09b6IzD-gNa_TM&hl=en&ei=Q1oPTJWMLIG0lQet7Plt&sa=X&oi=book_result&ct=result&resnum=3&ved=0CCQQ6AEwAg#v=onepage&q=lithium%20once%20daily%20dosing%20versus%20divided%20doses&f=false

I was interested in this topic because my pdoc wanted me to get blood work done yesterday during my appt and i mentioned how i had been trying the daily dosing for the past couple of days, and he said to wait another 5 days or so before getting the blood work done. just to see how my body adjusts to the change in dosing schedule.

[AJ]

A quiet mind is like Christmas come early. I'm so glad you've had 2 days of it. Let's hope for many more. Maybe you and Lithium will share nicknames or something.

[Woody]

At this point I would be doing like Elmo and wishing for Xmas all year round

I have this audio book on meditating that I read not so long ago, and it has the story of this newbie monk that has joined the whatever. On his first day, the master tell him to go up in the mountain to this cave and to meditate all day and not to come back before the end of the day. So the newbie monk goes up the mountain to the cave and tried to meditate. All day but he cannot seem to get his mind to stop long enough to get into a meditative state. SO when the sun starts to go down in the sky, the newbie returns to the whatever all frustrated. The master sees this and asks the newbie what happen. The newbie goes on to explain that as much as he tried, he could not quiet down his mind enough to start meditating. So master look at him all concerned and tells the newbie that the next day, when he goes up to the mountain to the cave, he want him to keep thinking. Think about anything and not to let his mind rest. So the newbie goes back up the mountain the next day little confused about the masters instruction, but after all he is the master, so he settles in his meditative posture in his cave on the side of the mountain and starts to think about this and that. But all of a sudden he catching himself not thinking of anything and gets worried that the master is really going to kick him out of the whatever as he has failed in following his instructions again! When he returns to the whatever at the end of the day, the master asks him how did things go, the newbie all ashamed tells him that he has failles once again to follow his instructions. The master smiles...

Let me summarize what we should have learned from this story. You cannot force your mind to do anything. You cannot force it to be quiet, and you cannot force it to be active. Its got a mind of its own and you need to go with the flow. This does not mean that we are powerless, there are some meditative practices that help dealing with the over active mind.

There are two good books that you can read. Finding The Still Point and Turning The Mind Into An Ally.

My brain is very active and other than the 500gm of Seroquel that I take at night to slam on the brakes so that I can fall asleep, there is nothing else that I can take. There is the Ritalin family of medication but my blood pressure goes through the room.

[paul m]

Hello All. First, good for you Karen for trying multiple dosing with lithium and extra good for looking up more info.

Second, it's time for me to hop on my soap box(it was getting dusty). If I wasn't already slightly crazy, docs would drive me there in a hurry.

There is very little new and unknown about lithium from a medical point of view, but docs do get sloopy. I have a 1999 copy of CPS( Compendum of Pharmacceuticals and Specialities) . It's the really big blue book that all docs are supposed to haul out ad read when they are unsure of a med.

It covers dosage information for most major meds. For lithium it specifically specifies dosing 3X per day during initial treatment. It also specifies that once stability of moods and dosage have been achieved and a maintance dose has been determined, then once daily dosing may begin. However it also adds that this dose may give a blood reading different than multiple daily dosing.

It also covers how important multiple daily dosing is to start with to minimize side effects and to "maximize" the leveling out of the mood.

It has been long known that many patients quit taking lithium because of the side effects, so why wouldn't a compentent doc automatically dose 3X per day to start with as per the makers instruction? As stability is achieved in mood there may be many reasons to take it only once per day, but that is 3-6 mths after starting it.

A doc gave me this book in about 2002 (they cost about $400) . Now if I knew this stuff in 2002, why are docs still giving out once daily dosing to new patients(or patients who havn't tried lithium before).

Ok I'm done ranting now. (on this subject) However, whether it is lithium or asprin we take, it our bodies that we are putting this stuff into and we all should try and learn as much as we can about any med we take. Take Care All. paul m