For those who take or have taken Abilify and/or Lithium...

[higgs_boson]

Hello,

1) For those who have gained weight with Lithium, have you experienced some form of weight loss after stopping Lithium?

2) Has anyone who has taken Abilify and/or Lithium actually felt "better" after stopping those 2 medications?

By better, I'm not referring to "mood", bur rather physical things, most notably a reduction in fatigue or tiredness.

I appreciate any experience you may have had with these meds, I'm seeing my pdoc soon and I'm now convinced that meds are no longer the answer as they are doing much more damage than good.

[AJ]

I gained weight while I was on lithium and lost it after stopping it. As for Abilify, I'm still on it.

[astronaut]

Hi higgs_boson,

I was on Abilify for over two years when I decided to stop. I thought that it was contributing to my fatigue, poorer memory/concentration, and my "numb" and affectless emotional life. I stopped taking the Abilify and another drug (Lamictal) at around the same time and I came off of both very gradually (over the course of about 5 months). Things got worse while I was coming off of them but then about 3 weeks after I was clean, I started to feel slightly better. Things improved gradually for about five months and then after 5 months of being off of the meds completely, I was better than I had been in years and years.

I am convinced that coming off of those meds has drastically improved my cognition, my memory, and my emotionlessness. The problem is that I can't tell you whether it was the abilify or the lamictal that was causing the biggest problems for me. I think that both mood stabilizers were preventing me from having any positive emotions. I definitely started to have more energy after I came off of those meds. That being said, it took a while to get that back. First, I had to wean off the drug. Then I had to wait for my brain to re-learn how to regulate its neurohormones without the influence of outside chemicals (the drugs). Even if you find out the half life of your drugs and calculate how long it will be for the drug to be completely out of your body, that doesn't take into consideration the time your brain takes to naturally recalibrate itself and lower its threshold for tolerating certain neurotransmitters.

good luck with everything. Your pdoc may do everything she can to disuade you from coming off of the meds. I can't speak for you but it was the best choice that I made in my treatment: to stop treatment. I'm not saying that meds can't be useful or helpful--I have taken an antidepressant that has been very helpful--but far too often I took meds that made me into an automaton and I lost my humanity and ability to function and do the things I used to like to do. You'll never know if coming off the meds will help you or not unless you try. Unfortunately, the process can be difficult.

good luck,
astronaut

[paul m]

Hello Higgs_Bosun. First I'll say that Astronaut gave a very well rounded answer. My answer is different because our illnesses and medications affect everybody differently.

I've had mood swings since I was a child, I didn't start taking meds for them till I was in my 30's. I then took meds for a long time and then quit them for a long time and once again I have taken them for a long time. Lithium has been a major drug on and off over the last 20+ years. My IQ or ability to think hasn't changed whether I've been on lithium or not.

What does affect my smarts or lack thereof, is whether I'm manic, hypomanic,normal, lightly depressed or deeply depressed. These days I pretty much only hit, lightly depressed, normal and lightly manic. Even so during those 3 phases, my IQ scores can change by 30 points. When my moods normal it's about the same as when I was in college.

I do have great difficulty in concentrating when I am changing meds, when the meds aren't working for me, or during the few times that I have to take heavy doses of antipyschotics. All psych meds made me tired and have concentration problems when I started them, usually for about 6 mths+/- a bit.

My tiredness level has been pretty consistant with a person my age until I ran into problems with parkinsons. Did I feel better when ever I wasn't taking psychiatric drugs. No, or perhaps temporarily when I went manic, but the downs I encountered more than balanced that.

My answer probably doesn't help you with your problem, for that you sometimes have to go trial and error, unfortunately.

I do know that if you do have a mental illness, and only you and your doc can sort that one out, then meds are only one factor in getting better. Unfortuantely some docs feel that meds are the only factor and that certainaly is not true. Take Care. paul m

[astronaut]

I would also like to add that another reason that I decided to stop the meds was because my depression and anxiety were worsening on them and although the meds prevented any manic-like symptoms, they did so by keeping me in a state of constant moderate-severe depression. I had been depressed for so long that I actually told my doctor that I was willing to risk the possibility of going into a deeper depression and risk the possibility of committing suicide if it meant that there was an outside chance that I could possibly feel good for just one week by coming off the meds.

I would like to highlight that unlike Paul, I have not had an obvious manic episode before, and have never been observed by a clinician to be manic or hypomanic at any time (although, I have been observed to be "mixed" before).

Also, I want to emphasize that, for me, the meds that I was on never made a recognizable difference in my mood. After taking them for one year, my functionality had improved in a very minimal way, and that was arguably from a number of other things that I had done/not done for my health during that time and that very slight improvement could have been just as much from the natural cycle of my illness as from any lifestyle changes or treatments that I participated in. I was more easily able to stop taking those two meds because I moved across the country and was working with a new doctor.

Recently, I have decided to come off of my last med. When I told the pdoc of this decision, she said that she did not support it and that I would likely become severely depressed again. She told me that she would no longer see me anymore because of my choice. Currently, I have no pdoc. But how could I keep taking that drug without some kind of support? I can't afford the meds. I am very concerned about some of the short term and long term physiological effects of these meds on my body and there weren't any doctors that had reassuring proof that the med was helping more than harming me. No matter what medication I have been on, no med has actually prevented me from going into another depressive episode at some point. If I am still going to have depressive episodes with or without the meds, why am I taking them? If the meds are bound to stop working after years of being on them ("poop out"), then why am I still taking them? If I am greatly upset by the stigma that comes with taking psych meds, why am I taking them? etc.
If I was taking a med that I was very sure was helping me feel alive and not dead inside, then I would continue to take it. But meds really bother me and cause me all sorts of excess physical, emotional and psychological problems and I get even more mixed up about which part of my suffering is the illness, which part is my environment, which part is the stigma, and which part is the meds.

Paul is right, meds can be essential for some people but they are not the only part of the picture of health. What other kinds of "treatment" people may require, depends on the person.

I have taken medications for years and years. I have done a lot of research and seen many, many clinicians and have carefully observed my own life and health and the patterns and fluctuations that have occurred for me and have made my decisions about meds based on this research. I did not make the decision to stop the meds lightly, although I did make the decision on my own. The body is so, so complicated that there is no human being out there that can know what will work for me or know what is best for me. When I decided to come off the meds, just the decision made me feel a bit better because I felt like I had some agency and control--something that I gave up when I let the doctor's label me, tell me what was wrong with me, misunderstand me, and treat me. I did that for a reason, I was suffering so much that I just wanted help so badly that I would do anything to get better. The problem is that the doctors don't really know how to make me better. I trusted the doctors for so long because there was nothing else for me to do, it was the only hope that I could see. When they didn't end up helping me, I stopped trusting them and I stopped trusting all people in general who told me to "go get help," because there is no such thing in the sense that they mean. Perhaps I could have been more honest with the doctors. I often watered down what was really going on, or else they just weren't able to read me. I'm not blaming the doctors and clinicians. They had to protect themselves too. It's complicated.

sorry if I've written a lot of this stuff before on other threads and am repeating myself!

astronaut

[higgs_boson]

Thank you all for your replies.

I have seen first-hand the outcome of taking a medication and how it can affect someone positively, although that person is not me but someone very close to me. So I'm certainly not saying meds are pointless, although I won't necessarily correlate meds with getting better, as there can be tons of other factors influencing the well-being of an individual.

Anyhow, the reason why I've decided enough is enough with meds is because of the lack of evidence. If I'm told I have a certain "illness" then I'd like the doctors to present me with evidences. I don't believe that I am the best judge of my own "condition" or whatever, patients don't always accurately describe best what they're experiencing. Clinical observation in psychiatry is outdated and needs to catch up with modern medicine. Anyways I'll try so as to not divert too much from this thread, but all I'll say for now is this: We are human beings, pdocs have no right to "gamble" with our life by prescribing medications that they have no clue as to how they work. Sure they'll tell how this active ingredient binds with such receptor or whatever, but such explanations should always be preceded by "We think that's how...", because there's just no sufficient peer reviewed data. Anyways...

I have no intention whatsoever to offend anyone on this forum with my comments, but as with most individuals we change with time. As I'm learning new things about my body, I'm also trying to understand why I'm swallowing these pills and what they are doing to my body, short and long term.

I hope I can lose some weight that I have gained with Lithium, and the various neurological side effects (which may be associated with another condition that I'm suffering from) can subside after stopping Abilify. I can't be sure if the meds are causing those but I can only be sure of it once I stop them.

Thank you once again

[uni]

This is such a complicated business with the meds. I'll keep it simple and say that I agree with loads of what has been said here, there are no easy answers, and every individual is different.

As for Abilify, I have never taken it. Lithium I did take for a few years when I was at university. For the life of me can't remember why I stopped, possibly because I moved back home and changed doctors. In any case, I don't recall being any more fatigued or tired than usual when on it, nor did I gain weight - mind you I was very physically active at the time. I did go for regular tests on the levels of it in my blood, which may have had a lot to do with why I tolerated it well; there is a narrow margin within which it works properly.

[sep]

This is an interesting discussion. Like HB, I will say upfront that I do not mean any offence to others' opinions. I did want to comment on what has been said about psychiatry however, which is of course just my personal opinion.

What has been said is true in some aspects. Psychiatry relies on symptom and pattern recognition which is less than perfect. I think it's unfair to 'blame' psychiatry as an entity for this. I don't think that psychiatry is outdated compared with other areas of medicine per se, ultimately because psychiatry will only ever been as advanced as general science and technology allows it to be. I was watching the agenda recently which was focused on ADHD rather than mood disorders, but some interesting points were raised by the panelists. One doctor in particular gave a comparison to how general medicine previously used to diagnose many decades ago in the exact same way that psychiatry continues to do today (he gave a specific example of a cardiac issue). The rest of medicine has somewhat 'lucked out' because organs aside from the brain are simply easier to understand and provide clear evidence of a problem, which is why scientific advancements have benefitted other areas of medicine more. For now, a fair assessment of psychiatry is probably that in a large amount of cases, diagnoses are accurate and treatment is possible. This is obviously less than perfect, but nothing fundamental can be done to change how difficult it is in dealing with the brain - it might just take time just like it took time for science to provide other areas of medicine with the tools necessary to be more precise.

I also think it's a bit unfair to argue that psychiatrists have no right to gamble with our lives, first and foremost because we choose to see them in the first place (aside from people who are taken by force to a psychiatric hospital ofcourse). From there I think they do their best to diagnose and offer treatment according to their expertise (and aggregate results in the field). Last year the psychiatrist I was seeing rejected my request to add a second medication, because he felt that I wasn't having significant symptoms frequently enough to justify it. As much I wanted to make the decision for myself at the time, I am really glad that he said no, because he was right. I trust psychiatry because of my experience with this man, and I trust my medication because I will never let myself forgot how bad things were when I couldn't function.

Anyways, just my personal opinion.

[astronaut]

I would have to agree with you sep, that psychiatry isn't the only area in medicine that should be criticized. All areas of medicine are flawed in many respects. Many diseases are poorly understood and treatments are far from perfect. Many times, certain treatments just don't work for people whether they have an infection, cancer or a mood disorder. Medicine, and the human body is not as well understood as we'd like to think it is and we still have a lot to learn. Whether it is a "mood disorder" or a disease observable in the physical body (i.e. a tumour), these things can affect us both physically and mentally, no matter what the source. I find that far too often, medicine works in a reductionist way, trying to isolate the problem from the whole and ignoring the reality that the problem is intricately connected to everything else that is happening in the body and the body's environment. Reductionism itself is a cultural-scientific perspective and has no similarity to reality, it is merely one way of looking at and exploring the world. Slowly, more forward thinking scientists, doctors and researchers are beginning to shift the way they think about their research and how to apply small scale findings to the bigger picture.

As for "gambling with our lives," I'm not sure that psychiatrists believe they are doing this. I think that psychiatrists are just as helpless as we are and most of them are really trying to do the right thing and to help us in the way they know best. Unfortunately, many psychiatrists cannot spend the time they would like to with their clients and they don't have the resources to continue to research and communicate with others in the field as much as they would like to. In fact, I also think that many psychiatrists and clinicians are so emotionally overworked that they have to put up their own walls against their patients in order to protect themselves. And psychiatrists often have to choose between two not-so-great choices. For me at least, I had been sick for so long and so dysfunctional that it seemed like a good choice to put me on a medication that would likely increase my chances of getting osteoporosis (I'm already at a far higher risk of osteoporosis than the general public due to other health things), than to not put me on a medication and risk me committing suicide. Unlike sep, all of my pdocs would have jumped on the opportunity to put me on any medication that I asked for and would have raised the dose anytime.

Unfortunately for me, sep, I was one of those ones forced to go to a hospital when I did not want to and I was forced to take medications that I did not want to take either. I had no choice because I was fifteen years old at the time and the choice was for my parents to make (a choice I think they would not agree with today). Some of the meds that I was given were actually not used to reduce my suffering but to make me easier to deal with for the staff when I threw temper tantrums (even though I was not violent and remained on my bed during these times). I was hospitalized for nearly three months and ever since that time I have had long and severe bouts of "deadness" off and on. I was young and naive and I thought that I could trust the doctors. I thought that medicine helped people. I had never been on medicine with "side effects" before. No one told me that I would continue to suffer so much and for so long after hospitalization. I have been given all sorts of diagnoses since that time and it has actually shaped the way that I think about myself and see my own identity. Sure, now that I am not a child anymore, I can choose to seek help or not from a pdoc but by choosing to see a pdoc, I am buying into that system of categorization that has left me feeling extremely disempowered, stigmatized and trapped. I'm afraid that my extensive involvement in the mental health care system has actually fundamentally shaped the way that I view myself and the world around me. Sep is right: it IS difficult dealing with the brain, it is so, so complicated! But why do I always feel like when I see a doctor, clinician, or pdoc, that I am so simple and stupid?

Sep, I respectfully disagree that in psychiatry "a large amount of cases, diagnoses are accurate and treatment is possible." There is too much disagreement and misunderstanding in the medical community as to what disorders actually exist and how to agree on diagnosing them. Not only that, but some "disorders" don't exist much in certain cultures or are labeled and treated differently in other cultures. A broken leg is a broken leg no matter what the culture.
As for treatment, just look at this forum and how many people have gone through years and years of treatment and med trials and yet they still suffer! Why do some treatments work for some people and not others? How do we know for sure which treatment is working when multiple things are done at once to help the patient? What counts as 'getting better'? Why do so many people commit suicide? Why does it seem like everyone and their dog is "depressed" these days? How do I know if the med is working or not when the side effects outweigh the benefits? What is my "accurate" diagnosis? Over the past ten years I have been diagnosed with: OCD, subclinical OCD, OCD NOS, "does not meet criteria for OCD," bipolar I, bipolar II, bipolar II NOS, Major Depressive Disorder, GAD NOS...etc. Okay, sure, maybe the labels don't really matter in the whole scheme of things, if we can just treat the suffering. But labels do matter in a societal way and labels are how doctors communicate with each other, with the patient, and with the public. Once I have the label, it is hard for pdocs to see through that. Everything I do and say is pathologized and is part of me being "bipolar." If I have a bipolar disorder: fine. But that is traumatizing to me and very upsetting and scary. They tried to change things that I liked about myself and they measured my wellness based on how "productive" I was, not on whether or not I could love people or see beauty in the world or genuinely care about anything. No one ever saw me, all they ever see when they look at me is a disease, an unwanted, hateful, annoying thing.

I'll also never forget how bad things were when I couldn't function. I truly think everyday that it is a miracle that I am alive right now. I am so happy to be alive but I still feel like I'm a disease and that that is all I ever was for huge chunks of my life.

astronaut

[astronaut]

ha! Whoops, that post was WAY too long. Sorry kids.

[Christina]

I too feel that I have gained weight taking Effexor and the myriad of other antidepressants over the last 22 years but I'm still quite slim thanks to my genes and trying to live a healthy lifestyle (eating properly and exercising when I can). However, the feeling of "wellness and normal" far outweighs carrying a few extra pounds.
I know some people don't consider psychiatry a true science and I'm no intellectual to debate this as others have done so well, but what I do know is that antidepressants saved my life. The pain I lived with since childhood was soundly eased when I was put on medication as a young adult.

[higgs_boson]

Update: So I met with my pdoc and she instructed me as to how to reduce lithium. We weren’t able to agree on stopping the abilify yet, that remains to be seen.

If I may ask, for those who have stopped lithium, over how many weeks or months did you gradually stop the medication? I’m currently taking 750mg and have been instructed to start taking 600 mg for 3 weeks, then 450 mg for another 3 weeks and finally 300 mg for 2 weeks (then stop). Is this the normal rate of discontinuation?

[AJ]

I was in the hospital when they took me off lithium with no dosage reduction (it made me worse rather than better) and started on another mood stabilizer the same day. It probably is best to have a gradual reduction in dosage so that you can be carefully monitored for worsening of mood. What reduction and time frame I think depends on individual factors such as current dosage, current mood state, and other drugs on board to name a few.

[paul m]

Hello Higgs_Bosun. I think that AJ's answer of :"It probably is best to have a gradual reduction in dosage so that you can be carefully monitored for worsening of mood. " probably sums up very well what your doctor is thinking.

In regards how fast is it possible to stop taking lithium, for me, very quickly, however it usually leaves me with a very severe hangover for several days. And as AJ has said, results vary by person.

If you want a professional second opinion, try asking your pharmacist. Take Care. paul m