Question:
The reason that I have been web-searching was to answer some of the
questions that I have had for a while --
* exactly how well is lithium supposed to work, and
* do I really need to take as much as my psychiatrist says, to have it
work effectively?
Answer:
Since I have heard these questions raised at asdm/m I'm going to post what
I've found. I keep hearing people on websites talk about trying much
lower dosages. I was keen to find that I could get by with less lithium.
The best study that I have found so far (please post others if you have
some, I'd love to see them) about what level you need is a study that
compared bipolars who were in the 0.8-1.0 range to a second group whose
levels ranged from 0.4-0.6. Those results clearly showed that the "normal"
range is better at preventing episodes.
So the following are results from 3 studies. The first result is an
effective graph that shows the effect of lithium in bipolars. The second
study showed that if you stay in the therapeutic range (0.8-1.0) you are 3
times more likely to prevent episodes than if you are in the "low" range
(0.4-0.6). Finally there is a study that looks at whether or not lithium
maintenance works over time (a 14 year study). I hope that some of you find
this as interesting as I did.
I'm BP1, have been on Li for years, and have had episodes "break through"
throughout that time. This answers some questions for me. I keep trying to
get off Li, but nothing else works nearly as well.
I would bet the 38% would lower with proper counseling along with Li. Was counseling even mentioned or looked-at in these studies? NOrmaloes will go manic if suddenly taken off Lithium
Lithium
CATEGORY:D
8% risk of serious cardiovascular anomaly, 2.7% risk of Ebstein anomaly
REF:1
BREAST FEEDING: Contraindicated [G3].
NEONATAL SIDE EFFECTS:Hypotonia,bradycardia
Me too -- nothing else works nearly as well. I would very much like
something to work better, *for me*, than lithium. So far no such good luck.
I suppose I can feel lucky that I have the Lithium at all -- watching "The
Hours" made me want to take a time machine back to Virginia Wolf with a
lifetime supply. Did you hear about the "rest cure" that they made her take?
(In the dark, no stimulation including no books or talk, for days.) Why do you think that low levels of Lithium plus proper counseling would
work for bipolar disorder? No, therapy isn't included in these studies. It
hasn't been shown to have any effect on the course of bipolar disorder. The
only effect that I know of that they have found of therapy on bipolar
disorder is that sometimes! a therapist can persuade a client into
medication compliance (isn't that a simply awful term!). I say these things
as a trained, experienced therapist who believes that therapy is very
important in the right situation. I do think the therapy helps a person learn to deal with the ramifications
of the behaviors induced, especially by mania. It usually doesn't work
alone. Therapy taught me how to recognize the symptoms of my illness and to
seek help when they started to escalate. Helps...most of the time. It's
hard when the shift is gradual. Then I don't notice the changes. My
opinion is that therapy works for develping interpersonal and relationship
skills, anger management and all that good stuff. A mood stabilizer is the
only thing that keeps my mood swings at bay. Speaking of which...I notice my dips and my irritablity have been getting
more frequent and worse as of date. Guess I need to keep a check on things
over the next week or so.
Ah, they ups and downs of BP.
