Lithium

[Lobo]

Hi,
I'm new here. I always posted on Family of Substance Abuse. My daughter has dual diagnosis. She has been clean for about 8 months now. However her bi polar issues are still running rampant. She has bi polar 1. she seemed to be doing pretty well on Seroquil, except she still had a lot of anger. Her doc changed her over to Lithium. So she was coming down form Seroquil and trying to build a level of Lithium and she was off the wall two days ago. She was acting like she was drunk and wasn't, she was argumentive and hyper. It was a real mix. I couldn't reason with her.
Has anyone had this type of experience? Does anyone know how long it takes for the Lithium to build up and level her out? I called her doc and she said do not go off of the Lithium because that is what is going to stabilize her mood. She said she is going through a manic phase because she is coming off of the Seroquil and trying to build up the Lithium.

Any input would be greatly appreciated. I am a concerned mom and I've not seen this type of behavior before.

Thanks.............Lo

[pedagogue]

Lithium will take awhile to titrate up (increase in dosing) to a level that stabilizes your daughter (effective therapeutic dose). If the doc goes too quickly there can be more side effects, so it is usually the lesser of two evils to take a bit longer and deal with the short term issues, hoping that stabilization will be longer term. Lithium has a lot of literature behind it and it can be effective once the right dosing is reached. I'd trust in your doctor and make sure to keep them in the loop over the coming week/weeks. Is your daughter seeing someone on an individual basis for therapy? Many community mental health centers offer sliding scale services for people, which can be really helpful when someone is trying to re-adjust to daily life. A few learned coping skills from therapy can go a long way. It can also be helpful for the family members as it can be a very stressful time in the household, and it is nice to have an ear of someone who may be able to help.

Best of luck.

[Lobo]

Ped,
Thanks for your response. Yes, she is seeing someone. She has a pyschiatrist and therapist. Her insurance covers it. She hasn't been going to her therapy lately though. Now that she had her meds changed she has to see her pyschiatrist. As for me, I am not in therapy right now. However it is very hard on me because she lives with me. When she is good, it is nice having her around.....but when it is bad, it is extremely difficult on me. My insurance does not cover any type of mental health issues. Some how I get through. I have a good family and good friends.

Thank you............Lo

[TiredMama]

From experience, when I swapped meds, my bipolar was at it highest and I leveled out when the meds where in my systems. I went from Depakote to Gabitril in a week and there was a time when I was very manic. When the Gabitril settled in, I got better.

[Lobo]

Tired,
I've never heard of those two meds. My daughter is bi polar 1. Is this something we should look into for that? What are the side effects? Do you think they are safer than lithium? Frankly, Lithium scares me, and I really don't know why.

Thanks...........Lo

[shutterbug]

Lobo,

1. Check around in your community by calling your state NAMI (National Alliance of Mental Illness) office....the number or web site is listed in my signature to see what is available for you for free. I know that i personally was able to find a Friends and Family of Bipolars group i could attend weekly at a local church. It REALLY helps to talk with others going through the same things.

2. Since your daughter is dual diagnosis with also having the substance abuse issues (as a large percentage of bipolars do)...it is SO very important for her to get stabalized. And luckily bipolar I is much easier to treat than bipolar II (which is what my diagnosis is).

3. Many bipolar I's do very, very well on Lithium. It probably scares you because you've been told that regular blood tests are needed to ensure the salt levels don't build up in her system to a dangerous level or anything, but Lithium is the oldest mood stabalizer around. It was the first one ever found to help bipolars. I tried it myself as my 3rd or 4th mood stabalizer go-round and either my doc started me on too high a dose or i was VERY allergic to it -- as it made me so insanely ill that i couldn't sit or stand up with out throwing up (or dry heaving) and after several days of that crap i was about ready to go to the emergency room.

Many have and continue to do VERY well on Lithium....including actress Patty Duke, who is also bipolar I and dual diagnosis with alcoholism. Actually, there are a TON of famous people with bipolar disorder and also substance abusers. I highly recommend reading her book called, "A Brilliant Maddness." It was the first book about bipolar disorder I read and the best one of the subsequent 100s. It alternates chapters between her telling her own story and then the next chapter is more "informational" like as it is written by her own psychologist and gives more fact type stuff about the illness.

Depakote was the first one i was put on 4 years ago and it also requires regular blood tests.

Topamax is the mood stabalizer i'm currently on and seem to be doing okay on it. However, i don't know anything about it -- which is VERY unlike me, but i was placed on it while i was pretty much out of it, so to speak and have yet to do any research on it.

Lexapro is another, which my dad and other i've known have used/use. I tried it also and think it should not be given to bipolar II's because of the fatigue side-affect many get with it (as we struggle with fatigue enough as it is).

???(oh shoot, i can't remember the name of it) --- Is another that many like and it has very minimal side-affects....some say none at all. I thought it was a good one for me too and don't even remember why i let my doctor change me, but it did cause my acne to worsen as the only side-affect i had. When I think of the name of it....i'll come back and post it.

I've yet to hear of the Gabitril.

Welcome to our forum and best of luck during this difficult time. Pedagague is very knowledgeable about meds and things so i'd suggest hanging in a bit longer and seeing if the Lithium takes hold. It does sound to me like she's definetly in a manic episode from being off the Seraquel and not yet stabalized on the Lithium yet.

Cheers,
Jenna

[shutterbug]

oh...and you can also visit NAMI online at NAMI: National Alliance on Mental Illness-The Nation's Voice on Mental Illness-Formerly National Alliance for the Mentally Ill (or .comand then look for your state's chapter (which i'm assuming you are in the states) where you'll find more information for your area. And you can also visit www.dbsalliance.org (or .com -- i never can remember). DBSA stands for Depression Bipolar Support Alliance.

[shutterbug]

that was suppose to say www.nami. org but it somehow created a link (not that i'm complaining really....i just like for people to have the address too b/c it's so easy to remember.

[TiredMama]

Originally Posted by shutterbug

Lobo,

1. Check around in your community by calling your state NAMI (National Alliance of Mental Illness) office....the number or web site is listed in my signature to see what is available for you for free. I know that i personally was able to find a Friends and Family of Bipolars group i could attend weekly at a local church. It REALLY helps to talk with others going through the same things.

2. Since your daughter is dual diagnosis with also having the substance abuse issues (as a large percentage of bipolars do)...it is SO very important for her to get stabalized. And luckily bipolar I is much easier to treat than bipolar II (which is what my diagnosis is).

3. Many bipolar I's do very, very well on Lithium. It probably scares you because you've been told that regular blood tests are needed to ensure the salt levels don't build up in her system to a dangerous level or anything, but Lithium is the oldest mood stabalizer around. It was the first one ever found to help bipolars. I tried it myself as my 3rd or 4th mood stabalizer go-round and either my doc started me on too high a dose or i was VERY allergic to it -- as it made me so insanely ill that i couldn't sit or stand up with out throwing up (or dry heaving) and after several days of that crap i was about ready to go to the emergency room.

Many have and continue to do VERY well on Lithium....including actress Patty Duke, who is also bipolar I and dual diagnosis with alcoholism. Actually, there are a TON of famous people with bipolar disorder and also substance abusers. I highly recommend reading her book called, "A Brilliant Maddness." It was the first book about bipolar disorder I read and the best one of the subsequent 100s. It alternates chapters between her telling her own story and then the next chapter is more "informational" like as it is written by her own psychologist and gives more fact type stuff about the illness.

Depakote was the first one i was put on 4 years ago and it also requires regular blood tests.

Topamax is the mood stabalizer i'm currently on and seem to be doing okay on it. However, i don't know anything about it -- which is VERY unlike me, but i was placed on it while i was pretty much out of it, so to speak and have yet to do any research on it.

Lexapro is another, which my dad and other i've known have used/use. I tried it also and think it should not be given to bipolar II's because of the fatigue side-affect many get with it (as we struggle with fatigue enough as it is).

???(oh shoot, i can't remember the name of it) --- Is another that many like and it has very minimal side-affects....some say none at all. I thought it was a good one for me too and don't even remember why i let my doctor change me, but it did cause my acne to worsen as the only side-affect i had. When I think of the name of it....i'll come back and post it.

I've yet to hear of the Gabitril.

Welcome to our forum and best of luck during this difficult time. Pedagague is very knowledgeable about meds and things so i'd suggest hanging in a bit longer and seeing if the Lithium takes hold. It does sound to me like she's definetly in a manic episode from being off the Seraquel and not yet stabalized on the Lithium yet.

Cheers,
Jenna

Here is something on it if you are interested:

GABITRIL Frequently Asked Questions

[TiredMama]

Originally Posted by Lobo

Tired,
I've never heard of those two meds. My daughter is bi polar 1. Is this something we should look into for that? What are the side effects? Do you think they are safer than lithium? Frankly, Lithium scares me, and I really don't know why.

Thanks...........Lo

I think you should give it time to settle in her system. Shutter gave you some great advice as well I am bipolar type 2 and was diagnosed with I was 20 years old.

[TiredMama]

Originally Posted by TiredMama

Here is something on it if you are interested:

GABITRIL Frequently Asked Questions

OH yea, I am not on this medication any more.

[pedagogue]

Jenna is on the money with the local services idea. The town/county gov't typically have community mental health centers that can provide services for low or no cost. They can be a great resource for individual and group support (people going through similar experiences). Often the family members are the ones suffering in silence, and it doesn't have to be like that.

[Lobo]

Ped, Tired, Shutterbug,
Thanks to all of you for your support. I feel better already. I was just told by my daughter that she did not take the lithium today because she is scared of how she is feeling. She was giddy, and her eyes looked strange. I don't know how else to describe it. At this point she is afraid to take it because she didn't like how she was. She literally was hardly able to stand up. She appeared to be like she was drunk and she wasn't.

I'm encouraging her to call her pychiatrist tomorrow. I can't make her do it....she is 26 yrs. old.

Shutterbug.......you have given me a lot of good advice. I am going to print this out for my daughter. At least she is sober at this point in her life, so right now we are just trying to get the bipolar under control. She actually seems much better since she stopped taking the lithium. I'll be back to talk to you some more.

Hugs to all of you.........Lo

[shutterbug]

I'm about to be off to sleep, but just wanted to say that if she is NOT a rapid cycling bipolar then perhaps she is experiencing an allergic reaction to it as I felt I did....Especially, with the not being able to stand up part, as that is not a bipolar symptom (well......unless it's out of the extreme fatigue i and many others experience during severe depressive episodes....but i suppose too that she could also be experiencing a mixed episode???)

I guess because of my own personal experience with becoming so physically ill when i started Lithium....I would suggest she either go back to her pdoc and kindly demand to be put on a different mood stabalizer since she believes the things she's experiencing are a result of the Lithium, and not the other way around.....or she could even try going to see and new pdoc and see what they say or suggest. There are so many other mood stabalizers out there than can be tried....so why not try something else if she's only been on it a few days? Just my 2 cents.

Also....i might suggest making a list of ALL the different things she's been experiencing personally and also the things that you've noticed as an outsider.....and take that list and hand it to her pdoc. Sometimes docs just don't quite listen and we have to work a little harder to explain WHY we think something isn't quite right. You never know....he/she might have seen all of those things before and have really good reasons for wanting your daughter to stay on the Lithium. Who knows?

hugs,
Jenna

[pedagogue]

Lobo,
It's important for your daughter to let her doc know the issues/side effects (they could be related or unrelated...but the more you let your pdoc know, the better). Nausea, dizziness, etc can be some common responses to meds. My non-medical, speaking as a lay-person advice......it could be dose related. Often side effects pop up quickly when a person is starts and/or titrates up (med increases) too quickly; lithium can be a chronic offender as often docs will start up a bit higher, so it takes less time to get to what they think will be an effective dose, though sometimes starting at a lower dose may have less initial side effects....but take longer. Her supervising doctor can speak to what is best for her. Good luck!