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Starting Lithium Today- questions about it

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Old 01-20-2009, 12:31 PM   #1
Data Bob
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Starting Lithium Today- questions about it

I'm starting lithium today, 300 mg SID (twice a day) and have some questions.

I've read a lot about it on various sites but I want to find people who actually taken it.

Food - recommendations are to take it with food to avoid nausea. How much food is enough? I rarely eat breakfast, maybe 3 times in a month.

My wife has a varying work schedule and the time of the evening meal varies quite a lot - it can vary from about 5:00 PM to as late as 8:00 PM.

If she has a late lunch she may not want anything until late at night and will sometimes merely fix a snack such as vegitables with dip. In this situation I may or may not actually fix a meal for myself.

I've never been on a regular eating schedule and am concerned about lithium causing nausea.

How must food must I eat to prevent, or lessen, nausea with lithium?

- I've seen warnings about taking ibuprofen with lithium. Does anyone know what will happen if you take ibuprofen while on lithium?

- recommendations I've seen say to avoid excessive caffeine. What is excessive? Should I try to cut it out completely?

Heart disease
- warnings say to tell you doctor if you have heart disease. I had a heart attack on 11/10/02. What are the dangers of taking lithium if you have heart disease? A nurse who drew blood for tests yesterday said something about lithium possibly raising cholesterol. Anyone heard about this?

My doctor knows about the heart attack but I'm not sure he has really given it due consideration. I faxed him a list of questions and am waiting for him to call me.

Blood work - recommendations are for testing once a week for the first few weeks, every 2 weeks thereafter for a couple of months and then monthly after that.

Testing should include kidney, liver, and thyrod functions and lithium level. If lithium can raise cholestero, should a lipid panel be included?

Does that sound right? If you are on lithium, how often do you have blood work done?

What are the side effects those of you taking lithium have had?

Has anyone had to stop taking lithium because of side effects or kidney, liver, or thyroid problems or damage?

Any assistance will be greatly appreciated.

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Old 01-20-2009, 02:45 PM   #2
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Re: Starting Lithium Today- questions about it

Bob, I have been taking lithium for quite a bit now. First the questions with drug interactions would best be answered by a pharmacist so that you are getting up to date current and correct information. As to blood testing mine is generally done once a month and includes a liver panal I have never seen a cholesterol level requested. As for food..hmmm I only take one dose a day at the moment (although we are talking about upping it two again) and I take mine at night before bed, so I don't take with any food. Generally however when medications say "take with food", often a slice of bread is enough...that's another question you could propose to a pharmacist if you wanted true medical advice.

Good luck and hope the lithium helps!

Old 01-20-2009, 11:29 PM   #3
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Re: Starting Lithium Today- questions about it

I'm the same so far as routinely eating goes and I take it in the morning and at night. I had been really concientious about it for a few months and had no problem, a couple of bits of toast and a cup of milk or a banana sandwich does the trick o.k. I have had problems in the past few weeks as I've hit the skids a bit and eating has gone away. I have very little appetite of a morning and evening, to the point that i'm not eating at these times, and that which I am eating is going straight through me- which makes me wonder if my other medications are hanging around long enough to do their job properly. It is important to eat before taking them- it also effect the levels in your system.
I haven't asked about ibuprofen, but my guess would be something to do with them both having a strong effect on the stomach- you wouldn't want to double any risks.
The main sideeffects I had were in the first couple of weeks and were mainly whizzing like there was no tomorrow, being really thirsty (which both affected each other), and a strong metallic taste in my mouth- which settled after about a month, but has returned now but I'm thinking it's got to do with the not eating and higher levels.
My doctor doesnt do bloodwork much which I don't understand. I'm back off the Friday- I'm thinking our 15 minute appt, might blow out.
Hope I could help.

Old 01-21-2009, 02:53 AM   #4
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Re: Starting Lithium Today- questions about it


am new to this particular site. i tood lithium 1200 for almost a year with no side effects other than a very fine tremor occasionally. i took with a small amount of food, a few grapes, piece of banana, a pancake or something very small. you may find yourself more thirsty than usual but a little more water helps with that. i continued to drink tea but found i wanted fewer cups of it.

unfortunately this med did not work for me but is one of the most successfull mood stabilisers. i also had blood work done every couple of weeks to check for toxicity levels, kidney function, thryroid function and liver function. all fine. give it time. and i really hope it works for you.

Old 01-21-2009, 03:21 AM   #5
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Re: Starting Lithium Today- questions about it

Good questions Bob.. when I took lithium I remember my hands shaking, I just wasnt steady. A wk/two into treatment everything was fine. You may not experience this but with any med theres the possibility of adjusting to minor side effects and this was one of them for me. Besides Ibuprofen, there are A LOT of over-the-counter meds you can not take with lithium. I dunno what happens if you do take them but Id be really careful since they MAY alter your levels and land ur system in a toxic state.

Old 01-22-2009, 08:45 AM   #6
Data Bob
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Re: Starting Lithium Today- questions about it

Thanks for all the replies.

This morning was lithium dose number 3 - 300mg.

In some site I've read, there is the recommendation that you drink betwen 2 adn 3 liters of water a day. That would be 4 to 6 500ml bottles.

I found yesterday, after only 2 doses, that I was thirstier then usual and I drank something over 2 liters yesterday.

Shall take it a day at a time and see just what the lithium does and does not do.

I'm not even sure I'm bi-polar.

This doctor, in the first appointment, decided that I didn't have MDD (Major Depressive Disorder) and said I was bi-polar.

I have never had a manic episode.

I think he picked up on my saying the M word (manic) once as we talked.

He also took my description of how I used to work (Systems Programmer for one of the largest bank holding companies in the state).

I would dive into new projects or problems and become productive or solve a problem before everyone else either was just grasping the basics of the project or where just beginning to understand a little about a problem.

I mentioned, to the doctor, that my manager (the directory of data processing) would sometimes call me "Rapid Robert" because of this.

I think on this basis, and that I've never really had any good results with several antidepressants, he decided I'm bi-polar.

He even said, "You've come to the right place.' That was months ago.

Two appointments ago, when my wife went in with me, he decided I was ADD.

He prescribed Vyvance and I took it faithfully for month - neither my wife nor I noticed any effect.

So, now I'm on lithium - wonder what it will do.

I'm also on Seroqjuel 400mg SID, Lamotrigine 200 mg SID, and Amitriptyline 100 mg.

I've been on Amitriptyline since 1985 or 1985 (cannot remember), starting at 100mg and working up to 200 mg

It helped a bit during the first couple of years and then it's effect dropped off.

I stayed on it because it helped some and because I was dependent upon it to sleep. If I don't have at least 50 mg I couldn't sleep. I might get 1 or 2 hours sleep at night and I would be in bad shape the next day.

The current doctor asked me what I thought about ECT - I asked him what that was, I didn't recognize it at first.

I didn't really answer his question and he went on to say that I should try lithium.

Frankly, ECT scares me. I really don't want someone shooting electricity into my head.

If lithium does not help, I'm going to tell him I'm really not sure of his diagnosis (as I already said a few times) and ask tell him I want to try the other anti-depressants again.

I've been on a lot of them over the years but perhaps the dose was too low or I wasn't on them long enough.

Well, I'll close this out.

Will report my progress on lithium - good or bad.


Old 01-22-2009, 07:00 PM   #7
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Re: Starting Lithium Today- questions about it


I don't take Lithium anymore haven't for a long time, but my pdoc does make me do blood drawsmonthly for several other meds that I take, he does a lipid panel, fasting glucose, and lamictal level. Seroquel can most definitely raise your cholesterol quickly. Just wanted to throw that out as an FYI, since you have the heart issues.


Old 01-23-2009, 12:24 AM   #8
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Re: Starting Lithium Today- questions about it

hi again bob, lithium can take a long time to work and sometimes just doesn't suit some people but please don't think about giving up on meds immediately, there are many more out there and because we're all so different with this disease it can take some tweaking with different meds before you feel a difference. 2litres of water sounds about right but the thirst will ease off. i too hate the idea, thought of ect. side effects sound very extreme.

Old 01-24-2009, 02:44 PM   #9
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Re: Starting Lithium Today- questions about it

I take the same dosage of Lithium as you. My doc told me I could take both caplets at night instead of one in am and one in pm. I found that really helped with nausea. I drink two cups of coffee a day. It doesn't seems to do any harm. As fay as ibuprofen. I forget why we can't take it but if we stay away from it then we're fine. In reference to blood levels and tests to have done I would defenitely research all information pertinent to your personal health and history. Educate yourself on every aspect and push for any tests that you feel are required. You are your own best caretaker when it comes to that. Docs often don't explore the individuality factors and sometimes push concerns to the side. Good luck. Lithium really works for me and I hope for you too.

Old 01-25-2009, 04:08 AM   #10
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Re: Starting Lithium Today- questions about it

hi again bob. hope lithium is going ok for you and not any bad side effects. just thought i should mention that we have to remember that our diet includes lots of fluids not just water and pdoc told me that if too much is consumed it can flush lithium out of your system too quickly which would affect the therapeutic levels. btw, blood work sounds right. weekly or fortnightly initially and then regularly after doc regularly checks cholesterol anyway, just go for your bloods fasting and ask that it be included. hope you are doing ok. don't know if i mentioned that i never had a manic episode either per se but have bipolar with dysphoric mania ( all the lows and no highs!)

Old 01-26-2009, 12:34 AM   #11
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Re: Starting Lithium Today- questions about it

hi bob, thanks for informative answer. i too did the research and followed the consumption of large quantities of water and at 1200/day of lithium my pdoc couldn't understand how therapeutic levels were so low! i wasn't including the orange juice and tea that i was consuming or other liquids! anyway the effects are different for everyone and i do hope it goes well for you.

Old 01-26-2009, 06:46 PM   #12
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Re: Starting Lithium Today- questions about it

Hello Bob, I've taken Lithium for 10yrs now, 600mg in the morning and 600mg at dinner. I get a Lipid test every 6 months,i've never had an issue with my thyroid. For me, lithium its necessary. Your case sounds different than mine though.

I live my life without restrictions, although I do eat right, excercise and get my rest. I also have taken the generic form of Remeron(anti D) 15mg during the same 10yr period, works great for me. If you have any questions I can help you with i'd be glad to answer if I can.

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