Posted by Ritch on March 19, 2003, at 23:34:33
In reply to Re: Sorry to ask again but need answers about Lithium » Ritch, posted by BarbaraCat on March 19, 2003, at 12:55:35
Yes, I think it does help with diarrhea generally. Constipation is the most prominent side effect of verapamil from what I understand (and what Susan reported). She wasn't taking it to counter a side effect. Her pdoc added it for improved cognitive function and mood stability and she reported that it helped a lot. However, her pdoc said that she only got positive response with it in a minority of BP patients (but a significant minority). I hope Susan jumps in and tells us the skinny. If I could find something for IBS that also helps mood stability that would be pretty cool. This is weird, but Neurontin did reduce IBS symptoms. Lithium and to a lesser extent Depakote tend to increase them. Neurontin blocks calcium channels selectively in the hippocampus. Too bad I can't tolerate taking Neurontin anymore. It caused this esophageal spasm/chest pain thing that I can't put up with.
> Hi Ritch,
> Yeah, it's confusing. Until we know how these mood meds work it's pretty much a crap shoot (er, I guess that was a pun). Most of what I've heard has to do with propanolol. I've seen anecdotal reports that it's a good augmentor with mood stabilizer activities and other reports that it aggravates depression. Probably worth a try with verapamil. What I'm curious about is if it helps IBS in general, alleviating both constipation and diarrea, or if it's primarily a constipating agent and so helps mainly with diarrea. - Barbara
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> > Hi Barb, Susan C. has been trying verapamil for awhile and it seems to be working well for her from what she posted the last time. I saw the link in a previous post about CCB's causing depression in heart patients but verapamil wasn't specifically mentioned. I'm not sure what "context" that verapamil is used with lithium (besides controlling IBS sx)-perhaps it is intractable mania that isn't controlled? Perhaps the possible danger with verapamil is aggravated depression (not cycling or mania). Many AED's affect voltage sensitive calcium channels which reduce neuronal firing to help prevent seizures, but I think their activity is much more selective than a CCB that is used to control high blood pressure.
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> > > Be real careful with calcium channel blockers. They can exacerbate mood disorders. No one knows for sure how mood stabilizers work, but one theory has to do with regulating calcium channels effect on neural electrical potentials. It could be that taking verapamil, propanolol, etc. counteracts the action of lithium, which would by definition reduce the side effects, but cancel out the effectiveness. Just a thought.
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> > > > Jill, the single most troublesome side-effect I got from lithium when I was on it was IBS-related diarrhea. I took sub-therapeutic doses (300mg/day) to try to keep it manageable when higher doses of lithium worked much better mood-wise (450-600mg/day was my *spot*). Just an FYI, but I was reading on one of the grand rounds slides here that the calcium-channel blocker verapamil is sometimes used to counter lithium-induced diarrhea. You might mention this to your pdoc. I wished I would have known about this strategy 20 years ago!
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poster:Ritch
thread:208633
URL: http://www.dr-bob.org/babble/20030319/msgs/210833.html