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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Thomas W on August 1, 2000, at 15:18:20
Can someone tell me what to expect while taking lithium?
My MD is suggesting it to see if it will either identify
or eliminate the possibility of bipolar. He says it will help make a
determination rather quickly.I understand that it requires a good bit of monitoring. Could
someone relate their experiences with this.Also, some things to watch for would help.
thanks
Posted by Sunnely on August 1, 2000, at 22:12:29
In reply to Lithium question, posted by Thomas W on August 1, 2000, at 15:18:20
> My MD is suggesting it to see if it will either identify
> or eliminate the possibility of bipolar. He says it will help make a
> determination rather quickly.This is an illogical way of arriving at a diagnosis of bipolar disorder. It's like putting the cart in front of the horse.
FYI, not everyone who responds to lithium has a diagnosis of bipolar disorder. On the other hand, failure to respond to lithium does not rule out the diagnosis of bipolar disorder.
At present, diagnosing bipolar disorder is still done the old-fashioned way: a thorough history taking (present and past medical/psychiatric history, substance abuse, family/social history, etc.); doing a physical, neurological, and mental status examination (psychological testing may be required); gathering collateral information from family, friends, significant others, etc. Laboratory tests including certain blood tests and brain scan may be ordered not to diagnose bipolar disorder but to rule out other conditions that may mimic bipolar disorder. Oftentimes, several evaluations/follow-up visits may be necessary to arrive at a diagnosis of bipolar disorder. In difficult cases, a second opinion consultation may be necessary to confirm the diagnosis.
= = = = = = = = = = = = = = = = = = = = = = = = => I understand that it requires a good bit of monitoring. Could
> someone relate their experiences with this.
>
> Also, some things to watch for would help.
> thanksCertain laboratory tests (aside from the usual physical, neurological, and mental status examination) are required prior to lithium treatment. Since lithium is mainly eliminated by the kidneys, your doctor should order a kidney function test. Since lithium can affect the thyroid, a thyroid function should also be done prior to treatment. If you are over a certain age (45 or more) or have pre-existing heart condition, an electrocardiogram (ECG) should also be done prior to treatment. It is also clinically prudent to have the following tests, too, prior to treatment: complete blood count (CBC) and basic metabolic panel consisting of electrolytes (sodium, potassium, calcium) and glucose, and urine analysis. For age-appropriate women, a pregnancy test should also be included, unless one is sure of the absence of pregnancy.
While you are on lithium, you should have your lithium levels checked periodically, more frequent in the early stage, then less frequent when your levels are more stable (e.g., every 6 months). Also, periodically, your kidney functions (blood test) and thyroid function (blood test) should also be checked every 12 months and 6 months, respectively. Your calcium level should be checked, too, periodically (every 2 years). As lithium may cause underactive thyroid, it may also cause overactive parathyroid (at lesser degree) and parathyroid tumor (parathyroid adenoma), reflected in high calcium levels. An ECG may need to be done, too periodically, depending on your age and health status.
Expect nausea, thirst, frequent urination, and generalized discomfort during the first few days of treatment. Expect a lag of up to 3 weeks before the full beneficial effects of the drug are noticed. Maintain adequate salt and fluid intake; do not go on any special diets without consulting your doctor. Avoid driving a car or operating hazardous machinery until response to the drug is determined. Be aware of signs of early lithium toxicity (diarrhea, vomiting, drowsiness, muscular weakness); if these occur, stop taking lithium and call your doctor immediately. Carry an identification or instruction card with toxicity and emergency information, or wear a medic-alert bracelet. Do not alter your caffeine intake drmatically while taking lithium. Avoid strenuous exercises and other activities (e.g., steam or sauna baths) that can cause significant sweating which can markedly raise lithium level. If you do, make sure you replenish the fluid lost from sweating. Flu symptoms and dehydration can markedly raise your lithium level, too. Certain drugs can interact markedly with lithium. (Ask your doctor or pharmacist for a list of these drugs. Several of them, prescribed and over-the-counter. Even Metamucil can affect your lithium level.)
BTW, do not take your lithium dose the morning of the blood test until after blood is drawn.
Posted by Janice on August 2, 2000, at 11:46:23
In reply to Lithium question, posted by Thomas W on August 1, 2000, at 15:18:20
hi Thomas,
Can't say much more than Sunnely has : >) Thanks Sunnely, I printed that out.
Here's some tips for nausea that work best for me: Eat about 4 bites of your meal, take the lithium, then eat the rest of the meal - the more the better. Drink a large glass of water during the meal. If you still get nausea, try buying some gingerroot at the healthfood store and taking it with the lithium with the meal.
There are a few medications that I couldn't take with lithium - birth control and another one (Olanzapine (sp?) - because the combination makes me very ill (all morning at the toilet). So check with your doc before combining it.
Good luck Thomas
if it works for you, it's a great drug. But ain't that the truth for all of them.
Janice
Posted by Thomas W on August 3, 2000, at 16:02:36
In reply to Re: Lithium question, posted by Sunnely on August 1, 2000, at 22:12:29
> > My MD is suggesting it to see if it will either identify
> > or eliminate the possibility of bipolar. He says it will help make a
> > determination rather quickly.
>
> This is an illogical way of arriving at a diagnosis of bipolar disorder. It's like putting the cart in front of the horse.
>
> FYI, not everyone who responds to lithium has a diagnosis of bipolar disorder. On the other hand, failure to respond to lithium does not rule out the diagnosis of bipolar disorder.
>
> At present, diagnosing bipolar disorder is still done the old-fashioned way: a thorough history taking (present and past medical/psychiatric history, substance abuse, family/social history, etc.); doing a physical, neurological, and mental status examination (psychological testing may be required); gathering collateral information from family, friends, significant others, etc. Laboratory tests including certain blood tests and brain scan may be ordered not to diagnose bipolar disorder but to rule out other conditions that may mimic bipolar disorder. Oftentimes, several evaluations/follow-up visits may be necessary to arrive at a diagnosis of bipolar disorder. In difficult cases, a second opinion consultation may be necessary to confirm the diagnosis.
> = = = = = = = = = = = = = = = = = = = = = = = = =
>
> > I understand that it requires a good bit of monitoring. Could
> > someone relate their experiences with this.
> >
> > Also, some things to watch for would help.
> > thanks
>
> Certain laboratory tests (aside from the usual physical, neurological, and mental status examination) are required prior to lithium treatment. Since lithium is mainly eliminated by the kidneys, your doctor should order a kidney function test. Since lithium can affect the thyroid, a thyroid function should also be done prior to treatment. If you are over a certain age (45 or more) or have pre-existing heart condition, an electrocardiogram (ECG) should also be done prior to treatment. It is also clinically prudent to have the following tests, too, prior to treatment: complete blood count (CBC) and basic metabolic panel consisting of electrolytes (sodium, potassium, calcium) and glucose, and urine analysis. For age-appropriate women, a pregnancy test should also be included, unless one is sure of the absence of pregnancy.
>
> While you are on lithium, you should have your lithium levels checked periodically, more frequent in the early stage, then less frequent when your levels are more stable (e.g., every 6 months). Also, periodically, your kidney functions (blood test) and thyroid function (blood test) should also be checked every 12 months and 6 months, respectively. Your calcium level should be checked, too, periodically (every 2 years). As lithium may cause underactive thyroid, it may also cause overactive parathyroid (at lesser degree) and parathyroid tumor (parathyroid adenoma), reflected in high calcium levels. An ECG may need to be done, too periodically, depending on your age and health status.
>
> Expect nausea, thirst, frequent urination, and generalized discomfort during the first few days of treatment. Expect a lag of up to 3 weeks before the full beneficial effects of the drug are noticed. Maintain adequate salt and fluid intake; do not go on any special diets without consulting your doctor. Avoid driving a car or operating hazardous machinery until response to the drug is determined. Be aware of signs of early lithium toxicity (diarrhea, vomiting, drowsiness, muscular weakness); if these occur, stop taking lithium and call your doctor immediately. Carry an identification or instruction card with toxicity and emergency information, or wear a medic-alert bracelet. Do not alter your caffeine intake drmatically while taking lithium. Avoid strenuous exercises and other activities (e.g., steam or sauna baths) that can cause significant sweating which can markedly raise lithium level. If you do, make sure you replenish the fluid lost from sweating. Flu symptoms and dehydration can markedly raise your lithium level, too. Certain drugs can interact markedly with lithium. (Ask your doctor or pharmacist for a list of these drugs. Several of them, prescribed and over-the-counter. Even Metamucil can affect your lithium level.)
>
> BTW, do not take your lithium dose the morning of the blood test until after blood is drawn.THANKS so much for the info. and your time!
Posted by kerry B on August 7, 2000, at 4:20:52
In reply to Lithium question, posted by Thomas W on August 1, 2000, at 15:18:20
> Can someone tell me what to expect while taking lithium?
> My MD is suggesting it to see if it will either identify
> or eliminate the possibility of bipolar. He says it will help make a
> determination rather quickly.
>
> I understand that it requires a good bit of monitoring. Could
> someone relate their experiences with this.
>
> Also, some things to watch for would help.
> thanks
Hi Thomas,
I have been on lithium for over a year now to help with my mood swings. Apart from making you really thirsty all the time, I have had no problems or side affects from it.
You have to have your levels checked every few months(to make sure you have the right quantity in your system) from time to time which is done by a blood test, but if you take it properly you should stay on track and it should help, being it the right medication for you diagnosis. I am on 1,000 mg's a day and my levels stay fine!!!!
Hope it is the right one for you. Best of luck!!!!kerry B
Posted by Noa on August 9, 2000, at 11:55:19
In reply to Re: Lithium question » Thomas W, posted by kerry B on August 7, 2000, at 4:20:52
Thomas, please see my post above under Greg's thread.
I agree with Sunnely about li not being a diagnostic tool. It can help non-bipolar people too, although some researchers seem to be of the mind that some depressions are in the biploar family even without hypomania or mania. Still, I think it is less useful as a diagnostic tool than as a treatment for your actual symptoms. It can help to boost the effect of your AD, can have AD effects of its own, can stabilize moodiness, etc.
This is the end of the thread.
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