![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Christina on October 13, 2000, at 10:09:33
I've been on anti-depressants (various ssri's) for about 6 years. The most common side effect i have is fatigue and loss of concentration.
I am currently on Effexor XR 75 mg/2x daily. The fatigue has been the worst on Effexor.
My pdoc recently prescribed 300 mg of Lithium to augment the Effexor (I have a family history of bipolar, but have not experienced much manic activity). I don't want to start this until I receive from feedback from others who have tried this approach.
Please... any comments (negative or positive) will be greatly appreciated.
thanks
Posted by SLS on October 13, 2000, at 12:42:29
In reply to Augmenting Effexor XR with Lithium, posted by Christina on October 13, 2000, at 10:09:33
> My pdoc recently prescribed 300 mg of Lithium to augment the Effexor (I have a family history of bipolar, but have not experienced much manic activity). I don't want to start this until I receive from feedback from others who have tried this approach.
> Please... any comments (negative or positive) will be greatly appreciated.
> thanks
Hi Christina.It is almost always worth trying lithium to act as a "helper" drug to an antidepressant, for both bipolar and unipolar depression. It has been observed for at least twenty years that adding lithium to antidepressants can work when the antidepressant by itself won't.
For depression - not mania - a strategy most often used is to add low-dosages of lithium. The range that I have seen studied is from 300-600mg - dosages generally too low to act as a true anti-manic mood stabilizer. Many people don't experience any side effects at such low dosages. So, it looks like your doctor has chosen a well-documented approach to treating you.
Hope it works for you.
- Scott
Posted by Christina on October 13, 2000, at 13:51:23
In reply to Re: Augmenting Effexor XR with Lithium, posted by SLS on October 13, 2000, at 12:42:29
Thanks for the input Scott. This helps alleviate some of the fears I have of trying Lithium.
Posted by Noa on October 13, 2000, at 14:32:09
In reply to Augmenting Effexor XR with Lithium, posted by Christina on October 13, 2000, at 13:51:23
It is an acceptable strategy for augmentation, but first, I wonder if hypothyroid has been ruled out, or if thyroid hormone augmentation has been tried. My personal experience was that hypothyeroid issues were the main problem that hadn't been adequately addressed. I actually started lihium and was on it for a couple of months, but ironically, it was the lithium that got us to take a closer look at my thyroid, and I ended up deciding I didn't need the lithium, but did need more treatment of the hypothyroid. I found that it is easy to overlook thyroid problems and the lab results are often interpreted as "normal" when they aren't. Have you had your thyroid checked? If so, feel free to share the numbers with us.
Posted by salarmy4me on October 14, 2000, at 3:49:04
In reply to Augmenting Effexor XR with Lithium, posted by Christina on October 13, 2000, at 10:09:33
> I've been on anti-depressants (various ssri's) for about 6 years. The most common side effect i have is fatigue and loss of concentration.
> I am currently on Effexor XR 75 mg/2x daily. The fatigue has been the worst on Effexor.
> My pdoc recently prescribed 300 mg of Lithium to augment the Effexor (I have a family history of bipolar, but have not experienced much manic activity). I don't want to start this until I receive from feedback from others who have tried this approach.
> Please... any comments (negative or positive) will be greatly appreciated.
> thanksYou're gonna need Verapamil to get rid of the tremor;
A sedative to help you sleep, and possibly a
stimulant (Cylert, Ritalin) to keep you awake.
Posted by JohnL on October 14, 2000, at 6:24:47
In reply to Augmenting Effexor XR with Lithium, posted by Christina on October 13, 2000, at 10:09:33
> I've been on anti-depressants (various ssri's) for about 6 years. The most common side effect i have is fatigue and loss of concentration.
> I am currently on Effexor XR 75 mg/2x daily. The fatigue has been the worst on Effexor.
> My pdoc recently prescribed 300 mg of Lithium to augment the Effexor (I have a family history of bipolar, but have not experienced much manic activity). I don't want to start this until I receive from feedback from others who have tried this approach.
> Please... any comments (negative or positive) will be greatly appreciated.
> thanksChristina,
At 300mg Lithium is really no big deal. You might have a bit of dry mouth, maybe not, and you might have to urinate a little more often than usual. But 300mg is an easy dose. Nothing to fear here. Where Lithium gets more difficult and a little scary is up in the 1200mg to 1800mg range.Generally 300mg to 600mg is a common range for augmenting antidepressants. Sometimes 900mg. I've heard of some people responding to it the very first day. With others it could take several weeks. It all depends on how directly it affects the real underlying chemical problem responsible for you symptoms. There are others who are not helped at all by it. Like me. You just have to try it and see how it goes. But I just wanted to assure you that at low doses, Lithium is generally very mild and well tolerated.
John
Posted by Christina on October 14, 2000, at 20:23:47
In reply to Re: Augmenting Effexor XR with Lithium, posted by Noa on October 13, 2000, at 14:32:09
Hypothyroidism is a logical problem to explore with my symptons.... however, I have routine thyroid tests and all are OK.
But for other others experiencing extreme fatigue, hypothyroidism can be the culprit.
Posted by noa on October 16, 2000, at 7:59:31
In reply to Re: Hypothyroidism, posted by Christina on October 14, 2000, at 20:23:47
Just FYI, a lot of docs read routine tests as "normal", but they may not be "normal" for all patients. If you want more info, I'd be happy to supply it.
Posted by Christina on October 16, 2000, at 8:32:07
In reply to Re: Hypothyroidism, posted by noa on October 16, 2000, at 7:59:31
> Just FYI, a lot of docs read routine tests as "normal", but they may not be "normal" for all patients. If you want more info, I'd be happy to supply it.
I would be interested in learning more. I had my thyroid removed ten years ago because of a benign growth. I now take Synthroid. My thyroid levels prior to removal and since then have always come back normal according to my doc.
Is there something else I should be award of?
Posted by noa on October 16, 2000, at 10:34:27
In reply to Tell me more about the normal reading....., posted by Christina on October 16, 2000, at 8:32:07
Yes. I don't know much about the removal of thyroid, etc., but check out these links:
http://www.egroups.com/links/psycho-babble-tips//Noa_s_thyroid_links_000963272558/
Mary Shomon's site is a good place to start--link is in this folder.What I do know is that when TSH is tested, docs rely on a "normal" range of between about .5 and 5.5, but that many of us don't feel ok unless our TSH is at the lower end of this.
My depression was horrible, and my fatigue, edema, fogginess, as well, when my TSH was around 3.6 and even 2.8. Now, my endo has me on higher doses of cytomel and synthroid, and my TSH is suppressed, and I finally have gotten better.
Another thing is that you may need T3 in addition to the T4 (Synthroid).
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.