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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 AMD on December 30, 2003, at 12:40:49
Folks,
I have been on and off lithium for about a month. It seems to be OK for the first day or so, but then I start feeling like a zombie, and stop taking it. My brain just starts to shut down.
Anyhow, after not having taken it for some weeks, I took 300 mg Friday and Saturday morning, and Saturday night went out with some friends to a club, and had a few drinks. I realize drinking and lithium don't mix -- you have to be careful -- but is there anything to worry about for that one night? I had had 600mg total in two days, so I didn't think it would hurt to hang out and party a bit (these days I go out only once or twice a month). To compound the problem, I had been smoking some cigars, which got my mind racing a little, so I popped another 300 mg that night (while still under the influence of alcohol). Would I /know/ if I had lithium toxicity? Is it permanent or fatal?
Anyhow, this point may be moot now -- after two further days at 600mg a day, I started feeling tired, and mentally blunted again. So I didn't take my pill last night or this morning. I also quit Celexa Thursday, and I think I'm just going to not take ANYTHING for the next few weeks, and see how I feel. All I know is that since I began taking Lithium, I've had alternating days of feeling tired, or extremely anxious (almost short of breath), foggy-brained, obsessed, unhappy, dull.... not a single day that I just 'lived' without the felling of not being myself. The Celexa since then has also been ineffective: instead of making me calmer and able to concentrate, I started waking up every morning with my mind and heart racing. (This while off the lithium.) I am soooo frustrated. I also have a job offer for a major high-tech firm, and now I'm worried that I won't be able to handle it (the first time I've ever felt that way about anything, ever!).
I am so fed up with this stuff. I'm markedly better than two months ago, when I 'crashed', but I am not 100%.
An entry from my journal for today:
About two weeks following my most recent foray back into the 'club' scene, I found myself again in the thick of New York regressiveness: Gauloises, a cigar, and half a dozen vodka and Redbulls. Unlike last time, however, my thoughts were not tinged with guilt after I'd sipped that first drink. On the contrary, I found myself in the awkward place of feeling overly alert amongst a group of half-drunk 20-somethings. That led me to drink faster, more heavily -- to drink with what I would call 'controlled abandon,' consciously seeking drunkenness, while drunkenly seeking consciousness. I didn't overdo it. But I did get intoxicated, and near the end of the night had felt myself slipping into the "no-cares" zone.
The next day I woke up anxious -- mildly hungover, for sure, but more disturbed by the anticipation of feeling (mentally) hindered than by any actual hinderance. It seems half the problem of depression is I spent most of the day, in fact, reviewing new vocabulary words -- need a definition of obdurate? badinage? salubrious? quotidian? I've got it! -- reading up on schizophrenia and brain regions (basal ganglia, anyone? occipital lobe?), and contemplating the imminent decline of my cognitive faculties. I read an article by Roger Avery in the Times, with a coinage I'll keep: temporary proximity. Or, better, temporal circularity -- as each of my days, though distinct, seems to simply be a mental rehash of the others. WHEN WILL I RECOVER MY CONFIDENCE, MY ENERGIES AND ENTHUSIASM FOR LIFE?
Drug wise, I started up the Li on Thursday morning -- taking one per day Thursday and Friday -- and then bumped it up to bid on Saturday. Monday I started to feel 'zonked' again, so I've quit it again -- for now. The mental blunting it causes is by far more distressing than what it is supposely helping. I've also finally quit Celexa. We'll see how this goes: a life without AD's!
AMD
Posted by GreatDaneBoy on December 30, 2003, at 13:39:59
In reply to Lithium and alcohol, and ramblings, posted by AMD on December 30, 2003, at 12:40:49
Hi AMD,
Are you taking lithium to control bipolar disorder? If so, talk to your doctor about Depakote. I was on lithium for a few months and I was stoned out of my mind (although my mood was stabilized). My doc switched me to Depakote and all has been well since. For me, it has the same mood stabilizing properties but no foggy-head type feeling. Alot of people on this board report having gained weight from taking it, but I didn't. Anyway, that's just my two cent's worth.Best of luck to you!
Dane =)
Posted by AMD on December 30, 2003, at 16:45:30
In reply to Re: Lithium and alcohol, and ramblings » AMD, posted by GreatDaneBoy on December 30, 2003, at 13:39:59
I was diagnosed bipolar about two months ago, by a young, inexperienced psychiatrist. Now, his diagnosis may be correct -- I do tend to show symptoms of hypomania at times, but not full blown mania -- but I have a hard time getting follow-up appointments and the drugs he prescribed have caused me nothing but grief for the past two months!
A summary:
* Was depressed in 2000 after a major breakup. No history of depression prior, although I had other related problems (eating disorders). The depression manifested itself as body dysmorphic disorder, for which I saw a psychiatrist for about two months, who put me on Celexa 20 mg daily, upped to 40 mg daily within a couple of weeks. This definitely helped, as I started feeling much more confident, and also less ADD-like -- able to concentrate more fully on tasks (although I have always overachieved regardless).
* During the same time, I had my first drink. And began a pattern of social drinking, Fridays and Saturdays mostly, mainly a couple times a month. I would classify it at that point as just social drinking -- got drunk, hungover like anyone, but it never affected my mood and/or mental status.
* In 2002 I began to get restless more often at work, and to drink more. Got irritated at work, felt stagnant, and decided to go off in another dierction professionally. I felt, if anything, more in control then, more intelligent and cognitive, with /excellent/ abstract problem solving abilities. Ravenous curiousity for life: technology, music, philosophy... really able to concentrate, very worry-free, enjoying life my life. Still on 40 mg Celexa daily.
* In late 2002, alcohol began to take more control of my life. Was drinking and now smoking more regularly, and often scheduling my day around the partying. Had taken a new job at a major hedge fund, and the partying was interfering with it. Still, though, it was not making me depressed -- I even started liking how it slowed me down, made me feel more able to concentrate. But it was definitely dominating my life, the "party" atmosphere. I opened up to my boss at the company about the problem, and said I was ready to change, when in reality I was still out doing the late-night, binge-drinking thing.
* In April 2003, I flew to California for my brother's wedding, and met there a girl I'd known from high school. We connected that weekend, and decided to give a relationship a try. She has a baby, which made things more complicated, yet, for me, a reason to really try to turn my life around. (At this point I was conscious that my life was poor for even a bachelor, but definitely not suited to a long-term relationship. I also began to realize I wasn't happy with how it was going -- I had lost control.)
* From April 2003 until October 2003, I limited by drinking, but would tell myself 'it's OK if I drink on a weekend' etc. But now a really dangerous pattern set in: every drinking episode now led to a binge and, for the first time, deadly depression following. I commited to starting a new life, moved across the country to be with my girlfriend, hunted for a new job, got a new apartment -- finally felt like things were going my way. But within a week of having started my new job and moved info my new apartment, I had the first of two binge drinking episodes that led to my hospitalization, and a deep depression that in the first case took two weeks to subside. Again, I continued the Celexa 40 mg.
This first binge, though, was tragic for a more important reason. For the first time, I was diagnosed bipolar, and the woman I'd moved to live with, the woman and baby I'd come to love, left me, citing the fact I'd been diagnosed bipolar as the reason. This crushed me emotionally. Her exact words were "I read about people on bipolar, and I can't be with you." Well, turns out she had ulterior motives in wanting to be with me -- but I digress.
Anyhow, as I said, I had been diagosed bipolar, and prescribed lithium to handle it, and Risperdal for a month to control the 'symptoms' until the lithium kicked in. I was also told to stop taking the Celexa.
Now, being told to stop cold turkey a medicine that had been (in my MIND) be life-changing in its way, was difficult to do. So I told myself, I'm not quitting the Celexa, but I'll take the lithium and risperidone.
So, I took the first lithium (300 mg) the morning of the diagnosis (a Tuesday), and proceeded to work. I felt a little tired, but dry mouth almost immediately set in, and I had to urinate often.
That night, I took risperidone (1 mg) and another lithium (300 mg), and in the morning, another lithium (300 mg) and my Celexa (40 mg). But that day I felt absolutely ZONKED. I called my doctor and told him the risperidone and the prospect of its dangerous side effects were too worrisome. Besides, I wasn't manic at that time -- just very depressed. I also told him of my hesitations taking the Celexa. He agreed that the risperidone wasn't necessary, but asked that I at least drop the Celexa to 20 mg for a few weeks. Again, I agreed, but ignored his recommendation on Celexa. That night I took the lithium again, but no Risperdal.
On Thursday, I woke up and felt sleepy -- and brain slowness had started to step in. I was consciously aware that my thoughts weren't as quick and analytic as they'd always been. So, I said, I'm done with this, and quit the lithium. I was on Celexa 40 mg again, and within two days had stopped feeling depressed and started feeling more of myself.
(Through all this I was mourning losing my ex, but what started as depression-based mourning was now simply true regret. It took awhile to get over this [understatement of the year], but I won't keep bringing it up. The part of my life is finally behind me.)
Unfortunately, three weeks following my beginning to feel OK again, I went to a party and drank again, and AGAIN ended up in the hospital. Without seeing the psychiatrist, I decided to try the lithium once more. I took it for about week before I realized, this is impossible. The brain fog had settled in worse than before, and I felt like a rock in a hard place: depressed on one hand, drugged out on the other.
I'll summarize now: the past two months since this most recent binge, I've spent about a week on lithium, and most on Celexa. In fact, I /never/ stopped taking Celexa until last week, which is the help I need now.
===========
As of last Thursday, I'd at that point quit taking the lithium for about three weeks, so having it out of my system, I wanted to reaccess the Celexa. It didn't seem to be working like it had. I found myself VERY anxious and racy-headed, something it had never caused before, and something I'd never felt before on or off medications.
So, I quit Celexa on Thursday, started Lithium (see previous post), and have now stopped Lithium. I want to see how I feel drug free for a change.
Here are my current symptoms, and I'd like some insight as to whether they're related to Celexa withdrawal, lithium withdrawal, bipolar, or something else.
Right now:
* I am extremely light headed, almost dizzy.
* Accelerated heartrate.
* Mental sharpness-- which to me yesterday was slooow, thus prompting me to stop lithium last night -- seems to be beginning to return.
* Short of breath.Is this Celexa withdrawal (it's the about the fourth day without any).
Lithium withdrawal (started for a few days, then quit)?
Related to bipolar? Am I even bipolar? Could I have ADHD, or simply had all this trouble due to the long-term Celexa use?
I can say that I stopped Celexa Thursday and started Lithium Friday morning, just 300 mg, which seemed to be OK. Friday I felt a little foggy headed in the morning, but by 2 p.m. in the afternoon I was ok. Any change just 300 mg would be enough to be theraputic, even if it never gets my blood level up?
How long before lithium fully leaves my system? With such a short-term, low dose, it all this fuzziness simply in my head? I can note a HUGE difference between the 300 mg and 600 mg daily. On 600 mg I felt much more stoned. Feeling this way is half the reason I GET depressed!
... Damn, I rambled here, but I'm writing this concurrently with a bunch of parallelized sqlldr runs, a schema Export, and controlfile recreation in Oracle, so bear with me.
AMD
> Hi AMD,
> Are you taking lithium to control bipolar disorder? If so, talk to your doctor about Depakote. I was on lithium for a few months and I was stoned out of my mind (although my mood was stabilized). My doc switched me to Depakote and all has been well since. For me, it has the same mood stabilizing properties but no foggy-head type feeling. Alot of people on this board report having gained weight from taking it, but I didn't. Anyway, that's just my two cent's worth.
>
> Best of luck to you!
> Dane =)
Posted by Ilene on December 30, 2003, at 19:02:14
In reply to Re: Lithium and alcohol, and ramblings, posted by AMD on December 30, 2003, at 16:45:30
I can't follow your on-again, off-again tale of drugged-out woe--I'm not exactly the sharpest person myself, these days--but here's my 2 cents:
Stopping/starting, stopping/starting is really bad for you. It just jerks your body around, plus sometimes if you stop a drug that has been working, it won't work when you start it again. (That happened to me.) It can also pop you in and out of withdrawal. It's a lot better to take the same amount every day unless you are having serious SE issues. It can take your body a while to get used to a new med. The adjustment period can be uncomfortable.
I've never taken lithium, but I've read it's hard on the body. Maybe you need a new pdoc.
If I were you I'd take an alcohol vacation, and I *don't* mean a booze cruise. Complete abstinence for some pre-determined period of time, at least 6 weeks. It's *obviously* giving you trouble.
I'd try to regularize my life as much as possible, which means the right kind of food at regular intervals, going to bed/getting up at the same time every day, not pushing yourself at work, working out 3X/week, stuff like that.
How's your anxiety level? Do you ever walk around feeling like you're about to be crushed, things like that? You seem to be worrying an awful lot. Could be you have an anxiety disorder.
Do you think that feeling of sharpness is hypomania or even mania?
Ilene
Posted by AMD on December 30, 2003, at 20:27:00
In reply to Re: Lithium and alcohol, and ramblings » AMD, posted by Ilene on December 30, 2003, at 19:02:14
Irene
I agree with everything you said -- the problem is in my current job walking around as a zombie is simply not acceptable, and, in the long term, 'getting used to it' isn't either. So I've felt 'rushed' to find something that works. Now. Lithium just seems to slow me down and actually make me depressed. And if this 'slowing down' is what the Li does, then it's no improvement over how I felt to begin with.
I am most likely bipolar -- that doesn't bother me as much as the stigma of it, which I experienced first hand with my ex-. I sometimes think, too, that some of this is just society's way of saying "this is who you should be." But I like being, uh, quirky. The problem is if the bipolar is causing physical or mental harm, which, in these alcoholic bouts, at least, it has. So I want a balance.
My quick thinking probably does relate to being hypomanic (at least partly), but clear thinking should not. And the hypo-induced thinking /is/ annoying. I can tell when I start getting a bit too distracted vs. just feeling like a person with above average intelligence. You know?
Unfortunately, when I start taking lithium, even reading a book gets difficult. I get a weird sensation in my mind, actually, that was never present before I started all these medication changes. It's hard to explain, just a weird kind of headache.
Nor should 'slowing down' make me feel depressed, should it? I take lithium, and I /get/ depressed. I feel slow-headed, and this makes me more depressed. Or maybe it's the cause, since I put so much emphasis on my ability (historically) to do anything I put my mind to. It's far to complicated to go into here, and my message was way too meandering to impart anything meaningful, but, I do know that it would be nice to feel 'calmer' -- to the extent that my being energetic simply isn't my personality -- without feeling freakin' retarded. Jesus -- I have taught at a university, worked for a former governor, started my own company ... and lately doing any of this would seem, frankly, overwhelming. And the lithium hasn't helped but only exasperated these feelings. If these affects are temporary, I'd love to give it a longer try (say a few weeks), but within a few days on the small, 600 mg dose, I start feeling blue, slowing down at work, feeling numb-brained. And that's a LOW dose? ... Can you see the conundrum I'm having accepting the current course of action?
I'm searching for another pdoc, which is damn difficult -- most in the area aren't accepting new patients.
The bottom line is this stuff is impossible to explain. It's the ol' Supreme Court dictum, I'll know it when I see it. I'll know I'm feeling OK when I'm feeling OK -- and if someone says, 'well, you're bipolar' but I live a product life without a day of depression (maybe by eliminating alcohol, maybe not), bipolar or not, I could care less what others think.
Thanks for your comments.
AMD
Posted by Ilene on December 30, 2003, at 21:55:28
In reply to Re: Lithium and alcohol, and ramblings » Ilene, posted by AMD on December 30, 2003, at 20:27:00
> I agree with everything you said -- the problem is in my current job walking around as a zombie is simply not acceptable, and, in the long term, 'getting used to it' isn't either.
What I meant was that your body adjusts to the SEs--they aren't as pronounced--not that you would get used to feeling like a zombie.
> I am most likely bipolar -- that doesn't bother me as much as the stigma of it, which I experienced first hand with my ex-. I sometimes think, too, that some of this is just society's way of saying "this is who you should be." But I like being, uh, quirky. The problem is if the bipolar is causing physical or mental harm, which, in these alcoholic bouts, at least, it has. So I want a balance.
>Some BP people like the highs (there's such a thing as dysphoric mania, though) and don't want to take their meds. The flip side is the low, low, low. Supposedly it gets worse if you don't treat it.
> My quick thinking probably does relate to being hypomanic (at least partly), but clear thinking should not. And the hypo-induced thinking /is/ annoying. I can tell when I start getting a bit too distracted vs. just feeling like a person with above average intelligence. You know?
>Sort of. I used to be able to think quickly. Now I can hardly think at all.
Most of what you said are things you should be saying to your pdoc. I think most prefer to start people on a drug that is safer than Li.
It's nice to know you agree with everything I say. Perhaps we should get married.
I.
Posted by AMD on December 30, 2003, at 22:09:27
In reply to Re: Lithium and alcohol, and ramblings » AMD, posted by Ilene on December 30, 2003, at 21:55:28
>
> Some BP people like the highs (there's such a thing as dysphoric mania, though) and don't want to take their meds. The flip side is the low, low, low. Supposedly it gets worse if you don't treat it.--------
So they say...
>
> Sort of. I used to be able to think quickly. Now I can hardly think at all.Are you bipolar? I assume this is a bit of sardonic humor ...
> It's nice to know you agree with everything I say. Perhaps we should get married.
I agreed with everything in your posting (needing to quit drinking, keep on the meds, see a new pdoc). As to the rest of it... where is it you said you lived? heheAMD
Posted by Ilene on December 30, 2003, at 22:32:19
In reply to Re: Lithium and alcohol, and ramblings, posted by AMD on December 30, 2003, at 22:09:27
> > Sort of. I used to be able to think quickly. Now I can hardly think at all.
>
> Are you bipolar? I assume this is a bit of sardonic humor ...I think I'm just an atypical depressive who's been damaged by years of depression & meds.
>
> > It's nice to know you agree with everything I say. Perhaps we should get married.
>
> I agreed with everything in your posting (needing to quit drinking, keep on the meds, see a new pdoc). As to the rest of it... where is it you said you lived? heheI'm not bipolar, I'm bicoastal...how much is it you said you made?
>Ilene
Posted by AMD on December 31, 2003, at 10:42:30
In reply to Re: Lithium and alcohol, and ramblings » AMD, posted by Ilene on December 30, 2003, at 22:32:19
Bicoastal. lol I'm keeping that one.
I think we're one post away from getting grounded by Dr. Bob. ... ;)
AMD
> > > Sort of. I used to be able to think quickly. Now I can hardly think at all.
> >
> > Are you bipolar? I assume this is a bit of sardonic humor ...
>
> I think I'm just an atypical depressive who's been damaged by years of depression & meds.
> >
> > > It's nice to know you agree with everything I say. Perhaps we should get married.
> >
> > I agreed with everything in your posting (needing to quit drinking, keep on the meds, see a new pdoc). As to the rest of it... where is it you said you lived? hehe
>
> I'm not bipolar, I'm bicoastal...how much is it you said you made?
> >
>
> Ilene
>
>
Posted by Dr. Bob on January 2, 2004, at 0:42:58
In reply to Re: Lithium and alcohol, and ramblings » Ilene, posted by AMD on December 31, 2003, at 10:42:30
> I think we're one post away from getting grounded by Dr. Bob. ... ;)
Right, I'd like follow-ups not about medication to be redirected to Psycho-Social-Babble. Here's a link:
http://www.dr-bob.org/babble/social/20031229/msgs/295608.html
Thanks,
Bob
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