![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by prodgirl on December 7, 2004, at 2:02:14
Li has taken the edge off the negative side of my highs as BP. I have always suffered from severe depression, and now, Li is not taking the edge off this at all. I've been taking Trazodone, but really feel I need another AD.
Going to see my pdoc on Thursday and need some help. I am already taking 1500mg of Li, and don't think she'll change that despite the low swings (I'm barely in theraputic range despite the high doseage). I just have no idea what ADs to talk to her about, and I know I must have something else to get me through the winter.
Any suggestions?
thanks!
Posted by barbaracat on December 11, 2004, at 1:28:46
In reply to Lithium + ADs?, posted by prodgirl on December 7, 2004, at 2:02:14
I can relate so well. Lithium has taken the edge off what were becoming constant mixed states depressions - baddddd news. But wasn't enough on it's own. Here is my history:
Added Lamictal. Worked well for 6 months then began pooping.
Added nortriptyline. My mom died and I went through a deep depression and anxiety. This tricyclic brought me out of it in about 3 weeks. I loved it and have nothing but good reports - except for the intoleratble mouth dryness it caused. I had to stop because of this which is really too bad because of all the SSRI's and the rest, this med was the best. I believe the dry mouth eventually would have lessened but it was too much for me. Even so, I would go with a tricyclic or MAOI anyday over an SSRI, especially with bipolar disorder.
Increased lamictal - eventually got up to 90mg which is high. Developed 'the rash' and was very sick. Lamictal has helped many on this board. I wouldn't go near it with a 10-foot pole. Plus it caused weird agitation with each new increase. Didn't like it. Stopped lamictal.
Was on no AD for 3 months and then started feeling depressed again. Scared from the lamictal experience I decided to try natural. I've been taking HBC Protocols Pharmaceutical grade St. John's Wort with good results for about 4 months. My husband has also benefitted from it. It does not work on the same principles as SSRIs and so the danger of switching to hypomania has not been an issue. Brands are very important and I've been happy with HBC Protocols. It takes about 4 weeks to kick in. Expect your pdoc to discourage you to this suggestion due to lack of enough clinical trials, and blah blah. I went ahead on my own and have been satisfied.
Fish Oil - I definitely notice when I get lazy and don't take it. I take Carlson's Finest 1 Tablespoon liquid a day.
I'm not in the therapeutic lithium range at all at only 600mg but it seems to be helping along with the rest. I believe that the meds potentiate each other and so I don't require as much.
If I can stir my butt, getting good sweaty exercise is by far the best AD going. It never fails. If I can prod my bones outside for 1 week and keep the momentum going, my mood improves about 300% and life seems worth living again. But it is soooo hard to get started. I'm usually too fatigued or frenetic, but it's worth it if you can manage even a few minutes here and there. Good luck and keep me posted. - Barbara
> Li has taken the edge off the negative side of my highs as BP. I have always suffered from severe depression, and now, Li is not taking the edge off this at all. I've been taking Trazodone, but really feel I need another AD.
>
> Going to see my pdoc on Thursday and need some help. I am already taking 1500mg of Li, and don't think she'll change that despite the low swings (I'm barely in theraputic range despite the high doseage). I just have no idea what ADs to talk to her about, and I know I must have something else to get me through the winter.
>
> Any suggestions?
> thanks!
Posted by prodgirl on December 11, 2004, at 14:09:44
In reply to Re: Lithium + ADs? » prodgirl, posted by barbaracat on December 11, 2004, at 1:28:46
Thanks, Barbara.
Sorry to hear about the Lamictal for you. It worked for me, I was at 400mg. Then I just pooped out. The mixed states were harrowing. I threw the towel in and went with Lithium. Navigating the side effects is tough, but it's beginning to work.
Went to my pdoc on Thursday, and we decided that I was going to go back to Lexapro. It was the first AD I took, and it worked wonders, until I pooped out. I'm only taking 5mg to start. The last thing I want is to be pushed to a hypo state when I am visiting friends and family for three weeks over the holiday. The west coast to east coast time change is enough to overcome, but to explain why you didn't sleep all night and really must take a 4 hr nap in the afternoon is just embarrassing.
I will talk to my pdoc about the fish oil in Jan. So many have posted saying how much of a help it has been to them.
I'm with you on the exercise. I moved to the beach a year ago, thinking the sun and the ocean 50 yds away would motivate me to get out and walk every day. Nope. Depression pulls it's hood and there is no getting out of the house yet alone on the CA beach with the pretty people.
Thanks again for your suggestion!
prodgirl
Posted by barbaracat on December 11, 2004, at 14:37:42
In reply to Re: Lithium + ADs?, posted by prodgirl on December 11, 2004, at 14:09:44
I think you'll find that with lithium, whatever you take will work better and you'll need less. It seems to be a potentiator. Lithium also has a neurogenesis and protective effect in that it actually grows dendrites in the brain. Non-bipolar longevity buffs take low doses of it for this advantage. I feel very fortunate that I can tolerate it because I feel it's doing good for me beyond the miracle it's done for my mood disorder.
One of the ways fish oil works is that it makes the membranes of the neurons more pliable and allows the receptors more freedom to float, emerge, recede within the cell membrane. Good stuff. But you have to take enough. Unless you want to swallow a handfull of pills, the liquid is the way to go since you'll need about 9G to have any effect. Carlson's Best has been rated very high in different consumer and lab reports for purity (mercury contamination and rancidity is always a concern), and the optimum ratio of EPA to DHA. Plus it tastes pretty good. I order mine through www.iherb.com which has great prices on nutrients.
I'm sure you and your pdoc are well aware of the possible problems with SSRIs and BP so be on the lookout with Lexapro. That's good that it worked before for you and a good sign. Perhaps combining it with lithium you'll be able to keep it at a low dose and avoid any side effects. I'm on a low dose trial of Wellbutrin on top of the St. John's to get me through the holidays. Christmas will forever be a bummer because my Mom was hit by a car while out walking this time two years ago and died from injuries, so I need a tad extra to navigate the winter. If WB doesn't work (it already seems to be perking things up) then I'll go back to nortriptyline in a heartbeat and put up with the smacky mouth.
I know what you mean about depression pulling the shades over the eyes no matter where you are. I live in a beautiful coastal mountainous area of Oregon and have spent too many gorgeous days huddled in bed. I hate beautiful days when I'm in a bad place. Wild horses couln't drag me out for a walk on those days, so I know how it goes (although if I whip myself into doing it I usually feel better for it - for a little while anyway). The trick for me is that when it lets up, to grab the oppotunity and get the hell out on the path, to the beach, wherever I can because maybe, just maybe I can keep it going and force past the next twinge and motivate past it. I think it can be done but I've never been able to sustain it for long enough and always succumb for a a few weeks every year. Ooooh, winter and rain and cold makes it so hard and for me, having fibromyalgia doesn't help either. Good luck and happy holidays. Oh, melatonin at about 3mg at night really helps with jet lag and sleep.
> Thanks, Barbara.
>
> Sorry to hear about the Lamictal for you. It worked for me, I was at 400mg. Then I just pooped out. The mixed states were harrowing. I threw the towel in and went with Lithium. Navigating the side effects is tough, but it's beginning to work.
>
> Went to my pdoc on Thursday, and we decided that I was going to go back to Lexapro. It was the first AD I took, and it worked wonders, until I pooped out. I'm only taking 5mg to start. The last thing I want is to be pushed to a hypo state when I am visiting friends and family for three weeks over the holiday. The west coast to east coast time change is enough to overcome, but to explain why you didn't sleep all night and really must take a 4 hr nap in the afternoon is just embarrassing.
>
> I will talk to my pdoc about the fish oil in Jan. So many have posted saying how much of a help it has been to them.
>
> I'm with you on the exercise. I moved to the beach a year ago, thinking the sun and the ocean 50 yds away would motivate me to get out and walk every day. Nope. Depression pulls it's hood and there is no getting out of the house yet alone on the CA beach with the pretty people.
>
> Thanks again for your suggestion!
>
> prodgirl
Posted by smith562 on December 11, 2004, at 21:26:08
In reply to Re: Lithium + ADs? » prodgirl, posted by barbaracat on December 11, 2004, at 14:37:42
Dear B-Cat,
I seem to need a small dose of lithium to make my ads work (450 mgs). I was on nardil 60 alone ... but I think it made me hypomanic. Now I am on zoloft 100 and lithium 450 and klonopin 1 ... but I feel apathy. My mood is calmer and less anxious, but flat and unmotivated. Have you had this problem? ... is it the meds or the depression?
Thank You,
Smith
> I think you'll find that with lithium, whatever you take will work better and you'll need less. It seems to be a potentiator. Lithium also has a neurogenesis and protective effect in that it actually grows dendrites in the brain. Non-bipolar longevity buffs take low doses of it for this advantage. I feel very fortunate that I can tolerate it because I feel it's doing good for me beyond the miracle it's done for my mood disorder.
Posted by barbaracat on December 12, 2004, at 16:06:40
In reply to Re: Lithium + ADs? » barbaracat, posted by smith562 on December 11, 2004, at 21:26:08
The question of are the blahs related to the meds or depression is a good one. It could be a little of both, but it sounds like you have an anxiety component and vegetative listless depression is definitely not typical with agitated depression (if that's what your's typically is).
I was on Zoloft for many years and it worked off and on pretty well. But it did cause alot of flattening of mood which at first was great because I was pinging like a live wire with anxiety, but then it got to be very boring. I couldn't cry appropriately or feel much of anything. I sat through an aunt's funeral trying to feel something but mainly feeling bored. The Klonopin is of course adding to your malaise but I'd guess it's the Zoloft.
Are you BP-II? In which case 100mg Zoloft or any SSRI could be problematic. For me, finally admitting I was BP and adding Lithium was like a blessed relief and everything worked better - not perfect though because I still get depressed and anxious, just not the awful mixed states kind.
After trying alot of things, I've found a pharmaceutical brand of St. John's Wort to be the best preventative for depression. It's put out by HBC Protocols and is the best I've found in quality and price. My husband has benefitted greatly from it as well and he didn't even realize he was chronically dysthymic until he started feeling better.
But if you're in a skid or in a definite depression, then SJW will not be enough. Christmas is a very hard time for me since I lost my Mom 2 years ago this month. I was feeling the signs of anxiety, weeping, fatigue, sleeplessness, despair that is much different than appropriate mourning. I started taking 100mg Wellbutrin along with SJW, lithium and occasionally neurontin and ativan. I think it's helping - I notice a definite improvement. No flattening of mood, anxiety or sexual side effects. But I have to watch for signs of hypomania which WB is rumored to cause. On the other hand, I've been reading research papers on how WB has proven to be a very successful AD for bipolars.
So, if you were me, I'd experiment with less zoloft and more lithium. Whatever you can do to reduce the zoloft and Klonopin will help the blahs, and lithium is an antianxiety and AD in its own right. It seems around 900mg is the upper limit of what I can tolerate of lithium, but that's just me. More than that and I get tremors and cognitive problems.
As for the Klonopin, you have to reduce that very slowly, if that's what you want to do, as I'm sure you and your pdoc are aware. Gabapentin, or Neurontin is good for the transition period. I like it also for general anxiety relief, as long as I keep the dose low and don't take it on a regular basis, it's much better than a benzo. Good luck and happy holidays.
>
> I seem to need a small dose of lithium to make my ads work (450 mgs). I was on nardil 60 alone ... but I think it made me hypomanic. Now I am on zoloft 100 and lithium 450 and klonopin 1 ... but I feel apathy. My mood is calmer and less anxious, but flat and unmotivated. Have you had this problem? ... is it the meds or the depression?
>
> Thank You,
>
> Smith
>
>
> > I think you'll find that with lithium, whatever you take will work better and you'll need less. It seems to be a potentiator. Lithium also has a neurogenesis and protective effect in that it actually grows dendrites in the brain. Non-bipolar longevity buffs take low doses of it for this advantage. I feel very fortunate that I can tolerate it because I feel it's doing good for me beyond the miracle it's done for my mood disorder.
>
Posted by smith562 on December 12, 2004, at 17:28:40
In reply to Re: Lithium + ADs? » smith562, posted by barbaracat on December 12, 2004, at 16:06:40
My situation is strange ... Father is BPII and Mother is Major Depression with Panic. I am a hybrid .... started to get panic age 25, then major depression 26 then typical ad poop out with imipramine and other ads.
I have tried the "Dr Phelp's" approach 3 years ago .... try lithium solo (still with panic and depression), then lamictal (still with panic and depression), then depakote (250 sent me into a stupor).
So I guess I am Bipolar III (I think hypomania with nardil) with panic disorder. My problem is mood stablizers do nothing for the depression and SSRIs flat me out and TCAs/Wellbutrin increase my panic.
Damned if I mood stablize, damned if I antidepress! Any thoughs .....
Smith
PS I have always enjoyed reading your posts ... I feel like my mood disorder is very similar to "Ritch" and yourself (I feel as I get older, more of the bp will emerge ... now age 32)
> The question of are the blahs related to the meds or depression is a good one. It could be a little of both, but it sounds like you have an anxiety component and vegetative listless depression is definitely not typical with agitated depression (if that's what your's typically is).
>
> I was on Zoloft for many years and it worked off and on pretty well. But it did cause alot of flattening of mood which at first was great because I was pinging like a live wire with anxiety, but then it got to be very boring. I couldn't cry appropriately or feel much of anything. I sat through an aunt's funeral trying to feel something but mainly feeling bored. The Klonopin is of course adding to your malaise but I'd guess it's the Zoloft.
>
> Are you BP-II? In which case 100mg Zoloft or any SSRI could be problematic. For me, finally admitting I was BP and adding Lithium was like a blessed relief and everything worked better - not perfect though because I still get depressed and anxious, just not the awful mixed states kind.
>
> After trying alot of things, I've found a pharmaceutical brand of St. John's Wort to be the best preventative for depression. It's put out by HBC Protocols and is the best I've found in quality and price. My husband has benefitted greatly from it as well and he didn't even realize he was chronically dysthymic until he started feeling better.
>
> But if you're in a skid or in a definite depression, then SJW will not be enough. Christmas is a very hard time for me since I lost my Mom 2 years ago this month. I was feeling the signs of anxiety, weeping, fatigue, sleeplessness, despair that is much different than appropriate mourning. I started taking 100mg Wellbutrin along with SJW, lithium and occasionally neurontin and ativan. I think it's helping - I notice a definite improvement. No flattening of mood, anxiety or sexual side effects. But I have to watch for signs of hypomania which WB is rumored to cause. On the other hand, I've been reading research papers on how WB has proven to be a very successful AD for bipolars.
>
> So, if you were me, I'd experiment with less zoloft and more lithium. Whatever you can do to reduce the zoloft and Klonopin will help the blahs, and lithium is an antianxiety and AD in its own right. It seems around 900mg is the upper limit of what I can tolerate of lithium, but that's just me. More than that and I get tremors and cognitive problems.
>
> As for the Klonopin, you have to reduce that very slowly, if that's what you want to do, as I'm sure you and your pdoc are aware. Gabapentin, or Neurontin is good for the transition period. I like it also for general anxiety relief, as long as I keep the dose low and don't take it on a regular basis, it's much better than a benzo. Good luck and happy holidays.
>
> >
>
>
> > I seem to need a small dose of lithium to make my ads work (450 mgs). I was on nardil 60 alone ... but I think it made me hypomanic. Now I am on zoloft 100 and lithium 450 and klonopin 1 ... but I feel apathy. My mood is calmer and less anxious, but flat and unmotivated. Have you had this problem? ... is it the meds or the depression?
> >
> > Thank You,
> >
> > Smith
> >
> >
> > > I think you'll find that with lithium, whatever you take will work better and you'll need less. It seems to be a potentiator. Lithium also has a neurogenesis and protective effect in that it actually grows dendrites in the brain. Non-bipolar longevity buffs take low doses of it for this advantage. I feel very fortunate that I can tolerate it because I feel it's doing good for me beyond the miracle it's done for my mood disorder.
> >
>
>
Posted by Ritch on December 12, 2004, at 19:09:44
In reply to Thank You! Thank You! » barbaracat, posted by smith562 on December 12, 2004, at 17:28:40
>...So I guess I am Bipolar III (I think hypomania with nardil) with panic disorder. My problem is mood stablizers do nothing for the depression and SSRIs flat me out and TCAs/Wellbutrin increase my panic.
Damned if I mood stablize, damned if I antidepress! Any thoughs .....
Smith
Hi, my troubles are similar (BP+panic). The stuff that works the best for my depression tends to make my panic problems worse (WB, stims). Depakote by itself (or just with clonazepam with no AD), tend to start making me depressed. The SSRI's *do* reduce panic anxiety, but they tend to make me mood cycle a lot more and then I get the apathetic depression from them! I'm afraid that the only thing I've found for this is to reduce *everything* to the lowest level that keeps pretty much everything under control. So, I take just enough Depakote to keep the mania away(believe me it does come back if I don't take *something* for that and I don't have to wait very long either). And I take just enough clonazepam to keep from getting full-blown panic attacks. Then I add the *smallest* dose of SSRI that will clearly improve anxiety. Because if the clon. goes up I will get depressed, if the SSRI goes up I will start cycling too much. If the Depakote goes up I will be sleeping 12+hrs a day.So... I really don't know what to recommend since I'm in a similar pickle myself (and I certainly don't think I've really solved it). I think Barbara's idea of slowly lowering the Zoloft might be the best place to start. IOW, look at what you are taking and see if there is something you can reduce or eliminate that is a potential *source* of trouble. Or at least try to figure out *what* is causing trouble. Hope this helps...
Posted by barbaracat on December 12, 2004, at 20:03:46
In reply to Thank You! Thank You! » barbaracat, posted by smith562 on December 12, 2004, at 17:28:40
Have you tried Lamictal? It's worked for alot of folks. I got the rash, but it wasn't directly related to lamictal. But it is activating and if you're prone to panic may not be the best way to go. I know how terrible panic is. I can take just about anything, but not panic. My panic used to be a cyclical thing, hang around for awhile and then leave for no reason. I eventually realized that it was part of the bipolar mixed states syndrome. Bleak depression fueled by agitated mania = panic. It would cause anyone to feel panicked, no? So, the recipe is always treat the bipolar first and then you can start experimenting with different ADs with less risk of panic and destabilization.
I personally think you're not on enough lithium, especially since it truly sounds like you're dealing with at least some form of BP (how many is it up to now? 500?). Until you get that stabilized you're shooting blanks as far as any other meds being effective for long.
You know, there are so many metabolic and chemical dysfunctions coming to light with tests to ferret them out. Sometimes all the mood meds in the world aren't going to address an underlying metabolic disorder. It could be hormonal (have you had your thyroid checked lately?) it could be a pyrrole disorder, so many things. A few on this board have gone to the Pfeiffer Institute to get massive and expensive testing and some found out interesting information and felt it worthwhile. Ed O'Flaherty on this board is an MD in Ireland and has a website that discusses some of these metabolic markers. He and others on this metabolic track feel that bipolar may be a pyrrole disorder - an inability to metabolize B6 and other important neurotransmitter precursors. Might be interesting to talk with him on this board and go to his site.. Here's a recent post with at least his name
http://www.dr-bob.org/babble/alter/20041123/msgs/427813.htmlI've been helped alot once I got some major hormonal imbalances dealt with, but of course, not 100%. All I ask at this point is to be kept well enough to be able to exercise because without that I get really wiggy. Unfortunately, most pdocs stop at the head and managed care doesn't do a good job with the rest of the body. I see a naturopath and a functional medicine MD. Might be worth looking into other body parts if you continue to get no relief from mood meds.
> My situation is strange ... Father is BPII and Mother is Major Depression with Panic. I am a hybrid .... started to get panic age 25, then major depression 26 then typical ad poop out with imipramine and other ads.
>
> I have tried the "Dr Phelp's" approach 3 years ago .... try lithium solo (still with panic and depression), then lamictal (still with panic and depression), then depakote (250 sent me into a stupor).
>
> So I guess I am Bipolar III (I think hypomania with nardil) with panic disorder. My problem is mood stablizers do nothing for the depression and SSRIs flat me out and TCAs/Wellbutrin increase my panic.
>
> Damned if I mood stablize, damned if I antidepress! Any thoughs .....
>
> Smith
>
> PS I have always enjoyed reading your posts ... I feel like my mood disorder is very similar to "Ritch" and yourself (I feel as I get older, more of the bp will emerge ... now age 32)
>
>
> > The question of are the blahs related to the meds or depression is a good one. It could be a little of both, but it sounds like you have an anxiety component and vegetative listless depression is definitely not typical with agitated depression (if that's what your's typically is).
> >
> > I was on Zoloft for many years and it worked off and on pretty well. But it did cause alot of flattening of mood which at first was great because I was pinging like a live wire with anxiety, but then it got to be very boring. I couldn't cry appropriately or feel much of anything. I sat through an aunt's funeral trying to feel something but mainly feeling bored. The Klonopin is of course adding to your malaise but I'd guess it's the Zoloft.
> >
> > Are you BP-II? In which case 100mg Zoloft or any SSRI could be problematic. For me, finally admitting I was BP and adding Lithium was like a blessed relief and everything worked better - not perfect though because I still get depressed and anxious, just not the awful mixed states kind.
> >
> > After trying alot of things, I've found a pharmaceutical brand of St. John's Wort to be the best preventative for depression. It's put out by HBC Protocols and is the best I've found in quality and price. My husband has benefitted greatly from it as well and he didn't even realize he was chronically dysthymic until he started feeling better.
> >
> > But if you're in a skid or in a definite depression, then SJW will not be enough. Christmas is a very hard time for me since I lost my Mom 2 years ago this month. I was feeling the signs of anxiety, weeping, fatigue, sleeplessness, despair that is much different than appropriate mourning. I started taking 100mg Wellbutrin along with SJW, lithium and occasionally neurontin and ativan. I think it's helping - I notice a definite improvement. No flattening of mood, anxiety or sexual side effects. But I have to watch for signs of hypomania which WB is rumored to cause. On the other hand, I've been reading research papers on how WB has proven to be a very successful AD for bipolars.
> >
> > So, if you were me, I'd experiment with less zoloft and more lithium. Whatever you can do to reduce the zoloft and Klonopin will help the blahs, and lithium is an antianxiety and AD in its own right. It seems around 900mg is the upper limit of what I can tolerate of lithium, but that's just me. More than that and I get tremors and cognitive problems.
> >
> > As for the Klonopin, you have to reduce that very slowly, if that's what you want to do, as I'm sure you and your pdoc are aware. Gabapentin, or Neurontin is good for the transition period. I like it also for general anxiety relief, as long as I keep the dose low and don't take it on a regular basis, it's much better than a benzo. Good luck and happy holidays.
> >
> > >
> >
> >
> > > I seem to need a small dose of lithium to make my ads work (450 mgs). I was on nardil 60 alone ... but I think it made me hypomanic. Now I am on zoloft 100 and lithium 450 and klonopin 1 ... but I feel apathy. My mood is calmer and less anxious, but flat and unmotivated. Have you had this problem? ... is it the meds or the depression?
> > >
> > > Thank You,
> > >
> > > Smith
> > >
> > >
> > > > I think you'll find that with lithium, whatever you take will work better and you'll need less. It seems to be a potentiator. Lithium also has a neurogenesis and protective effect in that it actually grows dendrites in the brain. Non-bipolar longevity buffs take low doses of it for this advantage. I feel very fortunate that I can tolerate it because I feel it's doing good for me beyond the miracle it's done for my mood disorder.
> > >
> >
> >
>
>
Posted by prodgirl on December 13, 2004, at 0:15:18
In reply to Re: Lithium + ADs? » prodgirl, posted by barbaracat on December 11, 2004, at 14:37:42
Barbara -
Any chance you had problems with your skin as a side effect from the Lithium? I saw my Pdoc this week, she said that it's normal and she would recommend a dermatologist. My pores have gone nuts, black heads on my face and weird non-pimples on my chest, upper arms and my sides. I spend alot of money on high end facial product as is, and I still can't figure out what to do.
Any suggestions?
Posted by barbaracat on December 13, 2004, at 1:29:51
In reply to Re: Lithium skin problems (Barbara), posted by prodgirl on December 13, 2004, at 0:15:18
My skin got a little oilier and I broke out somewhat at first, but I'm on a very small dose at 600mg and never got anything that was too bad. I'm also 53 so I'm not exactly zit prone like I was earlier on. The other thing I noticed that I've heard mentioned is that your hair might change. The texture of mine got strange for a while, like it was coated. My hair coloring looked off for a few months. Lithium is a metallic salt so it would figure that it would interract with hair coloring. All these things resolved in time though.
A few things come to mind. Because it is a metallic salt and some gets excreted through the skin, you may have a sensitivity to it which could be a simple irritation sensitivity or a more problematic one due to an actual allergy. Vitamin C at about 4M a day really helps with allergies and helps the skin alot because it builds collagen.
If the bumps are red and inflamed it's probably a sensitivity, but it sounds like it's blackheads and closed pore bumps which is more of a problem when excess oiliness is combined with thick sebum and slow skin cell turnover.
Have you had your thyroid checked? Lithium is notorious for causing low thyroid. It's made mine worse and is the main problem I have with it and why I attempt to quit every so often. A low thyroid will cause skin problems, and down the line other hormonal problems as well. Estrogen and thyroid are very linked and look what happens pre-menstrually with those zits. A low thyroid will also cause sluggish elimination and if those toxins aren't getting eliminated the normal way, the skin is the second best route.
If you're not taking fish oil it may help. It certainly can't hurt. You'd think oil is the last thing you need right now but after an initial break in period of a few extra zits it helps keep the pores clearer by emulsifying the sebum and keeping it from getting hard and oxidized, which is what a blackhead is, just oxidized too sticky oil. At any rate, my skin and hair are back to normal and the fish oil has helped all around. Vitamins A and E also help with turnover rate of skin cells. If your skin isn't inflamed, use a scratchy washcloth or something to exfoliate.
The other thing is you've GOT to drink extra water with lithium and it's good to put a pinch of sea salt in it to replace the electrolytes lithium pees out and to make the water more absorbable. The rule is to take your weight and halve it and that's the number of ounces you should be drinking a day, so if you weigh 120 lbs you should be drinking 60oz of water a day.
If all else fails, a dermatologist will probably put you on Retin-A to speed cell turnover. But give things time if you're just starting lithium, although Retin-A isn't a bad thing for wrinkle patrol.
As far as expensive skin products, you might want to go as pure and simple as you can for a while to reduce any possible irritants. Department store skin care products are loaded with them. You know what the best moisturizer is? Macadamia nut oil. It's the closest to natural skin oil, softens the blackheads and is and a heck cheaper than Clinique. I put a squirt of lavender essential oil in it for the extra disinfectant properties. Plus it's great to cook with - just leave out the lavender! A great skin cleanser is - you'll love this - unflavored yogurt, something like Nancy's or even better, Pavel's, using a washcloth. It's antibacterial, has natural alpha hydroxy exfoliators and restores a perfect acidic pH. The only thing is it's a pain in the butt to retrieve it from the fridge every night and it's cold. But I just put some in a squeeze bottle (otherwise it's way messy from the carton) and it works great. Cheap and better than the expensive stuff. As much as we love to believe that rubbing on a product will product miracles, good skin is mainly an inside job, a product of hormonal balance, good nutrition, good elmination of toxins, adequate water and good skin cell turnover rate. Gee, maybe I should open a booth at the mall. I just won't tell them it's yogurt. - Barbara
> Barbara -
>
> Any chance you had problems with your skin as a side effect from the Lithium? I saw my Pdoc this week, she said that it's normal and she would recommend a dermatologist. My pores have gone nuts, black heads on my face and weird non-pimples on my chest, upper arms and my sides. I spend alot of money on high end facial product as is, and I still can't figure out what to do.
>
> Any suggestions?
>
Posted by prodgirl on December 13, 2004, at 2:50:26
In reply to Re: Lithium skin problems (Barbara) » prodgirl, posted by barbaracat on December 13, 2004, at 1:29:51
Very insightful - just what I expected! I'm 30 and still a bit zit prone :( I'm an Aveda girl, which means the products are supposed to be all natural and organic. It's the only thing that made my skin "normal" - I'm fair skinned with ginger hair. I travel an obscene amount for work, and a different water in a different city every day just wreaked havoc on my skin. I exfoliate every day, but I will look into something with a little more punch. I'm with you on the water - I drink about 12 glasses a day, especially with the Lithium. I started drinking 8oz of Gatorade as well, to keep the electrolytes up.
One thing that I have used for the past three years which is now really coming into mainstream is tea tree oil. I apply it straight to my skin with a cotton ball. It used to take care of those closed pore bumps very well. Smells great, good to mix in with moisturizer. Most women are agasp at putting oil directly on their faces-looks like we are ahead of the game.
I will definately try the yogurt and vitamins. I want to hold off on the dermatolgist for a while, like you said. I've only been on Lithium for a short time, although, long enough for the annoying side effects to kick my rear. I should have full blood work done after the new year to check my Ts.
Again, thank you!
Posted by barbaracat on December 13, 2004, at 12:39:22
In reply to Re: Lithium skin problems (Barbara), posted by prodgirl on December 13, 2004, at 2:50:26
Thanks for your ideas too. I love Aveda. One of the few products I'll use. Definitely get that thyroid tested and please let me know the results. I already was hypothyroid and lithium exacerbated it and my TSH levels were all over the place. Things are stable now on a natural T4/T3 thyroid.
I have a suggestion about the Gatorade which is not a really healthy drink for many reasons, despite the electrolytes. There's a product that was recommended to me when I was getting dehydrated at high elevations called Hydralyte (used to be called Gookinaid). It's electrolyte replacement but alot more. I originally bought it at the health food store where I heard about it but order it now directly through the website at http://www.gookinaid.com/. It comes in a powder that you mix with water. Even my picky 9 year old nephew loves the taste.
Read the literature - very interestesting stuff. The sweetener they use is glucose which is the only sugar that the brain can use and used in IVs. The other sports drinks use anything from sugar to aspartame (horrors) to fructose because they're alot cheaper than glucose, along with artificial colorants and preservatives and plain junk. It also helped with my fibromyalgia muscle pains alot because it helps get magnesium into the muscle fibers. And it tastes great, especially Fruit Punch flavor. It's also a whole lot more economical than Gatorade. Do youself and favor and check it out.
I was thinking about your skin issue and what puzzles me is you said you have bumps and stuff on your sides? I can see the face and chest/back and upper arms because of the oil glands, but sides? That's a strange one.
> Very insightful - just what I expected! I'm 30 and still a bit zit prone :( I'm an Aveda girl, which means the products are supposed to be all natural and organic. It's the only thing that made my skin "normal" - I'm fair skinned with ginger hair. I travel an obscene amount for work, and a different water in a different city every day just wreaked havoc on my skin. I exfoliate every day, but I will look into something with a little more punch. I'm with you on the water - I drink about 12 glasses a day, especially with the Lithium. I started drinking 8oz of Gatorade as well, to keep the electrolytes up.
>
> One thing that I have used for the past three years which is now really coming into mainstream is tea tree oil. I apply it straight to my skin with a cotton ball. It used to take care of those closed pore bumps very well. Smells great, good to mix in with moisturizer. Most women are agasp at putting oil directly on their faces-looks like we are ahead of the game.
>
> I will definately try the yogurt and vitamins. I want to hold off on the dermatolgist for a while, like you said. I've only been on Lithium for a short time, although, long enough for the annoying side effects to kick my rear. I should have full blood work done after the new year to check my Ts.
>
> Again, thank you!
Posted by katia on December 13, 2004, at 15:07:48
In reply to Re: Lithium skin problems (Barbara) » prodgirl, posted by barbaracat on December 13, 2004, at 12:39:22
Hi Barbara!
How're you? I've been trying to find a post of yours awhile back regarding St. John's Wort. I want to order some and I know you had a suggestion. What was it again?
Thanks-
Katia
Posted by barbaracat on December 13, 2004, at 18:24:32
In reply to St. John's » barbaracat, posted by katia on December 13, 2004, at 15:07:48
Hi Sweetie!
It's HBC Protocols. www.hbcprotocols.com. And here's the direct link to the St. John's page:
http://www.hbcprotocols.com/products-HV280.html The website has some good articles in general if you search the box in the upper right.I'm doing OK. Just OK, but it's manageable. As long as it's not mixed states, I can live with just about anything.
I'm up to 100mg WellB and not sure it's the right med for me. Feeling kind of jaggy which is too bad because I was hoping for a dopamine kind of thang. Like it would magically make me not want swampwater, but no such luck. Think I'll just go back to the SJW and lithium and deal with the lethargy some other way. A light box? Can't hurt and Costco has a cute portable little number. What was your experience on WB?
Haven't called Theresa yet. I need to just talk to her about it all. Right now I'm feeling like it's one more thing and someone else to be accountable to, which is good, but in my present crappy state of mind I tend to dig in my heels and rebel against anyone 'telling me what to do'. That's been a theme coming up for me lately. I need to talk this over with her since I have no experience with a coach and my concern is that it's a results oriented nice nag, but still a nag. Dumb?
Just got through last week, my Mom's 2 year memorial. Amazing how grief comes up in sooooo many different guises, in waves, like you mentioned. Oh well, we're supposed to feel sad about this stuff although it's still hard to deal with.
How about you? Working on getting clients or just taking a breather during Christmas? This is supposed to be such a happy season but it brings up all kinds of unmeetable expectations and forced jollyness. But we DID order a houseful of triple-paned gorgeous wonderful windows. I think I told you. Installed in February and I can't wait. Snug and tight and real good looking - some leaded and beveled glass, etc. I suspect it's going to do a major feng shue clearing beauty thing and start the process for clearing and beautifying our entire inner and outer spaces.
> Hi Barbara!
> How're you? I've been trying to find a post of yours awhile back regarding St. John's Wort. I want to order some and I know you had a suggestion. What was it again?
> Thanks-
> Katia
Posted by smith562 on December 13, 2004, at 18:56:12
In reply to Re: Thank You! Thank You! » smith562, posted by barbaracat on December 12, 2004, at 20:03:46
Hey B-Cat,
I got sucked up into Dr Phelps site and actually did try lithium up to 1200 mgs (blood level .9) with worsening depression and lethargy. Up to 450 is good, I like the calmness and clearity it gives me. But starting at 600 I get quiet-depressed-fatigue.
Then I went to an "NYU" Big wig and tried lamictal up to 300mgs with initial help, then poop out.
I dropped the zoloft to 75 today and added back 100 of wellbutrin ... I feel human again today finally.
Once again, thank you thank you. Reading posts from you and mitch keep me going and I know I am in a better place today with pbabble (working and in a good relationship).
Sincerely,
Smith
> Have you tried Lamictal? It's worked for alot of folks. I got the rash, but it wasn't directly related to lamictal. But it is activating and if you're prone to panic may not be the best way to go. I know how terrible panic is. I can take just about anything, but not panic. My panic used to be a cyclical thing, hang around for awhile and then leave for no reason. I eventually realized that it was part of the bipolar mixed states syndrome. Bleak depression fueled by agitated mania = panic. It would cause anyone to feel panicked, no? So, the recipe is always treat the bipolar first and then you can start experimenting with different ADs with less risk of panic and destabilization.
>
> I personally think you're not on enough lithium, especially since it truly sounds like you're dealing with at least some form of BP (how many is it up to now? 500?). Until you get that stabilized you're shooting blanks as far as any other meds being effective for long.
>
> You know, there are so many metabolic and chemical dysfunctions coming to light with tests to ferret them out. Sometimes all the mood meds in the world aren't going to address an underlying metabolic disorder. It could be hormonal (have you had your thyroid checked lately?) it could be a pyrrole disorder, so many things. A few on this board have gone to the Pfeiffer Institute to get massive and expensive testing and some found out interesting information and felt it worthwhile. Ed O'Flaherty on this board is an MD in Ireland and has a website that discusses some of these metabolic markers. He and others on this metabolic track feel that bipolar may be a pyrrole disorder - an inability to metabolize B6 and other important neurotransmitter precursors. Might be interesting to talk with him on this board and go to his site.. Here's a recent post with at least his name
> http://www.dr-bob.org/babble/alter/20041123/msgs/427813.html
>
> I've been helped alot once I got some major hormonal imbalances dealt with, but of course, not 100%. All I ask at this point is to be kept well enough to be able to exercise because without that I get really wiggy. Unfortunately, most pdocs stop at the head and managed care doesn't do a good job with the rest of the body. I see a naturopath and a functional medicine MD. Might be worth looking into other body parts if you continue to get no relief from mood meds.
Posted by katia on December 14, 2004, at 2:43:39
In reply to Re: St. John's » katia, posted by barbaracat on December 13, 2004, at 18:24:32
> Hi Sweetie!
> It's HBC Protocols. www.hbcprotocols.com. And here's the direct link to the St. John's page:
> http://www.hbcprotocols.com/products-HV280.html The website has some good articles in general if you search the box in the upper right.
Hey you!
** If you get a light box, make sure you get a good one. Apollolight.com is VERY good. I got Apollo IV. I recommend this company.
> I'm doing OK. Just OK, but it's manageable. As long as it's not mixed states, I can live with just about anything.>
> I'm up to 100mg WellB and not sure it's the right med for me. Feeling kind of jaggy which is too bad because I was hoping for a dopamine kind of thang. Like it would magically make me not want swampwater, but no such luck. Think I'll just go back to the SJW and lithium and deal with the lethargy some other way. A light box? Can't hurt and Costco has a cute portable little number. What was your experience on WB?** Experience on WB for me? Jaggy and crazy as you mention. Maybe reduce the amount some? As I said when I gave you WB, it didn't work for me. But neither does Lithium...
>
> Haven't called Theresa yet. I need to just talk to her about it all. Right now I'm feeling like it's one more thing and someone else to be accountable to, which is good, but in my present crappy state of mind I tend to dig in my heels and rebel against anyone 'telling me what to do'. That's been a theme coming up for me lately. I need to talk this over with her since I have no experience with a coach and my concern is that it's a results oriented nice nag, but still a nag. Dumb?** No, not dumb at all....you don't know what to expect. And a coach doesn't have to be a nag, but the relationship is what you design it to be. I recommend just calling her. To me, when I feel like "support" is just one more thing to do...when I do it things sooo shift for me and I can transform out of that space.
>
> Just got through last week, my Mom's 2 year memorial. Amazing how grief comes up in sooooo many different guises, in waves, like you mentioned. Oh well, we're supposed to feel sad about this stuff although it's still hard to deal with.
>** I'm feeling for you. My great uncle died yesterday of stomach cancer. I had a feeling about him two weeks ago and was going to send a card. it took me until Sat. to send it and he died on Sunday. I'm very upset over the timing. I have a picture of him on Rock's alter. I wonder if Rock met him?
> How about you? Working on getting clients or just taking a breather during Christmas? This is supposed to be such a happy season but it brings up all kinds of unmeetable expectations and forced jollyness.
**I'm trying my hardest to market myself, but I'm not getting any bites. The rest. biz is driving me crazier than bipolar!!
But we DID order a houseful of triple-paned gorgeous wonderful windows. I think I told you. Installed in February and I can't wait. Snug and tight and real good looking - some leaded and beveled glass, etc. I suspect it's going to do a major feng shue clearing beauty thing and start the process for clearing and beautifying our entire inner and outer spaces.
>
**Good for you! I'll see it one day!
HAve a good xmas Barb!
Katia
> > Hi Barbara!
> > How're you? I've been trying to find a post of yours awhile back regarding St. John's Wort. I want to order some and I know you had a suggestion. What was it again?
> > Thanks-
> > Katia
>
>
Posted by katia on December 16, 2004, at 13:59:44
In reply to Re: St. John's » katia, posted by barbaracat on December 13, 2004, at 18:24:32
How much does your hubby take? What's the "normal" dose range?
Katia
Posted by barbaracat on December 16, 2004, at 15:22:36
In reply to Re: St. John's » barbaracat, posted by katia on December 16, 2004, at 13:59:44
The normal is 3 a day, or 900mg and that's what he takes. He takes them all at night, rather than spaced out over the day and he feels that works better from a convenience standpoint as well as effectiveness. I take 2. I think lithium potentiates whatever I take and anymore than that just didn't feel as good. There are other things in this formulation, like B6, folic acid, and the neuroactive form of B12 which act synergistically. You might feel a little buzzed at first, or 'activated' but it calms down quickly. It took both of us around 4-5 weeks to notice that it definitely was working, so you have to be patient. But then one day, you suddenly notice that things are seeming lighter and brighter in a way that's different than the lift from SSRIs.
Sorry about your great-uncle. It's always hard to lose a holder of the family history and lore, and the loss and sadness ripples throughout the family and community. Especially this time of year. I'm sure he's romping with Rock (and probably Merlin too since I get the feeling the two of them are buds on the other side).
> How much does your hubby take? What's the "normal" dose range?
> Katia
This is the end of the thread.
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