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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by SLS on November 30, 2009, at 7:54:00
It has been doctrine for quite a long time that lithium was effective for treating bipolar I, but not bipolar II. Thus, Depakote and Tegretol became the first line treatments for Bipolar II. More recent medical literature suggests that this dichotomy is not valid, and that lithium is effective for treating both subtypes of bipolar disorder.
The following paper addresses the use of lithium for maintenance treatment as opposed to acute treatment.
- Scott----------------------------------------------------
Lithium Maintenance Treatment of Depression and Mania in Bipolar I and Bipolar II Disorders
Leonardo Tondo, M.D., Ross J. Baldessarini, M.D., John Hennen, Ph.D., and Gianfranco Floris, M.D.OBJECTIVE: Effects of long-term lithium treatment for depressive and manic phases of type I and type II bipolar disorders were compared. METHOD: Clinical research records of 317 patients with DSM-IV-defined bipolar disorder (188 with type I and 129 with type II) were analyzed for frequency and duration of affective episodes and hospitalizations before (mean=8.38 years) versus during (mean=6.35 years) lithium maintenance treatment. Treatment effects were also assessed by survival analysis of interepisode intervals and by multivariate regression testing for factors associated with response to treatment. RESULTS: Bipolar I and bipolar II patients were ill before treatment a similar percentage of time, but the subtype distinction was supported descriptively. Lithium had superior benefits in type II patients, with significantly greater reduction of episodes per year and of the percentage of time ill. Reduction of depressive morbidity was similarly strong in both diagnostic types. During treatment, bipolar II patients had 5.9-fold longer interepisode intervals and were twice as likely as type I patients to have no new episodes. Starting lithium maintenance earlier predicted greater improvement. CONCLUSIONS: Lithium maintenance yielded striking long-term reductions of depressive as well as manic morbidity in both bipolar disorder subtypes, with greater overall benefits in type II patients and with earlier treatment.
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Posted by Phillipa on November 30, 2009, at 10:41:52
In reply to Lithium for Bipolar II, posted by SLS on November 30, 2009, at 7:54:00
Scott I don't think they had the subtypes when my ex deceased now ex-father-inlaw took lithium. But each spring and fall he'd go off to lose weight and go into mania for about two weeks to a month. They crash and just sit for a long time. Don't know what other meds he was on. How's your trial going still well I hope. Love Phillipa
Posted by SLS on November 30, 2009, at 13:03:30
In reply to Re: Lithium for Bipolar II » SLS, posted by Phillipa on November 30, 2009, at 10:41:52
> Scott I don't think they had the subtypes when my ex deceased now ex-father-inlaw took lithium. But each spring and fall he'd go off to lose weight and go into mania for about two weeks to a month. They crash and just sit for a long time. Don't know what other meds he was on. How's your trial going still well I hope. Love Phillipa
Hanging in there...
- Scott
Posted by Maxime on December 3, 2009, at 21:20:05
In reply to Lithium for Bipolar II, posted by SLS on November 30, 2009, at 7:54:00
Scott, does lithium cause weight gain?
Posted by SLS on December 3, 2009, at 21:41:42
In reply to Re: Lithium for Bipolar II » SLS, posted by Maxime on December 3, 2009, at 21:20:05
> Scott, does lithium cause weight gain?
I know that some people report significant weight gain with lithium. It doesn't affect me that way. In fact, the last time that I was on lithium for an extended period of time, I was able to lose weight. You might be okay with it. Historically, lithium has made for a good augmenter of Parnate.
- Scott
Posted by Phillipa on December 4, 2009, at 19:36:16
In reply to Re: Lithium for Bipolar II » Maxime, posted by SLS on December 3, 2009, at 21:41:42
Scott your're lucky my deceased ex father in law gained tons on it???? Phillipa
Posted by Katgirl on December 5, 2009, at 9:55:25
In reply to Re: Lithium for Bipolar II » SLS, posted by Phillipa on December 4, 2009, at 19:36:16
I have heard that lithium can affect your thyroid and thus cause weight gain. So, I would assume checking thyroid levels on the med would be a good idea. If the thyroid started to go out of wack, adding a thyroid medication might then be an option and might help alleviate the weight gain.
Posted by Phillipa on December 5, 2009, at 20:12:06
In reply to Re: Lithium for Bipolar II, posted by Katgirl on December 5, 2009, at 9:55:25
I have hasimotos thyroiditis and wouldn't be allowed to take lithium. Phillipa
This is the end of the thread.
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