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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by wishingstar on November 7, 2006, at 20:24:57
Hi everyone, I dont post over on this board much.. mostly on the psych board.
I have severe suicidal depression. I have been through just about every "typical" anti-depressant out there (all the SSRIs, effexor, wellbutrin, etc) with no improvement. The wellbutrin, the most recent drug, gave me weird side effects and I just came off it a few days ago.
My doctor just switched me to lithium. In the past he had talked about using it to augment a SSRI, but now I am on it by itself. I am taking it, but concerned. I am fairly familiar with the drug and how it works in bipolar disorder, but I havent read much on its use for unipolar depression. I have very few mood swings so it's not even the mood stabilization the doctor is going for. He told me that although it might not help the depression much, it should help decrease the suicidal thoughts. I dont really see how those cna be seperated, but I'm trying it nonetheless.
Have any of you been on/heard of lithium for unipolar depression? If so, what kind of effect did you get? I'm really nervous about the dulling effect I've heard it can have. I am already feeling very dull and empty and have a hard time getting out of bed. I certainly dont need any additional toning down.
Thanks for any thoughts.
Posted by Phillipa on November 7, 2006, at 22:37:38
In reply to lithium and unipolar depression, posted by wishingstar on November 7, 2006, at 20:24:57
I think there was just a recent thread on lithium and suicidal ideation. Love Phillipa google may be in order
Posted by Pfinstegg on November 7, 2006, at 22:56:40
In reply to lithium and unipolar depression, posted by wishingstar on November 7, 2006, at 20:24:57
Lithium has been used for a long time for unipolar depression. I take it for that, at a low dose (450 mg.). At that dosage, i feel a moderate lift in my spirits, without the dulling. How much are you taking? It's been by far the best drug for me, compared to the SSRIs, SNRIs and tricyclics. The other thing about it - I think it acts quite rapidly, so you know within just a few days if the drug, and the dosage, is right for you. You may need to experiment a bit with the dosage, so as to not get a lot of dulling- that can be terrible.
Posted by Emily Elizabeth on November 8, 2006, at 9:13:03
In reply to lithium and unipolar depression, posted by wishingstar on November 7, 2006, at 20:24:57
Yes! Lithium can be great for unipolar. It didn't take me 100% of the way to feeling better, but it helped a lot. It also is also specifically known for reducing suicidal thoughts. (Amazing, huh?) This has been supported in research and it also was my experience.
I can't speak to using it alone, as I use it in combo with a bunch of stuff. I know that it is one of the most-researched augmenters. You might ask your pdoc to elaborate on why he decided to use it alone rather than as an augmenter.
Good luck!
Best,
EE
Posted by clint878 on November 8, 2006, at 17:13:03
In reply to lithium and unipolar depression, posted by wishingstar on November 7, 2006, at 20:24:57
Research indicates that bipolar I individuals taking lithium are 20 times less likely to commit suicide than similarly-diagnosed people not taking lithium. This effect is not matched by other mood stabilizers or antidepressants.
That's the research that the doctor probably hopes will carry over to your case.
Posted by blueberry on November 8, 2006, at 20:51:58
In reply to lithium and unipolar depression, posted by wishingstar on November 7, 2006, at 20:24:57
Your endurance thus far has been amazing and you deserve a standing ovation. Hang in there! There are many friends at pbabble to relate with.
I rebuke the spirit of depression that is trying to keep you down. I cheer and praise the spirit of joy. It is temporarily under a crushing weight but will come springing to life to reward you for all you've been through.
Definitely give lithium a try because it has a good reputation and it represents a totally different biological and genetic approach than anything you've tried. Like everything else, the trick is to find the right dose.
There are two other heavy-hitter strategies to keep in mind. MAOI antidepressants for one. And ECT electroconvulsive therapy.
Another oddball that might go very well with lithium or by itself would be provigil.
I've been where you are and I have the utmost respect for you.
Posted by wishingstar on November 8, 2006, at 21:56:09
In reply to Re: lithium and unipolar depression, posted by blueberry on November 8, 2006, at 20:51:58
thank you everyone for your responses! You all have helped me to feel more encouraged about the lithium. Today is day 3, and no real side effects have shown up, which is great. I double the dose tomorrow. Hopefully in a week or so I'll know how its going to work.
My doctors original idea was to use it to augment an anti-depressant as one of you mentioned, but we havent been able to find an AD that works even slightly. So far, all have been like sugar pills for me. I think adding another is still the goal though. We have talked about trying one of the MAOIs.. I forget the name, but it recently came out as a patch rather than a pill. Unfortunately, its very expensive, but that will likely be the next attempt if this doesnt work.
Thank you blueberry for all your kind words. I really do appreciate that.. it means quite a bit to me. The fight can be so long and frustrating, but really, not fighting just isnt an option.
Thank you everyone!
Posted by linkadge on November 12, 2006, at 11:17:30
In reply to Re: lithium and unipolar depression, posted by Pfinstegg on November 7, 2006, at 22:56:40
No longer taking Tianeptine ?
Linkadge
Posted by wishingstar on November 12, 2006, at 15:34:10
In reply to Re: lithium and unipolar depression » Pfinstegg, posted by linkadge on November 12, 2006, at 11:17:30
Sorry? I dont think I've ever taken that. Maybe remembering the wrong person? :)
ws
Posted by Jost on November 12, 2006, at 20:29:02
In reply to Re: lithium and unipolar depression » linkadge, posted by wishingstar on November 12, 2006, at 15:34:10
Hi, wishingstar. I also was going to ask about Maois. The patch, which is called Emsam, is really worth trying. I've had a very good reaction to it.
But if expense is an issue, I wouldn't necessarily give up on Parnate or Nardil. Of course, it depends on your situation. I know you've been going through a very hard time lately. But if you've tried almost everything else, one of them might make a difference.
You do have to be careful with some other medications and some foods (not as many as is often thought). The food prohibitions are only for a certain number of things-- and pretty easy to get to know, after an initial period of just checking on certain products.
But the Maois are very good drugs, which could really help, and be worth trying.
Jost
Posted by yesac on November 13, 2006, at 12:41:25
In reply to lithium and unipolar depression, posted by wishingstar on November 7, 2006, at 20:24:57
Just wanted to chime in here with my experience.
I'm a lot like you. I have quite severe, suicidal, agitated depression. I went through tons of antidepressants with no response. Some made me feel worse, particularly Prozac and Parnate.
Finally, with much trepidation, I tried lithium. I've been on it now for about a year and a half. It's the first drug (out of 2) that has helped me even a little bit.
It's not to say that everything's great now. Mostly what lithium helps me with is the agitation and flipping out/snapping. I used to want to bash my head into a wall a lot of the time. But lithium doesn't do much for depression, and quite honestly, it doesn't do much for suicidality either. But combined with Seroquel, my depression and suicidal thoughts seem to be reduced a little bit.
It took about 6 weeks before lithium kicked in, and it was only when I got to 600mgs. If I go down to 300mgs, it doesn't work at all.
In terms of side effects, I have one major side effect.... a fine hand tremor. Basically, my hands quiver all the time, which gets really f*cking annoying, but there's nothing much I can do about it, so I just have to put up with it. I haven't noticed any "dulling", except when I tried to take 900mgs, I got really weirdly spaced out.
So that's my experience. It hasn't been a miracle drug or anything, but it's done more than every other drug I've taken (except Seroquel), so I guess that's something.
By the way, I just finished a 10 week trial of EMSAM (the MAOI patch).... it didn't do anything for me.
Good luck. I hope you have some success with lithium.
This is the end of the thread.
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