Mania caused by Starting Lithium ?

[~hellbaby~]

Anyone know if this is common?
Almost 10 months ago, when the Depakote stopped working, we weaned my son off all meds. but abilify. The past two months have been a gradual spiral downward that bottomed out this week. When we stopped meds it was agreed if they became necessary again we'd try Lithium because we've exhausted most everything else. Last night he had the first dose (300mg twice daily)
This morning he was a lot less arguemenative and seemed in a better mood, nothing that made me think twice though. He had his second dose and went to camp. He came home pretty keyed up, too happy. He went from on a scale of 1-10, a 2 this morning to a 10 by dinnertime. I skipped the med. tonite until I talk to the pdoc.
Is this something that should happen?

 

[dragon_gurl]

Meds

Often when switching/ or starting new meds, it takes time to adjust too. Talk to his Dr. and might i recommend if you are not already seeing a phychatrist, and not just a general practioner. Often time Family Dr.'s are only aware of the basics involving Phyc. Meds. Sometimes it takes a few different drugs "cocktail" to really get someone straight, as opposed to just one. Best of luck. I hope everything works out well

 

[mblanton]

My first question would be why he was switched from depakote to lithium when the two drugs have nothing in common. Depakote is primarily used to treat seizure disorders and sometimes used as a mood stabilizer. Lithium is a pretty serious drug in my opinion. There are two very important things that must be done when using this drug. 1. The drug must be given consistantly at the same time everyday and never skip doses. 2. Lithium can build up to toxic levels in your system very quickly and it is very important that your doctor monitor these levels with blood work at least monthly. If the diagnosis is a behavioral disorder your son should not be treated by a family practice doctor (they do not have the expertise with these types of medications). Seek out a qualified psychiatrist and take your son for a visit. Also, make very informed decisions concerning your sons care, as some of these drugs can have terrible long term side effects. If your MD decides to discontinue a medication and prescribe a new medication demand a step down program before going off the first medication, as stopping any medication abruptly can have serious behavioral side effects.

I hope this helps.

Mike

 

[cremebrulee]

I agree 100%!!!!

My first question would be why he was switched from depakote to lithium when the two drugs have nothing in common. Depakote is primarily used to treat seizure disorders and sometimes used as a mood stabilizer. Lithium is a pretty serious drug in my opinion. There are two very important things that must be done when using this drug. 1. The drug must be given consistantly at the same time everyday and never skip doses. 2. Lithium can build up to toxic levels in your system very quickly and it is very important that your doctor monitor these levels with blood work at least monthly. If the diagnosis is a behavioral disorder your son should not be treated by a family practice doctor (they do not have the expertise with these types of medications). Seek out a qualified psychiatrist and take your son for a visit. Also, make very informed decisions concerning your sons care, as some of these drugs can have terrible long term side effects. If your MD decides to discontinue a medication and prescribe a new medication demand a step down program before going off the first medication, as stopping any medication abruptly can have serious behavioral side effects.

I hope this helps.

Mike

I couldn't agree more with you Mike. Sounds like a weird switch of meds ~ what is your son being treated for anyway? With those two drugs it's really hard to see any connection........


~Creme

 

[cremebrulee]

One more thing~ has your son ever had an MRI done? I am truly interested in finding out what they are treating him for or what the dx had been in the past.


~Creme

 

[~hellbaby~]

My first question would be why he was switched from depakote to lithium when the two drugs have nothing in common. Depakote is primarily used to treat seizure disorders and sometimes used as a mood stabilizer. Lithium is a pretty serious drug in my opinion. There are two very important things that must be done when using this drug. 1. The drug must be given consistantly at the same time everyday and never skip doses. 2. Lithium can build up to toxic levels in your system very quickly and it is very important that your doctor monitor these levels with blood work at least monthly. If the diagnosis is a behavioral disorder your son should not be treated by a family practice doctor (they do not have the expertise with these types of medications). Seek out a qualified psychiatrist and take your son for a visit. Also, make very informed decisions concerning your sons care, as some of these drugs can have terrible long term side effects. If your MD decides to discontinue a medication and prescribe a new medication demand a step down program before going off the first medication, as stopping any medication abruptly can have serious behavioral side effects.

I hope this helps.

I couldn't agree more with you Mike. Sounds like a weird switch of meds ~ what is your son being treated for anyway? With those two drugs it's really hard to see any connection........


~Creme

Thanks, it is the long term use that concerns me in someone thirteen years of age.I should have clarified "pdoc" is often used in adolescent bipolar groups as an abbreviation for 'Pediatric Psychiatrist'.
We spent three years with two different psychologists before going to the pediatric psychiatrist. After questioning and discussion we started effexor, an antidepressant. It was determined he was bipolar and not just 'clinically depressed' by his reaction to the drug and other factors. Meds. (medications) where tweaked a bit and within a few days I had my child back. A true miracle.
I agree that lithium is a serious drug; bipolar, or manic depression is a serious and debilitating disorder. It is still a mystery to the medical profession, finding drugs that work is easier that finding out why they work .Lithium is the only drug that has stood the test of time over generations.
So you pick your poison, the drug or the disorder, it is not so easy sometimes.
The thing about the lithium is the therapeutic level is very near the toxicity level and if improperly monitored could be potentially deadly. My other concern is the long term affect on the kidneys. These are some of the reasons we waited until other combinations of mood stabilizers, anti psychotics, and seizure meds. either did not work or stopped working after about four months.
Depakote is more effective for rapid cycling than lithium and is used extensively in treating bipolar disorder, second only to lithium. Here is some of the information .(divalproex is depakote.)

Bipolar Disorder Daily News Blog: Lithium vs Depakote in child bipolar ~"Overall, given that lithium is significantly less expensive than divalproex, it makes sense that it would be a logical first choice if all other things are equal. However, individual circumstances may dictate that divalaproex is better to start with. Also, if one doesn't work, it is reasonable to try the other drug before going to other medications. Not all drugs work for any particular individual so it is always helpful to work closely with a psychiatrist to determine the best medication regimen for an individual patient, but these data indicate that for a population of people on average, lithium and divalproex are equally effective"



FROM~Depression, Bipolar II - Treatment...... "Remember, after considering lithium and Depakote, which around the rest of the world are the absolute, for sure, obvious medications to use for bipolar disorder; there are also other mood stabilizer options, from aripiprazole to Zyprexa, so to speak. ...........
Depakote at 500mg/day is not generally enough for symptom control, but when combined with low-dose lithium, it can be a very effective medication. "

As things turned out, it appears that he was just really keyed up, and maybe a little placebo effect too and he was not going 'hypomanic' because lithium has never been known to cause the onset; according to the pdoc.

 

[Layne]

Depakote

Actually, Depakote is fast becoming the "drug of choice" due to the lack of side effects, and yes, as a mood stabilizer. As far as toxcicity, unless you are physically turning yellow, most docs are not incredibly concerned, as it turns out this has been way over played as a major concern.

Layne

 

[Layne]

How much Depokote was he taking? As a mood sabilizer, the avg. dose is around 1500 mg per day, and of course, they now produce a Depakote ER, (extended release) so you only have to take it once at bed time.

 

[~hellbaby~]

Actually, Depakote is fast becoming the "drug of choice" due to the lack of side effects, and yes, as a mood stabilizer. As far as toxcicity, unless you are physically turning yellow, most docs are not incredibly concerned, as it turns out this has been way over played as a major concern.

Layne

That is comforting to know.His pdoc was really making a point of it, (the lithium toxicity) and stressing the importance of drinking a LOT of water if he is sweating . We fiddled around with different doses of dep.(depakote) It was actually one of the drugs we had better luck with and a longer run than the others, weight gain was a big problem 45lbs. gained in all. Luckily he was a skinny kid to start but is still trying to lose the weight. We maintained the 1500 several months with 5mg abilify at night,( I think because he(psychiatrist) wanted to keep it in his system if needed) but then had to add rispridol and fiddled with those doses, then lamactil which really messed him up so by then it was a new med or dose each week and he was thinking he was a freak and I was walking on eggshells, so I asked the pdoc to stop meds and see what happens. We weaned off all but the abilify, (I don't know why he keeps him on that all the time?) and had EIGHT months stable
Longer than any run with meds. It was looking like abilify might be enough, and boy, we really tried to not go back on meds. but every week was darker than the one before until the proverbial poop went flying.
So here we are, dancing again

 

[Layne]

I feel your pain

Biggest reason NOT to use Lith. is if you sweat a lot. Then, he is right it is a problem. I exercise, run, etc. a lot, so that is not a choice. The Depakote does NOT cause weight gain. It does, however, make you WANT to eat more, especially sweets. As hard as it is, I stay on a NO SUGAR diet, and do fine on it. Send me a private message if you wish to discuss further details. I am not a professional, by any means though.

Layne

 

[Layne]

Oh yea, one more thing...................

Has he, or would he (your son) considered practicing yoga?

Layne

 

[~hellbaby~]

Has he, or would he (your son) considered practicing yoga?

Layne

lmao, I can't even get him to go across the street and run around the baseball field when he is so filled with anger and frustration he just shakes, but I will bring it up.I don't like the lithium, he seems to be sinking deeper into dispair; the agitation is lessening in frequency and depth but gloom is replacing it. He seems to be trudging along more detached everyday. I do not want his life to be like that. He has not smiled for days but tries to act like everything is ok. The only time he was close to this before was what made me take him to the psychiatrist in the first place. I don't even feel comfortable leaving him alone.

 

[Layne]

Please don't laugh............

I was only asking the question, because I find that it helps me a LOT. I too, would have never thought something like that to be effective, but coupled with depakote, and an occasional xanax, I do pretty well.

Layne (speaking from experience, personally)

 

[~hellbaby~]

I was only asking the question, because I find that it helps me a LOT. I too, would have never thought something like that to be effective, but coupled with depakote, and an occasional xanax, I do pretty well.

Layne (speaking from experience, personally)

I just lost my reply somehow, anyway, I am going to bring up the meditation, maybe if he'll do it a little before bed.....The psyche. said he has seen some improvement with a certain type of omega 3 capsules. I do not like what the lithium is doing to him, it seems like big price to pay. It's hard to explain but he seems to be getting like a flat piece of paper or going from a raging river to a stagnant mud puddle.

 

[Sarek11]

I just lost my reply somehow, anyway, I am going to bring up the meditation, maybe if he'll do it a little before bed.....The psyche. said he has seen some improvement with a certain type of omega 3 capsules. I do not like what the lithium is doing to him, it seems like big price to pay. It's hard to explain but he seems to be getting like a flat piece of paper or going from a raging river to a stagnant mud puddle.

Having two people in my household with Bipolar disorder, I've been dealing with them for over 2 years now on various meds. My oldest son takes Depacote along with Geodon which seems to help. He was started on Neuronton and Geodon, which my wife takes, while it helps her, it didn't him at all. Depacote by itself didn't do much of anything, but the combination did. As the Dr explained to me, the was looking for both of them to have a state of what was called hypo mania. Somewhere just above even keel. My son is almost 18 now, and takes 2 500mg Depacote, and 160mg of Geodon every evening. Some things our Dr told me to make sure of that is very important for persons with BiPolar disease is: Make sure they take their meds at the same time everyday, make sure they get plenty of restful sleep. Go to bed around the same time and get their 8 hours. Make sure they eat properly, a good diet is very important. I hope this helps. These last things seem to be very important. I can tell when one of them doesn't take their meds on time, sleep well, or eat properly.

 

[Lady Amber]

My friend's father is on Lith, and he has severe problems. I never knew exactly what happened, just that she told me it made him more "manageable" He has to get his blood tested often, as she told me that lith is a serious drug and in a way poisons you, which is why the blood tests were so important that he go every single time. She said that he was a graphic designer, but since taking Lith his creativity is somewhat shot. I guess there's a trade off. But she did say that since taking the Lith, he's been better. I hope everything turns out better for your son.

 

[Nikasha]

This is the information my bi-polar friend gave me when I asked her about Lithium and mania.

She said that too much Lithium can definitately make you manic, because of the way it allows seratonin to pass between your cells. She said that replacements meds are Prozac AND Dilantin (which is an anti-siezure med) or Prozac AND Topomax (which is used to tread obsessive compulsive disorder). She said that sometimes the Prozac and Topomax combo can change your "motivation" so Wellbrutrin (an anti-tobacco med) is added to return you to "normal." This is the combo that she is on. She said that Paxall is a "cover up the symptoms" drug rather than a "correct the imbalance" drug. And she stressed the need for counselling.

I don't know if either of those two combinations would work for you, but I wish you the best of luck.

 

[~hellbaby~]

Having two people in my household with Bipolar disorder, I've been dealing with them for over 2 years now on various meds. My oldest son takes Depacote along with Geodon which seems to help. He was started on Neuronton and Geodon, which my wife takes, while it helps her, it didn't him at all. Depacote by itself didn't do much of anything, but the combination did. As the Dr explained to me, the was looking for both of them to have a state of what was called hypo mania. Somewhere just above even keel. My son is almost 18 now, and takes 2 500mg Depacote, and 160mg of Geodon every evening. Some things our Dr told me to make sure of that is very important for persons with BiPolar disease is: Make sure they take their meds at the same time everyday, make sure they get plenty of restful sleep. Go to bed around the same time and get their 8 hours. Make sure they eat properly, a good diet is very important. I hope this helps. These last things seem to be very important. I can tell when one of them doesn't take their meds on time, sleep well, or eat properly.

we have been having a problem with the sleep, he's 13 and wants to stay up late, it has an effect on him for sure but being 13 has problems on its own too, I keep that in mind. I know with the abilify, if its even 2 or 3 hours late the next day he feels it.thanks