Posted 7/11/2009 9:34 AM (GMT 0)
HI there,
Lithium can also cause considerable weight gain in some and it is not necessarily diet related, it is to do with fluid retention casued by Lithium, so you have double whammy taking Zyprexa too , but if it helps to stabilize the mood successfully and allows someone to feel happy and normal or more level and actually functional then its worth the extra wieght gain, though not desirable. No point being thin and miserable or seriously depressed or manic and destroying your life or making everyone else deeply unhappy with very unplesant dysphoric manif or hypomanic aggressive/ abusive or reckless behaviours or ruining relationships. Its a compromise. Regular exercise can certainly help to minimise some of the additional weight gained by the Lithium and Zyprexa and careful attention to dietary intake. IT shard work but worth the effort. Good luck. DElighted the combination of meds is working for him at long last.
I wish my partner would consider trying Lithium again. He was taken off it years ago as it is not always considered so helpful in frequent rapid cycling, apparently, though some more recent research disputes tese findingss now and says it can be just as effective but probably needs a farly high does or to be combined with another stabilizer such as Depakote or Sodium Valproate, and possibly even the addition of an atypical antipsychotic. I sincerely wish he could find something that would work as this illness is wrecking our relationship and happiness and getting in the way of any normal life together.He was transferred onto DEpakote but on far too low a dosage. Since then it has benn increased from 750mg Depakote to 2000mg Depakote, but he still sufferred very much with depressions. Every time he was given any type of antidepressant with it, he rapidlu became very hypomanic, verging on manic and these episodes lasted fir many many months, sometime 3-4. Once off the anti Ds he was no as hpomnic, but became very depressed with shorrter periods of breakthrough hypomanias, and that woulfd be followed by wekks of Mixed moods, in which although he had an underrlying depressive mood, the hypomanic mix tended to predominate and was most unplesant. For a few months he was also given Seroquel which apperaed to hep restore more rational thinking and reduce hostility but it was never given apparently in a sufficient dosage ( Only 150mg- 300mg maximum ) to be in any effective at aborting an existing hypomanic epiosde or at preventing a worse hypomanic episode eventually, during wich he stopped it al together and never resumed it until this year whe I encouraged him to take it again as he had so much agitation and had just come out ofa 5 month mania/ hypomania which was so destructive and distressing, and I believe was triggered by the addition of Lamotrigine. IN the past 3 years it appears all of his highs have been brought on by reintroducing lamotrigine or after every increase above 50mg. WE have had the worst 3 years of cycling with very long epiosdes of maainly hypomania with shorter months of Depression, when he usully agrees to renain off Lamotrigine as at that point when he comes back down he realizes the Lamotrigine has beencausing him to temain far too high andhe is highly aggressive, dismissive, severs our relationship, threatend all manner of poilce interventions when I contact his mental health team or family to let them know he is unwell, as he believes himself to be very well when high but clearly by his activities is far from that. I KNowe I have to inform them but this angers him even more, though I would point out he uses this as as justification or to rational his aggressive behviour. It is not infact the cause of his anger, because his hostility started out of the blue without us falling out and preceded me communicating with anyone about his need for help. He has no insight right from the start of a hypomanic epiosde. His judgement is lost very early on and remains lost throught the whole episode.
He is hypersexual, contacting people on inappropriae websites, indiscriminately socializing, aleays wanting to take off somewhere abroad or staright up to London, starts drinking more, taking lots of diet coke loaded on caffeine, starting all sorts of risky financial and business ventures though has no money to fund them.
The problem is when he sees his mental health team ,if they can engage with him ,which is difficult when he is high as he believes there is no problem and wil not turn up to appointments, they do not always spot his symptoms as he can be so articulate and plausible about his poerceived wellness nad ofcourse he does not describe anything of the activities I know he si doing oitside of thr consultation room, and he is not hostile to them as he is to me. It is very hard to get them to cahnge anything and they keep recommending Lamotrigine, so he says, though as I am not there I do not entirely believe this. I think it is he who wants to continue it. He will not allow me to come to the consuktaions. He used to in the past but never whe he is high, as he opposes my observations and knows I am likely to suggest he is taken off Anti Depressants in the past, as they always do whe high , or lamotrtigine in past 3 years in place of them which I can see quite clearly make him v ery aggressively high indeed.
I am at my wits end. He has just deserted me agin as soon as he became hypomanic, he was off and I was pushed away in very intimidating terms, though we had no fall out or uoset at al. He just seemed to change mood overnight whilst on his own for about 2 days but had not been high when he left my house to attend to something at his flat. I subsequently discovered about 10 days later as I suspected that he had recommenced lamotrigine once on his own, and Probably disbelieved it would make him high and tha he could hide it from me. I do understand he wants to take it ina desperate attempt to treat his depression swhich are awaful and I have rerpaetedly asked his team fir reassessment of his meds and to be offerred a suitabel alternative to lamotrinie to treat boith phases of the illness. lamotrigine is only effective as a fast elevating so called stabilizer to treat the depressive ohases of the illness, and it does wotk quickly which is why many people love it, however ,It is unlike all the other anticonvulsnat stabilizers in so much as it offers no protection agianst the manic phases, and I have confirmed this with the psychpharmacologist. IN effect it is more like an anti depressant, and is not a true stabilizer like Lithium and valoproate, and I believe ot should not be heralded as the new wonder drug for Bipolar. I would not touch Lamotrigine with a barge pole ! I has caused the worst and the longest and most destructive highs he has ever had, as bad as any antidepressant switching into mania or hypomania, but much longer epiosdes of damaging highky irritable, risky and agressive hostile hypomania with a total and unshakeable loss of insight.