Lithium Struggles - Looking for options

Hello all,

I am new to the site and I'm hoping to find some help (and some hope) from the community.

I was diagnosed Bi Polar in 1992 (at age 17). I was prescribed Lithium and within a few months my dosage was set at 1800mg. I took that dosage for about 16 years. I always had an aversion to taking the pills, so there were periods where I would just stop taking them, but within a couple weeks I would start to feel that old 'sense of impending doom' and start taking them again. The only real problem I ever had with Lithium was psoriasis. It kind of runs in my family and taking the Lithium aggravated the symptoms. Around 2007 or so I saw a new doctor who cut my dosage down to 900mg and I seemed to do pretty good with that.

Anyway, in 2008, my wife got pregnant and I got this crazy idea that I would somehow miss out on all the emotions of becoming a parent if I stayed on medication, so I decided to stop taking the Lithium all together. I ended up being medication free for two years. This was disastrous.

The mood swings and the agitation was pretty familiar and I dealt with them okay, but I started to experience other symptoms that I had never had before. I lost about 35 pounds, most of it relatively quickly, and I became convinced that I had severe medical problems. I became hyper-aware of my own mortality and was constantly obsessed with my health, literally feeling as if I could die at any moment. I was having near feinting dizzy spells (which I'm now convinced were anxiety attacks). I spent thousands going to doctors, getting test after test, never having any conclusive results. I almost had a rather invasive stomach surgery, but one night, before I got that scheduled, I had a complete breakdown. The overwhelming suicidal feelings got me thinking about seeing a psychiatrist again.

So, in 2010, I got a new doctor. She wanted me to go back on the Lithium because it had been successful for me in the past, but I was hesitant. I had read an article that had me convinced that that my dizzy spells were really caused by a layer of salt surrounding and suffocating my brain as the result of my prolonged use of the drug. I ended up taking Seroquel for a couple weeks until I got past the paranoia enough to take the Lithium.

I have been back on Lithium (900mg) since October. I stopped losing weight. All of my other "physical" symptoms seemed to stop as well. However, the psoriasis has gotten pretty bad. All of my skin is extremely dry and I have some particularly difficult and painful areas below the waist (front and back). My dermatologist can't seem to find anything to stop it, so,even though the Lithium is working, I asked my doctor if there was an alternative. The only alternative she offered me was Lamictal. The descriptions I'd heard about the Lamictal rash scared the crap out of me and I wasn't sure if I'd catch it in time since my skin is so sensitive from the psoriasis. So I decided to stay with the Lithium and deal with the skin problems.

That was until this week when the Lithium seemed to just stop working. I have been depressed and anxiety ridden all week. I haven't been able to get a thing done at work and I am having frequent self-destructive fantasies about quitting and/or leaving my wife, getting drunk (which for me is nearly equivalent to suicide), or just disappearing from my life all together. I have an appointment with my doctor coming up and I'm hoping to discuss some better solutions for me medically.

I'm not trying to open myself up for public diagnosis, but I am hoping to find someone out there who has experienced some, or at least any, of my problems. What are some alternatives to Lithium? Does anyone out there taking Lithium have issues with psoriasis? What do you do about it?

I'm sorry I wrote so much. I've been dealing with this diagnosis for most of my life and this is the first time I've really talked about it. Are there support groups or anything like that? How can I find one?

Thanks. I may end up trying the Lamictal. I'm getting to the point where a fatal rash isn't even all that scary - at least not the fatal part. I was hoping, more than anything, to find out if there are any other alternatives. Seems like there's got to be more than two options, right?

I've been on lithium since October and have not noticed any side effects except increased thirst/urination. I've also been on lamictal since November. I did not have any side effects (no rashes of any kind) while starting & tapering up the lamictal. I'm now at a stable dose & still have not noticed any side effects.

Because of your history of skin problems, perhaps you should speak to your dermatologist & get his/her opinion on you taking lamictal. Serious rashes are very rare if you follow the recommended taper schedule for lamictal, but they are something that you have to watch for, and although minor benign rashes are somewhat common while starting the drug, any rash that you get while starting lamictal should be check out by a doctor, just to be safe.

Skeye

me 900mg. started 2 and a half months ago. lithium on seroquel as well. made me hper 2 begin with, thirst and urination also. but is helping. with compassion, jamie

i take lamictal, and i wasstarted on a very low dose, 25mg for the 1st 2 weeks, then up to 50mg for 2 weeks, then up to 100mg for a week, now im at 200mg and i have no complaints. i admit, i was scared as hell when i read about the possible rash, but the more i read about it, the more i realized how rare it is. try it. you'll never know unless you try. there's so many different meds you can take. As far as support groups, this site is a support group in its self. but maybe talk to your psychiatrist about seeing a therapist and he/she can help you in finding a support group. There's sooo many resourses out there for ppl like us... hang in there.

Phil there are loads of options, with treating bipolar. Tortoise11 has given you very accurate information. There are a wide range of mood stabilisers and anti-psychotics that you can trial that should be able to treat your bipolar without dermatological side effects. Also do we actually know the psoriasis is because of the lithium??? Psoriasis can be completely unrelated to Lithium ingestion. I agree a referral to a dermatologist may help. The illnesses may need to be be treated separately. My experience in Australia's medical system is that specialists are very good at working with each other. I hope that is the case where you are so that together your pdoc and ddoc can nut out a good strategy that doesn't aggravate either illness. I'm not a pdoc but because you seem to have paranoia interfering with getting and staying well, anti-psychotics might help address that symptom (seroquel is just one ant-psychotic). As far as I know mood stabilisers largely don't help much with paranoia. The bonus is that antipsychotics generally have the same mood stablising effect as a mood stabiliser. By far, the most alarming part of your post is that you are not getting regular blood tests while you are taking lithium! This is an extremely dangerous situation! I am surprised your doctor is still prescribing lithium. Lithium should never continue to be prescribed to patients not complying with the regular testing. Regular testing is imperative when taking lithium, no matter how many years you may have been taking it. I see this as your most urgent and immediate issue to address. Also you haven't mentioned therapy. Bipolar can be a very destructive illness not just to the sufferer but to their family and friends. Support and guidance around you and yours can make a huge difference in helping you and the people who love you manage this impactful illness. Good luck.

(Pammy, I'm glad you are getting great results. Its so nice when we find the key that unlocks our health :) )