Lithium vs. Antipsychotics: The Rise, Fall, and Rise Again of Lithium
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- เผยแพร่เมื่อ 15 ส.ค. 2023
- Explore the journey of lithium, a game-changer in the late 1940s, as it transformed the treatment landscape for bipolar disorder. Join Dr. Tracey Marks, a dedicated psychiatrist, in this deep dive into the historical prominence of lithium, its subsequent decline in the wake of second-generation antipsychotics, and the compelling reasons why it might be time for a reevaluation. Delve into the intricacies of lithium's usage, including its narrow therapeutic window, monitoring requirements, and the benefits it offers at the cellular level. As we examine the potential side effects, organ impacts, and compare it with modern antipsychotics, we'll shed light on lithium's unparalleled advantages like its anti-suicidal properties, circadian rhythm stabilization, anti-aging effects, and more. Whether you're newly diagnosed with bipolar disorder or looking for a comprehensive understanding of treatment options, this video promises to be an enlightening exploration of a once-golden treatment. For additional insights into bipolar disorder classifications and medication effects, be sure to check out these two videos.
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REFERENCES:
Post RM. The New News about Lithium: An Underutilized Treatment in the United States. Neuropsychopharmacology. 2018;43(5):1174-1179. doi:10.1038/npp.2017.238
Mertens, Jerome et al. “Differential responses to lithium in hyperexcitable neurons from patients with bipolar disorder.” Nature vol. 527,7576 (2015): 95-9. doi:10.1038/nature15526
Ratheesh, A et al. “A systematic review of interventions in the early course of bipolar disorder I or II: a report of the International Society for Bipolar Disorders Taskforce on early intervention.” International journal of bipolar disorders vol. 11,1 1. 3 Jan. 2023, doi:10.1186/s40345-022-00275-3
Balan, Estelle et al. “Physical Activity and Nutrition: Two Promising Strategies for Telomere Maintenance?.” Nutrients vol. 10,12 1942. 7 Dec. 2018, doi:10.3390/nu10121942
Joseph, Boney et al. “Long-Term Lithium Therapy and Thyroid Disorders in Bipolar Disorder: A Historical Cohort Study.” Brain sciences vol. 13,1 133. 12 Jan. 2023, doi:10.3390/brainsci13010133
Lundberg, Martin et al. “Lithium and the Interplay Between Telomeres and Mitochondria in Bipolar Disorder.” Frontiers in psychiatry vol. 11 586083. 29 Sep. 2020, doi:10.3389/fpsyt.2020.586083
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I take a low dose Lithium at 250 mg for my Major Depression. It worked within days. Great for reducing my suicidal thoughts and plans. Only side effect has been mild Psoriasis which i am able to control now.I love this medication. It has helped to save my life.
Did it also help you being more active and have motivation?
@@napoleonfeanor it put me into remission. Completely stopped my depressive episode and made me feel happiness and joy and amazement and contentment, etc for the first time in years. I felt alive after years of being in darkness. That lasted almost 20 months. Then Depression hit hard again. It was recommended to increase my Lithium dose, but at the time my Psoriasis wasn't in control and I didn't want the Psoriasis to get worse. So we increased my antidepressant instead. Not as effective as the Lithium.
I’m so so happy for you!
you mean 250mg? elemental? lithium carbonate or orotate?
@@bob15479 why does it matter? Is she allowed to have her private medical information?
As a MH patient I find Dr Tracy as a gold standard clinician. In my experience she puts many clinicians to shame with her knowledge, skills and attitude. Thank you.
I’ve been on Lithium for 18 years and I have not been hospitalized for 18 years.
How old were you when you started? Does it have side effects?
Thank yourself not litium :)
Psilocybin saved my life. I was addicted to heroin for 15 years and after Psilocybin treatment I will be 3 years clean in September. I have zero cravings. This is something that truly needs to be more broadly used in addiction treatment.
A lot of people have testified about this and I really want to give it a shot. I put so much on my plate and it definitely affects my stress and anxiety levels
The Trips I've been having have really helped me a lot,I finally feel in control of my emotions and my future and things that used to be mundane to me now seem incredible and full of nuance on top of that I'm way less driven by my ego and I have alot more empathy as well
Tripping is not really bad but find a good mycologist Who will teach you the right things you need to know
It won’t because it isn’t an expensive
treatment 😢 insurance companies care not about patients actual health
@@idealdrugs it's expensive if you go to a doctor for it. If you have an open minded therapist and know the right people a few treatments would be very affordable
I have bipolar 2. I was on antipsychotics for about five years, and then I developed tardive dyskinesia. Because of that, I had to switch to lithium to keep my mood stable. As the antipsychotics slowly got out of my system, I realized just how "fuzzed out," emotionally and intellectually, they'd made me. I knew the antipsychotics had not been good for my creativity at all, but when I switched to lithium, my creativity actually returned! I'm a writer, and having access to my emotions is a really important part of my creative work.
But it dulls emotions and creativity at least it did for me
This appears to be a debatable point that needs some clarification. Perhaps Dr Marks could explain this in a future video?
@@supme7558 everybody has a different experience. We can't help but have a different experience. What works for one person may not work for another, and that's just the "fun" of psych meds. I'm sorry lithium dulled your emotions and creativity.
I have type 1. So far published 2 of my 10 books recently. I wrote in 3 years. "A pine holding the sun" "The road from redemption" on amazon. Just stopped taking my lithium. Feel way better. I have borderline so for me bipolar is really not the main issue.
I have tardive dyskinesia as well in my face on the right side from the antipsychotics I was on for ocd and anxiety ..now I'm on olazipine and I asked for lithium but my dr said not now and so I'm just living my life the best I can ..on these drugs I have no motivation to do anything its the depression that is the hardest and it's hard enough bipolar type 1 and it's harder to treat plus I have brittle diabetes which causes me to have a more difficult time ..I've been clean for 25 months and 6 days from smoking meth and it was hard ..it is hard and I'm proud of you keep up the writing ..good luck peace be with you
I'm a second-year nursing student and started working at a psychiatric hospital focusing on rehabilitating psychosis patients a few months ago, and this video was an extremely helpful summary. Thank you!
Thanks for your work with people who hurt and may not even know why
As a medical student I really love these videos, especially small details about its history and facts, like the ion transport thing! So cool.
Look into lithium orotate! It's been extremely helpful for me. It's less toxic, more bioavailable, and available without a prescription. It's changing my life!
Soon to be physicians should be working with stable patients that can share their history, medications they take and life changes experienced. I also believe physicians should be trained in self defense as any psychiatrist can tell you of the dangers of working with unstable people.
@@lilystarr226 One thing to careful of is bio-availability. Orotate has a higher uptake level than Carbonate....hence, you can develop toxic levels at a much lower dose.
@Vypersnow808 You may want to look into generic Latuda. It won't leave you drained.
@@lilystarr226What about the risks to kidneys and thyroid?
This is absolutely the best overview of lithium I've ever seen. I wish ALL sources of information were this straightforward, factual, and effectively delivered. THANK YOU 🙏🏼
Excellent. I think it's important to note that Lithium is not only for Bipolar Disorder. I have Borderline PD and have been taking it for 6 years now - initially to reduce suicidal ideation but it does also work for the mood stabilising needs of my disorder
This was so interesting. I'd been put on pretty much every antipsychotic / mood stabiliser prior to lithium. All were either ineffective or caused me unbearable side effects. And then I got put on lithium and it literally changed my life. I had no side-effects from it and was able to finally live a life without the most awful depressive episodes. I was on it several years and have recently come off it after being stable the entire time whilst on it, so far so good, my mood has remained stable even off it. This medication was just an absolute life saver for me.
So happy for you 😍💖
I had the same experience. Lithium saved my life too!!!
have you been diagnosed with bipolar disorder?
@@vittorja yes, bipolar type 2
@@fixelish and now you’re med free? How long have you been on medications?
i'm bipolar and lithium absolutely saved my life. being on it long term has given me health problems and i'm in the process of switching to a different medicine now instead of taking more pills to treat my side effects. i'll definitely miss the stability it brought me. :(
What size dose were you on?
I had the same situation. The Lithium started poisoning me after three years of use. I was really bummed, but the thyroid and internal organ issues were nothing to mess around with.
ok i have bi polar one severe one lithium saved me at first too to the point i was scared to stop taking but THEN i was given lamictal and wait VILADONE which is for mood omfg girl i am a happy Un moody able to get out of my mind and not manic or depressed but lithium is only great for mania once out of mania you will become severely depressed
i was only 600 mg and it almost killed me i gotta speak up on the mood drug they gave me viladone 20mg daily its a new drug out saved me@@greywolf369
my thyroid is gone ive hypo now@@jeffaltier5582
This is fantastic. Years ago I worked with "manic depressives" , inpatient. I have seen the misdiagnosis and have seen the swings from manic to depressive and back again. And I have seen the results of lithium. It's astounding. I have always felt that this was one diagnosis that was caused by some kind of body chemistry problem, because these patients were not psychotic. Episodes that seemed like it, but not. They say Winston Churchill was manic depressive and did his writing in his manic state. It was also a diagnosis that was considered to have the highest cure rate and these patients were know to have high intelligence. I saw both. The mania was what brought them to the hospital, but Lithium took care of that. It was considered an error to prescribe antipsychotics. One time we had a patient that did not go into the depressive state for many months, and he was on antipsychotics that whole time with no success. He threw furniture. Then one day we couldn't get him out of bed, followed by several more days. I called his mother to see if this was typical and they had their own name for these swings. I ran to the doctor and asked that this patient be put on Lithium and his diagnosis changed. It was like a miracle. The side effect that this patient didn't like was the stomach upset. He was such a bright young man. And the problem had been an incorrect diagnosis. I don't understand this new label "bipolar disorder". Manic is manic, unmistakable once you see it a few times. But that was inpatient work, not a brief appointment. However I met a guy recently who I wanted to tell to take his lLithium! So thank you so much for providing such terrific information. I never knew the science behind it. I just knew that what I was seeing was not "mental illness" in the sense of real psychosis or severe neurosis. So lovely to hear exactly what it is in terms of body chemistry. This is a real service you are doing. BTW it didn't take a month to see the results. It was much faster. Too bad that after 80 years the scientists haven't figured out how to make Lithium safer in terms of long term effects. This illness should be in a category all it's own and treated by specialists specific to this diagnosis. Just my opinion..
Extremely well presented and well researched video, thank you Dr. Marks! As someone with bipolar disorder who has started Lithium treatment about 2 months ago (along with being on Quetiapine for 1 year which I'm tapering ff of), I always try to educate myself on these things to know what it is exactly I'm taking, how they work and how they compare to other options etc. I still learned a lot of new information from this video ! Thanks ☺️
DR. TRACY. you make living life with this so much easier. youre such a blessing to the mental health community. i love your videos & your mission
I absolutely love every video you make whether it applies to me or not. Looking at your videos really calms me down and gives me hope. I suffer from depression since March and it’s scary.
I had to jump on for this one. Lithium was the only drug that had actually helped me. I never had a problem from it. I was on it for years. The regular blood tests were not a problem. I was worried about how it might be effecting my kidneys.
The other day I was remembering how much it helped and it was the only drug that helped me.
I agree 💯
have you stopped it then?
Thank you for a comprehensive and easily understood presentation on lithium. As a retired pharmacist and physician, I have witnessed the positive therapeutic effects of lithium over the past 50 years.
Thank you! I appreciate hearing that. 👍🏽
I'm about to give up. Been fighting therapists and doctors for 8 years. They only claim I'm depressed and need to get a job. I can't work bc I'm so depressed and lethargic. Bipolar runs very clearly and severely in my family. I live in Scandinavia. No wonder ppl are killing themselves.
I've taken lithium for 30 years and I'm the only non-alcoholic in my family.
Thank you for the excellent presentation! My tale is cautionary. I took lithium for decades. Doctors changed over the years - each glanced at the current lab results but not past results. “Off” labs were chalked up to dehydration or lab error. When my health care system made labs available to patients online, I noticed that my creatinine was clearly increasing over time. At sixty, I now have chronic kidney disease and bradycardia. Track your own labs if you take lithium. Atypicals can suck but kidney disease is no picnic either.
yes, the serum creatinine test is what I monitor the most closely and it seems to correlate with the dosage
Kills the liver to
Yes, this applies to all health care. Track your own labs, ask as many questions as you need to. This is how i was able to get diagnosed with and treated for an illness that the doctors missed. They didn't have the time to put all the little pieces of the puzzle together.
Couldn't agree more. Read your results etc. Ask questions. You are your best advocate
My mother has suffered depression all my life. She was on lithium from 80s till 2012. Inspite of her blood tests showed her lithium at upper end of range the dr didn’t recommend any change and she had severe health issue reduced to 90 pounds and had to be taken off of it eventually.. replaced by depakote. Her health improved but now has chronic kidney disease now from years of lithium use. Depression is still an issue. As caregiver since childhood to now I am mentally done with this up and down in her mental health.
I love my lithium and absolutely detest atypical antipsychotics.
I was put on antipsychotics as a teen. On them I went from an engaged straight A student to gaining 100lbs, turning into a zombie, sleeping through every class, And eventually dropping out after being pushed to by school offcials.
My psych never listened when I said it made me miserable. I am still furious at every adult in my life at the time that was Supposed to be looking after me
They destroyed my life and robbed me of my future. The antipsych meds they put me on was about managing me not helping me And I'll never forgive them for it
This has happened with me too and sadly I was also a minor so couldn't resist the antipsychotics.
I relate with you, you're not alone 💜 In my case they blamed my moods on my migraines so they put me on excessive antiseizure medicines. When I became a total zombie, losing memory, and failing, I was taken to another prescriber who said I was being overdosed by my neurologist. She said it gave me severe chemical imbalances in my brain and I would return to normal once I was taken off all meds. I definitely improved, but I was nowhere near stable. Everyone acted like I was normal and fine but I definitely wasn't and I don't know why people just let me suffer like that. I'm 26 and only recently figured out I'm bipolar 2.
My family didn't take me to get any meds, so you were lucky they did that. It wasn't till 20s when It was suggested. 52 now, after listening and reading comments. Sounds like a better choice.
@@lilystarr226 sending love and light to you honey.
It's tough to live with bipolar disorder but my God blesses you with the strength to sail through life smoothly.
@@YolandaReardonmy experience with the antipsychotics was so negative I refused treatment starting at 19. I didn't trust anyone that told me they wanted to help and began to self medicate with alcohol.
I'm 33 now. I got sober at 29 and got a bipolar 1 diagnosis
It took a particularly intense episode involving a barfight and facing jail time in order for me to get past my anger and distrust .
Life is hard still. I'm homeless right now. But I'm happy and on my way to figuring things out.
Lamictal is the only medication that has helped me. I've been on it for 2-3 years now and it's been a life changer for me. *Bipolar Type 2*
I take Lamictal as well. It allows me to be on a low dose of lithium and still see all the benefits
as a completely anecdotal aside, the Taro brand generic seems to be better than brand name or other generics. I am not a doctor.
if you take the extended release, go for the generic brand dr reddy. its the closest ive found to brand.
Your channel is so informative. I love the straight facts✨🙌 Thank you, Dr. Marks.
"Emptying your bank account to build a rocket" "making plans to sleep with your boss's spouse"! 😂😂😂
i felt so targeted lmaooo
I have been watching your videos since 2018 when I was first diagnosed with depression and then later when I get rediagnosed with bipolar... You are my favourite TH-camr by far! Your videos are so informative, scientific and yet easy to understand!
I 2nd this 💯... I started watching in 2019 though
Very instructive presentation. Thanks Dr. Marks!
Thank you Dr. Marks! I Keep learning more and more from all your videos!
You're very welcome and I'm glad you're learning!
AMO EL LITIO,
From the moment I used lithium the very first time I thought "I have been waiting for this so many years".
Thanks for the video
you are providing such a good and insightful report about Li i cant find adjectives to describe !!
on top your calm and respectful personalityadd another load of gold to what youre doing !!
Thank you !!
This is so interesting and impressive. Also very thought provoking 😮
Dr Tracey , thank you for that. As a registered nurse I'll admit im not a fan of Lithium , has too many side effects.
I think I’m starting Quetiapine today. My psychiatrist and I went through all the options and this medication sounded like the best option to treat my mania and depression. PERFECT TIMING on this video, thank you!
i’ve been on quetiapine for a few years and honestly it’s what changed my life! i’m on 25mg normal and 175mg extended release. bipolar, generalized anxiety disorder and bpd
@@nutz13_ wow and just that medication alone really treats all 3 disorders? I feel like I have some comirbid issues as well. I’m not diagnosed yet but the DR said let’s just get this mania under control and we’ll go from there.
This was EXCELLENT. Better than any grand rounds I ever attended, and better than any psychopharmacology for healthcare providers inservice.
Thanks for getting the word out on this one!
really important and nice to know and understand the differences thanks Dr Marks
Very informative and easy to understand! Great video! Thank you so much! 🙏💖💖💖
Thank goodness I learned a lot in your short video, keep it up 👆
While lithium seems to be the market darling be vigilant and do not skip the blood test
Absolutely. It’s been a game changer for me. Get levels and kidney function done regularly.
This is a very useful video Dr. Tracey
I love your videos. Thank you for sharing such valuable information.
Hi! Appreciate your videos!
I would like to know what you know/think about lithium orotate.
I heard of lithium orotate through the grapevine about 7 years ago, and I have been taking small supplement doses of it since then. I have never sought a diagnosis of bipolar disorder, but I do see symptoms of it throughout my lifetime. When I have tried stopping the supplement, or accidentally skipped it for more than a few days, I always see a return of intrusive negative thoughts and more suicidal ideation.
I have a family history bipolar disorder. My aunt took lithium carbonate for over 20 years, and evenutually had to switch to other drugs later in life, due to lithium carbonate side effects. My mom spent decades on many other moor stabilisers, anti-depressants, and anti-psychotics. She also had severe side effects later in life, and both of them died relatively young, in their sixties.
Seeing all of that happening as a child, and later as a young adult, I had/have a strong aversion to prescription drugs for my mental health. That led me to seek out many other options, and one of the ones that had worked for me is lithium orotate.
I have read about lithium orotate crossing the blood brain barrier more easily, and his having less risk of toxicity, and I also remember reading about some complex red tape reasons that lithium orotate was not studied by pharmaceuticals in the past (don’t recall the whole sorry now though).
Still wonder why other lithium salts that might be safer are not explored, when they might be hugely beneficial for some patients, like me.
Thanks for your work!
Dr. Marks.
Your videos are so informative but also very clear and supported for better mental health. I have bipolar II with an anxiety disorder. this video is the best explanation of how lithium works and the benefits. I am currently on a dose of 300 mg. It was reduced because of the tremors I had in my hands. I was concerned that it was even helpful at the lower dosage. after watching your video I have a better way to evaluate if I should encourage increase of my lithium for better mood stabilization.
Thank you for all that you do for the mental health community.
Thank you for your educational videos🙏🏻
I'm so happy, cause today I found my friends, they're in my head.
Delivery was EVERYTHING.!! 💐
Such a great video! Thanks!
Very good lecture on this topic - thanks!
You are helping me through my MH course in nursing school i can say that!!
I take 900mg of lithium for my bipolar disorder, latuda for my psychosis and quetiapine for my anxiety. It's a pretty effective combination. My quality of life increased drastically. 😊
I've been on lithium for 12 years.
I have my blood checked every six months now, and I have a full check-up every year.
Thank you for sharing, I am strongly considering lithium.
@@greywolf369 It makes me very thirsty, but it works wonderfully well on me.
I'm actually quite happy with Lithium. I've been taking it for 6 years and it helped a lot in reducing the number of episodes. My hypomania is pretty much gone too. The only problems are the hand tremors and the blood tests, but I already have to get my blood checked every few months, so I don't mind.
I met John Cade when I was a little girl. A gentleman who helped so many.
Very informative. Thanks.
Thank you Dr. Marks for this thorough video. I just switched from Geodon to lithium this month because Geodon saps my energy
Fantastic info
PLEASE BE AWARE OF POTENTIAL KIDNEY STONE ISSUES FROM LITHIUM!
I took lithium for a few years for refractory depression with my antidepressants. I'm unipolar, yet my doctors wanted to augment the antidepressants.
I never would've taken it had I known that I would have stones every few years since and almost died from sepsis last time.
At least take only time released like eskalith if you absolutely must!
It can make you develop kidney cysts as well! 😕
@@rosedemai1230 damn! I didn't know that, thx!
And cysts would make it easier for stones to form and get stuck, I'm sure. 😰
It's so hard on the system!
I think maybe certain people can have a better tolerance to it maybe. But even with my blood and urine checked every month, it didn't matter for me.
Long term can mess with hormones with your kidney. It is rarely occurs. However i got chronic kidney damage no warnings after 6 months. I got dehydrated and it lead to chronic lithium toxicity which is harder to notice. I say use it as a last resort.
excellent video... thanks
An alternative view of Lithium blood monitoring: Whilst we often think that needing blood tests for Lithium is one of its pitfalls, it could alternatively be seen as a very good thing being one of the few drugs where you can precisely monitor the blood level and adjust accordingly, knowing exactly what a therapeutic level range is and what is toxic (narrow therapeutic index is still an issue but it can be managed). Only a few medications offer this precision. The fact that antipsychotics and others alike don't have blood monitoring could be seen as a weakness; we often have no idea if a patient has therapeutic or intolerable blood levels as the recommended doses have been determined from a generalised sample of the population as a 'one-size-fits-all' approach. That coupled with antipsychotics needing metabolic monitoring as is, the need for blood tests with any of these treatments is inevitable.
Your videos are very clear and informative. A suggestion is to mention Cognitive Behavior Therapy in all your videos to stress that CBT has all the permanent benefits for all medical conditions with zero side effects.
Good stuff, thank you! I got cycled through the antipsychotics and fancy new stuff for almost a year(while my life was falling apart around me) before they finally tried lithium. Once I got to therapeutic levels the change was almost instant. Stopped the ramp up to mania that I was on and I haven't come anywhere close in a year and a half now. It saved my life. Shame they didn't try it sooner. You mention a lot of reasons for this that make sense... But you forgot the one that my pessimistic self noticed right away: my monthly copay for lithium is pocket change... Like 19 cents I think. My monthly copay for Latuda(which did nothing for me and I was taking religiously when I had the manic episode that lead to my divorce) was over $1000. $1,400 and change if memory serves.
A huge word of caution. My dad at 74 passed away last year and was on lithium for 40 years. 7 years ago he started getting gout and psoriasis and really severe arthritis.
Turns out his psychiatrist passed away and his new gp put him on a lithium pill that was a higher dose, but lab tests weren't being done.
For years we had no idea why these new health problems were getting worse. Eventually he started getting the tremors in his hands and vomiting. Rushed to hospital and finally the doctors there figured out he had massive toxicity from lithium
His last several years of life were truly horrible because of lithium. The amount of angiush he went through with his body is something that haunts me.
The lithium caused permanent neurological damage, it's a syndrome called SILENT. He was crippled because the lithium destroyed his nervous system amongst other organs it wrecked like his kidneys
Yet another case of modern medicine doing more harm than good 😕
Meanwhile lithium has saved my life
Interesting video. I have been taking lithium for years and it’s been fine for my highs but I found over time I still slipped in psychosis and severe depression. I ended up being suicidal even while taking 1000mg per day. A couple months ago things were so dire that my GP asked me to take an antidepressant as well as the lithium. I felt better but I was still depressed. Then a few weeks ago I saw my psychiatrist and he recommended that I take an antipsychotic called Latuda as well. It’s only been a few weeks but the combination of all thing works so well. I read that the antipsychotic can treat bipolar depression as well as psychosis. I honestly did not think I could feel this good without being manic. I feel like all three medication have different roles in my treatment. My life has changed so much now.
So on point this lady is ❤ i started lithium recently and i feel awesome i have bi ploar and anxiety
why do you not mention the effects of Lithium Citrate or Lithium Orotate ?
there are several forms that are water soluble and dont cause tremors
I've been taking lithium orotate for over 6 years.
She probably doesn't know about it. Doctors don't know anything about non-prescription remedies.
@@BeingBetter cool, ive tried to collect all 5 or so orotates , some are so powerful it's a bit much
@@kjbrocky i get that too, in some forms it's so very cheap, and sold more like chemical supply, largely over looked, and perhaps avoided as it can be handled so much less seriously
Dr marks, ive been diagnosed with bipolar d/o. Been given lithium and depakote. Currently, my doctor stopped my lithium and am only on valproic, lamotrigine, quitepine. Now, im still with depression and the suicidal thoughts just wont go away and would say hello from time to time. Am on monthly follow up check ups but i really want more frequent ones. Its so hard to live like this.
Great info. I use lithium and its nice to hear extra info on it
Lithium works great, it's just unfortunate how much weight it makes you gain. I'm taking Seroquel, and it works the best for me, but again I'm struggling with the weight gain and trouble losing weight while on it. It makes me really tired and hungry. It would be awesome if they could develop a drug for bipolar disorder that doesn't make you gain weight rapidly and excessively.
Thank you for the wealth of information Dr. Marks. Can you share some thoughts on Loxapine?
Thanks so much! My son is inpatient and the doc wants to start him on this and get rid of Depakote and I didn’t know what to ask or say except yes, since the other meds hadn’t been working.
Great points! I agree that lithium needs to be considered more. When it works for someone, it solidly works in a more clear-cut manner than so many other psych meds do. The newer antipsychotics certainly have their place but aren't a cure-all. I'm more cautious prescribing them today than I was 10 or 15 years ago when we weren't as aware of all the metabolic side effects.
I couldn’t tolerate lithium (made me feel nauseous and that didn’t change) and I’m glad I couldn’t as my doctor did not explain side effects properly or how serious they were. I said I wanted to stop it and they said they were thinking the same because of my kidneys. I was like “wut?” Then they went on to explain the serious side effects.
Thank you!
When I was diagnosed with Bipolar II in 2004, my doctor prescribed Equetro. It was not effective. Finally he switched me to a low dose of Lithium (300 mg per day was the therapeutic dosage for me) and that was the best decision ever. True, frequent trips to the lab were necessary but I didn’t mind. After 15 years, I finally felt stable enough to manage my symptoms with lifestyle changes and natural herbs. I feel like a “normal” person. If I ever need prescriptions again, lithium will be the medicine of choice.
300 mg for bipolar is on the very low side, I wouldn't think you'd even need blood tests at such a low level. I just came off of 1200mg daily (lithium carbonate,) and switched to 20mg (elemental lithium) daily from 520mg (4 tablets) of lithium orotate (An OTC chelated form of lithium.)
There are virtually no studies on the efficacy of Lithium Orotate for Bipolar mania due to the lack of commercial interest. Anecdotally, it seems Lithium Orotate could be an adequate stand-in for high-dose lithium therapy.
So far so good, I plan on sticking with this regimen for life (as one might do on any lithium therapy,) I've got a leftover bottle of Haldol (typical antipsychotic) I can take, on-the-fly, as needed if I feel a real mania brewing (assuming I'm able to self-diagnose the oncoming mania or care to stop it, lol. They can be so fun, if you know what I mean.)
I'm glad it's working out for you, look into low-dose lithium via lithium orotate, A bottle of 180 tablets is dirt-cheap and people rate it VERY high.
Thank you so much, recently I started to have Lithium, and your video helped a lot to understand how it works.
after 25 days, I suffer from anxiety and shaking my legs. but 2mg of Akineton helped a lot to be settled.
I take 900 Lithuim and 10 olanzapine.
BP2 here. 1350 daily lithium really seems to help. Mania reduced and I'm no longer suicidal. Stopped antidepressants but I'm sticking to lithium.
Thank you Dr. Good to know.
I have to take lithium for cyclothymia, thank you so much it’s very instructive
Thank you!!!
I was on lithium for about 5 years. I had severe mania before beginning on it, and it helped significantly. But sadly, I developed such a severe hand tremor that I could drink hot beverages safely, eat soup without throwing it everywhere, and my handwriting went absolutely horrible with being unable to hold my hand steady (even bracing it against my other thumb). My hand would jerk uncontrollably across the paper, scrawling lines of ink in the process.
I’ve been off lithium now for about 4 years. Though the tremor is much less, most. Days I still have enough tremor that I can’t write notes, annotate “paper books,” correspond by by hand, etc, in a realistic way.
Is it normal to have a long-term residual tremor after stopping lithium? Thanks for any informed responses!
Thank you
Very interesting. Thanks
I was sick for years with hyperparathyroid disease/hyper-calcium caused by lithium long after I stopped taking it. Surgery is the only option for HP.
Thank you for your amazing content and education as always Doctor! You’re a godsend 🩵
Could you expand on why it wouldn’t work as well on mixed episodes? I was on lithium for years and had a heart issue because of it. I have mixed state and it never seemed to help. Also no matter how hard we tried, I never reached a therapeutic level. I was on it for over a year. I decided to go for ECT and it has changed my life.
Thanks for this video; people in my circle have BD and this helps my understanding.
Hi. I live in the UK. Thank you for your wonderful videos. Could you look at combination therapy of Lithium and Sodium Valporate. I take both, this time round for a straight 16 years. This has been pararell to medium to high dose Quitiapine plus up to recently Sertraline. Im in a quandary now to stop one of the former meds. My choice is Sodium Valporate but my Clinician says not. I get transient suicidal ideas and expansive moods. I appreciate how you set out the pros and cons of meds and it would be nice to see a clip doing the same for Li and Na Valporate; singularly or combined. Please keep your work up as its greatfully accepted and constitutes an objective source of information for me to draw upon.
Dr Marks, I'd like to know your opinion on lithium vs antipsychotics for a person with a strong family history of dementia, e.g. both parents.
Excellent
Hello Dr. Marks,
I appreciate your TH-cam videos and I am a huge fan. Could you please do a video that discusses Postpartum psychosis, how to treat it, and how mania plays a role in it. Also how it is similar to or differs from Bipolar disorder. It's just that it's a topic that is not so discussed and a lot of women end up being misdiagnosed not knowing what they are dealing with.
Hey I just found your channel and I would love you to do a video on slow cycling bipolar. I'm honestly not sure if it's even called that, or if it has a name because it's rare. But I mean the cases of people who get mania that lasts months, even years in extreme cases before the depressive crash - and whose cycles take years to build to. This is the type my partner has and it has made recognizing the building mania far more difficult. I'd love to know if there are certain meds that work better or worse, or what other methods slow-cyclers, specifically, have found effective.
Doctor, as we are talking about the older Bipolar medications, can You make a video about Valproates and their pros/cons in comparison to SGA and Lithium?
Thank you Dr. Marks. I love your videos their very inspirational and informative and healing 💙. My question though is Lithium good or would Ketamine be a better choice or neither, be a helpful treatment for ADHD ❓❓ I have a major depressive disorder, anxiety, chronic migraine along with chronic pain due to degenerative disc dis-ease, osteoarthritis,osteoporosis. I am truly grateful for your videos, Blessings 🌞 🌷🙏
I love this video! Especially the science at the end... Is there more neurosciency stuff on Borderlines?
I take lithium everyday for my psychosis
And if i go a week without it
I experience a serious lack of sleep, a delusional sense of reality with stories, and an intense ambition to achieve a big task in one day ( which leads to no sleep.)
Having an episode in stores, not being able to focus on my speed while driving, a lack to being able to comprehend conversation due to hearing things beyond my understanding.(confusion)
I take the medication to keep me safe from being hospitalized and
Safe for those that care about me and others.
🙏 Im been stable 8/10 since 2020🙏
And i enjoy alot of your video
Im still learning my diagnosis .
Thank you.
Dear Dr. Marks
Please make a video about the side effects of antipsychotics.
I got tardive dystonia from rispridone and orap and had DBS finally.
Any treatment?
I was on lithium and a whole lot of anti psychotics during my teenage years.
Ive been unmedicated for over ten years. Getting sober has helped alot.
I asked for lithium a couple years ago and they wouldnt put me on it but offfered aripripizole which i did clinicial trials on. I decided to stay unmedicated.
Are pharmacogenetic tests available for these drugs, so people could be aware of how their body would metabolize the medications? Would this aid them in finding the best drug for their body?
I really wish I had seen this video back in May. I was put on Depakote, which didn't react well with me. I'm on lithium now, and it's done a lot to stabilize me.
I’ve suffered from treatment resistant depression and bipolar 2 since 2010. Wasn’t until I was in the mental hospital two years ago for an attempt on my own life that I got put on Lithium. It was like a weight being lifted off of me. It was the first time in over ten years that I didn’t have an overwhelming urge to harm myself. I asked my psychiatrist of five years why we hadn’t tried it before and she said lithium is generally a last option medication when other things aren’t working. I’m still on it and it’s still working. Everyone I told that I was on lithium said it’s awful and it ruined their life, but for me it’s been a literal lifesaver. I will say the toxicity level is no joke. The difference between a half pill and full is the difference between having diarrhea and shaky hands, feeling light headed, and having mild hallucinations (seeing things out of the corner of my eye) also not supposed to take Ibuprofen, but I have endometriosis so I don’t really follow that. I have also been hypo thyroid since I was 18 (I’m 39 now) and did have to adjust my thyroid meds a tiny bit after starting lithium. Overall it’s been great and I’m super grateful for it. I still suffer from depression symptoms but not feeling like I have to run into traffic or jump off a building has made it worth it. Only side effect I can tell is that I sweat more, if I stand up too fast I get super dizzy, and I am addicted to soda like she said but I’ve been doing well at drinking flavored waters all day. I’ve tried ketamine under doctor supervision several times and it did nothing. This was a great video, I never hear people talk about this med.
I have tried Lithium Carbonate a couple of times, for ongoing treatment-resistant major depression (no mania). This year, I tried it for about 6 months (950 mg daily), but the “Lithium shakes” were just too much to take. Any benefit was very subtle, so I tapered off it this month. This video was extremely interesting!
I'd like to know how lithium orotate compares. It's basically food state so has pretty much no side effects. A lot of people seem to take it for depression. Personally I found it helped reduce anxiety but not depression.