Be Nice To Yourself and Don’t Buy Supplements Online

Buying supplements online seems like a good idea, a cheap way to get supplements we want or can’t get in our country. I’m Canadian and some stuff just isn’t available here. I admit, I used to be a bit of a diet pill junky, or collector. I’d buy the stupid things and take a couple, get sick, and throw them all out when I got busted by my mom. I did that for 8 years. I wasted a lot of money. I admit, I still scour the Internet for diet pills. Bad habit. I don’t use them anymore, but I find them interesting.

simpsons

I am a very pro-treatment and pro-medication kind of gal. I’ve never found that naturopaths or homeopaths have worked for me, but I know those they’ve worked very well for. I’ve tried over the counter stuff for my bipolar disorder and it hasn’t worked. If it’s worked for you, great. Feel free to share experiences. I won’t deny that over the counter stuff works, it has helped me with other problems (pain, PMS, cramps. I hate painkillers, for example). I also won’t deny that it isn’t as tightly regulated as it should be, and that it can be dangerous. People need to see their doctors before taking it and follow precautions, especially if they mix it with meds. These are medications, too, just not as tightly regulated.

People are wary of prescription drugs. In the US, in one year, they spent $26.7 billion(1) on non-prescription supplements. I’m making a guess at this, but there is less guilt in taking something over the counter, less embarrassment than asking your doctor? It seems the world is split, some avoid prescription meds, and some overuse them. The happy medium isn’t big enough!

The FDA and a subsection (Dietary Supplement Health and Education Act DSHEA) have found:
– Some supplements found in stores and online can cause heart, kidney and liver problems with no warnings.
– There is little to no quality control and toxic substances such as pesticides, heavy metals or (for some strange reason) even prescription drugs are being sold with no knowledge to the customer.
– China is a major supplier of raw ingredients, which are often contaminated, have never had their factories inspected by the FDA.
Many products also exaggerate their claims, meaning, they say the supplement can prevent, treat or cure a disease. This is harmful advice, and this is illegal.
Consumers of the products often have no idea
A lot of the users of the supplements don’t know what they’re getting. It’s like a surprise, but it can hurt or kill you! A lot of vitamins and supplements purchased online contain very little nutritional value and can kill you, your kids or your pet. Seriously, if they get into them. There are a few reasons why buying online is a bad idea(2).

counterfeit

1. A medication can be “counterfeit” and dangerous. (I’m picturing a pill in fake Adidas with an Ak-47)
2. The product has probably expired, if it is real, and the seller has repackaged it for resale.
And for the best one 3. It’s stolen. No quality control.

If you can’t get it at home, don’t order it online. This includes even Amazon.

Counterfeit?
Counterfeit basically means “fake”, or “ripped off”. This is different from medications where there is a brand name and a generic, because the generic actually has real ingredients in it. A counterfeit mediction just looks real. It doesn’t act real. It’s never going to have as much active ingredient as it claims, and if you check out the link to where I’m getting this info, you’re literally paying a lot for a little bit of sawdust, according to the FDA.

roundup

Note: The criminals rarely get charged because it’s too hard to figure out who to charge, where it began and so on. Sad. This is costing a lot of money, $600 billion, to be, well, estimated, which is almost as much as terrorism costs. Cheap is so tempting, but it’s not legit.

Expired
All medications expire and can do weird things after they do. They can become more potent, less potent, or make you change colours and see things (or make you see yourself change colour?) It’s a bad idea to take that expired cough syrup. You’ll probably cough it back up into the toilet, for example, if you’re lucky. Generally a medication or supplement is good for 6-12 months after being filled at the pharmacy. Sometimes longer. Selling an expired product is illegal, its dangerous, because the product may or may not work, it could make you sick, and all the criminal has to do is slap a new date on the package.

expired

They can get any amount of $ they want. The pills aren’t counterfeit. If someone complains it doesn’t work, the “seller” and throw them a few good pills, or ignore it. Nobody knows exactly how effective this stuff is anyways. It’s a dangerous game when you buy online. Here’s a link on expired medications: http://www.rxlist.com/script/main/art.asp?articlekey=87599

As for stolen, well, that’s self explanatory. You could get a good product once, a bad product another time. Hit or miss.

When In Doubt
If you’re going to use supplements:
1. Don’t buy them online. Go to a local health food store.
2. See your doctor and pharmacist. Check for interactions. Get that physical every year, or every other year. Some doctors are very open to supplements. I know many that have a few concoctions for PMS and cramps!
3. Don’t take anything for weight loss, sexual ehancement or building muscle.
4. If it’s from the US, or you’re living in the US, it has a “USP Verified”(3) mark on the bottle. Their website is linked below with everything they verify.
5. You CAN overdose. More is not better.
6. If something feels wrong, tell your doctor. If it’s really wrong, go to an emergency clinic, or the ER.

Safely Buying Supplements
1. Buy from the manufacturer or a reputable operation in your own country. Try not to cross borders. Do not import things illegal in your country. (For example, ephedra, easy to get OTC in Canada, is illegal in most USA States)
2. Reputable companies supply a lot more information, ingredients, quality control info, and websites with more info, and even have phone numbers.
3. Avoid really cheap stuff.
4. Avoid sites like ebay and amazon, this is your health!

1. http://www.consumerreports.org/cro/2012/05/dangerous-supplements/index.htm
2.http://www.garyshealthtips.com/why-you-should-never-buy-supplements-on-amazon-or-ebay-a-must-read-by-former-fda-special-agent-gary-collins/wn

3. http://www.usp.org/usp-verification-services/usp-verified-dietary-supplements

Lithium Orotate – Consult a Doctor First

Consult a doctor

Consult a doctor

Just a quick response to my lithium orotate article.
Lithium orotate is lithium. Simple as that, it is just a different chemical formation. I have been called all sorts of names, a liar, an advocate for “Big Pharma” and so on. Lithium carbonate is probably the same price – it’s an inexpensive drug and it’s monitored by pharmacies, labs and you can’t buy it easily online and you know what you’re getting (in an ideal world, at least, you should know). Levels should be checked.

Lithium is dangerous to the kidneys in any formula, yes. However, lithium orotate is more dangerous. It is an over the counter supplement. This does not mean “safe”. Tylenol is deadly to the liver, for example, and is sold anywhere. Take enough, and you’ll need a new liver. What a crap example, I know.

Lithium has to be at a certain level in the blood to be therapeutic for the patient. I’m in a country (Canada) with socialized healthcare. I get blood tests for free, I get my meds cheap, yes, I have that advantage. (I can’t take lithium, but it did help for many years, I did end up with mild kidney disease called “diabetes insipidous”) It’s not the safest drug, I know that from experience. It has shitty side effects. It hasn’t changed much over the years. But it works.

Lithium orotate is dangerous simply because anyone can get it. Online supplements are more dangerous because you don’t know what you’re getting. People tend to abuse something advertised as “natural”, because “natural” sounds safe. Look at things like diet pills from GNC, a year later, they get banned because people end up with heart problems. The “healthy living store”.

I’m not saying all natural supplements are bad. But they all say to take with the advice of a doctor. Self prescribing anything is a bad idea. Especially for a psychiatric illness as serious as bipolar disorder. Especially with something like lithium. Blood levels are generally reduced to every 6 months, sometimes less once a dose is established.

A few things to remember.
Natural is NOT always safe.
Always consult a doctor, whether it be a GP or psychiatrist, before taking any over the counter medication or supplement. It could interact with something you already take, or even eat.

Be cautious if you order something online. The dose might not be accurate. It could contain something you don’t know of. It could contain something you’re allergic to. It could contain something that could come up on a physical or blood test as a false negative or positive.

A health food store doesn’t exactly have the most qualified people to give medical advice. This is medicine we’re talking about. Your mind and body. Again, see a doctor.

If you experience any weird side effects STOP.

Be cautious. Nothing works the same way for two people.

This is all my opinion. I do not have any links for you.

More than just a lift: Off label use for Antidepressants

A brief history of antidepressants

Antidepressants were accidentally discovered by chance in the 1950’s.(1) While seeking out a medication for schizophrenia, the main diagnosis at the time, drugs were found that could “tweak” the balance of the brains neurotransmitters (even though they didn’t really know how it worked at that time) Patients that weren’t schizophrenic got worse, but other patients, depressed (“neurotic”) had bouts of euphoria.

In 1955, the miracle cure Tofranil (imipramine) was patented, and others started coming up with similar tricyclic(2) antidepressants. Relief came to 60-80% of the patients, but there were terrible side effects and tricyclics can cause heart problems, much moreso than many other psychiatric drugs. In 1987, Prozac, the first SSRI(3) was created, with the same effectiveness and less side effects.

Image

Wellbutrin (Buproprion)

Wellbutrin was created as an atypical antidepressant but they found it helped aid people in quitting smoking, in which it is called Zyban. (When I took it, I got so anxious, I started smoking again after 6 months smoke free!) It is a mild stimulant and is the fourth most prescribed antidepressant in the USA.(4) It is very effective and can be an add-on drug to an antidepressant without worrying about serotonin syndrome, a dangerous syndrome caused when there is too much serotonin in the brain. Often, it is prescribed because SSRI’s can effect sexual functions, and this can help get them back, as well as lose some weight while you’re at it!

Zoloft (Sertaline)

Zoloft is used to treat depression, obsessive compulsive disorder, panic disorder and social anxiety. It is the second highest selling antidepressant in the USA(5) and is approved for children and adults. It works in a similar fashion to tricyclic antidepressants and some say it helps control urges, such as binging and purging. I took it for bulimia, but it made me incredibly violent and agitated, so I was taken off it ASAP.

Off-label Uses 

Off label uses of antidepressants are on the rise. One in five doctors prescribing antidepressants are not psychiatrists(6) and aren’t being used for psychiatric purposes. They can help with: fatigue, non-specific pain, smoking cessation, headaches, abnormal sensations and premenstrual tension.

 Prozac, Zoloft and Paxil are approved for premenstrual tension. Wellbutrin for smoking cessation and Cymbalta for diabetic neuropathy, chronic musculoskeletal pain and fibromyalgia. Some antidepressants control menopause symptoms as well as hormones do, and if you switch it around, beta-blockers help anxiety. Many medications for schizophrenia were used off-label for bipolar disorder or to augment an antidepressant, and are now on the market, FDA approved for both, such as Abilify, Seroquel and Zyprexa. Many antidepressants can help with pain (migraines, for example) such as Elavil (amitriptyline).

 Hell, Viagara is even prescribed to some women to improve their sex lives too!

  1. http://www.time.com/time/health/article/0,8599,1952143,00.html

  2. Three-ring chemical structure

  3. Selective Serotonin Reuptake Inhibitor

  4. http://en.wikipedia.org/wiki/Bupropion

  5. http://en.wikipedia.org/wiki/Zoloft

  6. http://depression.about.com/b/2011/08/09/off-label-antidepressant-use-on-the-rise.htm

  7. http://www.consumerreports.org/cro/2012/05/off-label-drug-prescribing-what-does-it-mean-for-you/index.htm

  8. *Note: Off-label does not mean illegal. It is generally not FDA approved for that specific condition. Also, antidepressants don’t have the abuse potential of many other meds.

How Meds Are Named

You’ve seen them out there, the meds with the silly names: Abilify, Geodon (Zeldox in Canada), Elavil, Viibryd. Effexor, Xanax, Depakote (called “Epival” in Canada) but how do they come up with these names? It doesn’t seem to make much sense!

 Actually, it makes perfect sense. A drug on the market has 4 names(1): a chemical name, a company name, a generic name, and a brand name. The examples I listed are brand names.

The chemical name is a scientific name given by the meds structure and rarely heard of for consumers. A company developing that specific drug will use the chemical name before giving it a generic name.

The generic name is given to identify a drug during its (useful) clinical lifetime. This is it’s “INN”.(2) It includes pharmaceutical substances or active ingredients. It has a unique name that is used worldwide.

When a company patents a drug, its trademark name is made, which is owned by the company and only they can use it. This goes away when the patent expires and you can get a generic. Some drugs, like Depakote/Epival, have more than one brand name. (3)

There are naming rules for medications! They sway away from h, j & k because of pronunciation problems. In English, it could make sense, but it could potentially be insulting in another language.

The Greek and Latin roots are studied when naming a drug. A brand name is often more catchy than the generic name, and also easier to pronounce. All of the meds I take, except for Abilify, are generic. Generics tend to cost less and have more companies competing to make the best generic. Contrary to popular belief, generics are pretty much exactly the same as the brand-name drug. The name can’t have any connotations of “promising to be better” in it, either.(4)

For example, Geodon (Geo-don) means “down to earth”. It can get really confusing!

 

  1. http://www.ucb.com/rd/info-centre/drug-naming

  2. International Non-proprietary Name

  3. http://cen.acs.org/articles/90/i3/Drug-Names-Come.html

  4. http://insidemystory.com/2012/08/02/choosing-a-name/

  5. https://www.msu.edu/~defores1/gre/roots/gre_rts_afx2.htm?…

 

Medications Part 3 – Benzo Comparisons

Benzodiazepine’s (shortened to benzo’s, otherwise known as tranquilizers) are one of the most prescribed drugs in the US. I’ve been taking benzo’s since I was 17 years old, that was the first med my psychiatrist put me on: Clonazepam (Klonopin for those in the US) I’m going to compare a few of them, explain the difference between dependence and addiction, and go through discontinuation, or withdrawal, symptoms.

Benzo’s are highly abused, especially Xanax, since it has a euphoric feel to it at first. I take Xanax (alprazolam) twice daily (.5mg twice a day) A year go, I was taking 0.5mg 4 times a day, or more. I slowly tapered down to 0.5mg twice a day and now I want to just have it around for anxiety or panic attacks, like before going to the dentist, or getting on a plane. I’m not saying this is for everybody: Some people need to be on benzo’s full time. I’m just setting a baseline for myself. Benzo’s are also good for seizure control, but you still need an anticonvulsant for regular maintenance.

Benzo’s are prescribed for a variety of reasons: Anxiety, insomnia, alcohol withdrawal, seizure control, muscle relaxation, something to calm you down before a procedure (like surgery, or the dentist).(1) They are CNS(1) (central nervous system- brain and spinal cord) depressants, but that doesn’t mean they’ll make you depressed. It is a physiological depressant, not a psychological one(2).

There are many benefits to taking a benzo, such as quick relief for anxiety. There are short term and long term benefits, anxiety and insomnia being a short term benefit. Valium is commonly used to help an alcoholic to get off of alcohol without horrible side effects. Librium is used for other drugs, as well, as it’s long acting and less harsh on the system to withdraw from. They are far less toxic than other medications.

There are risks to taking benzos, though. Some people have an opposite reaction and get very angry. They can be sedating (well, they are tranquilizers) and you shouldn’t drive until you know how it effects you. They can cause addiction, physical dependence and are not easy medications to get off of(4). It hasn’t been declared if it is safe to take them during pregnancy ornot. They also show up on a drug test.

Image

There are many different benzo’s to try, here are the4 most commonly used today:

Valium (diazepam): Treats anxiety disorders, muscle spasms and alcohol withdrawal symptoms(5) and sometimes used in the treatment of seizures. It has a long half life (up to 200 hours, with 6-8 at the beginning and slowly tapering down) so it’s one of the easiest benzos to discontinue, although it still sucks. Discontinuing a benzo should only be done with a doctors supervision.

Ativan (Lorazepam): Used mainly to treat panic or anxiety attacks. Comes in sublingual (under the tongue) form so it works faster. Kicks in pretty fast. Has a half life of 12 hours. (6)

Xanax (Alprazolam): Has the shortest half life of about 6-8 hours, and produces a euphoric feeling at first. Often given before surgery, or for insomnia, but most commonly used for panic attacks. (7) I sometimes take a pill, and ignore the taste, and dissolve it under my tongue if I get really panicky.

Klonopin (Clonazepam): A long acting benzo which is great for anxiety and panic disorders, and in higher doses, it helps with seizure control as well. (Also the first benzo I ever took!) It has a long half life of 18-20 hours, but it’s still not fun to come off of.(8)

Benzo’s are abused(9) and that is why some psychiatrists don’t prescribe them to people with an alcohol or drug background, or at all. I saw one psychiatrist and her first thing on the agenda was to get me completely off of Valium. Over my dead body. I fired her and went back to my (just retired and waiting for a referral) psychiatrist. But psychostimulant’s were perfectly fine, to her. Derp?

To someone not taking benzo’s on a regular basis, yes, they can be abused. They can be abused if they’re taken on a regular basis, too. They are a scheduled drug and if you get caught with them you better have them in the original prescription bottle or have a prescription/doctor’s note with you. They are scheduled because of their tendency to be abused. I crossed the Canada/US border with a bottle of Valium, no problem, it had everything on the label.

Some people start abusing benzos because they like the way they make them feel, their doctor has prescribed them for a good reason, and they get hooked after a while, and start taking more.(10) The more you take, the more you need, and if you find yourself without, well, you’ll go through withdrawal. Many people mix benzos and alcohol (sometimes even as a date rape drug!) which is combining two CNS depressants, and that has bad news written all over it. It greatly impairs your ability to think, as well as stand up. Thousands of people go to emergency rooms in the US every year for mixing benzos and alcohol.

Benzodiazepine withdrawal can be hell on earth. Many healthcare providers will switch you over to Vaium, because of the long half life (it gradually leaves your system, slowly, rather than Xanax, which is quickly out of the system causing you to crave it). The most common, and the most likely, side effects from withdrawal are: perceptual distortions, abnormal skin sensations, difficulty waking, anxiety, tension, agitation, restlessness and insomnia.

Some less common effects are: feelings of unreality, extreme depression, depersonalization, paranoid thoughts, headache, and seizures. Rare withdrawal symptoms are: psychosis, confusion and fits.

  1. http://www.webmd.com/mental-health/benzodiazepine-abuse
  2. http://medical-dictionary.thefreedictionary.com/Central+Nervous+System+Depressants
  3. http://www.benzo.org.uk/lader1.htm
  4. http://en.wikipedia.org/wiki/Benzodiazepine
  5. http://www.emedicinehealth.com/drug-diazepam/article_em.htm
  6. http://www.emedicinehealth.com/drug-lorazepam_oral/article_em.htm
  7. http://www.emedicinehealth.com/drug-alprazolam/article_em.htm
  8. http://www.emedicinehealth.com/drug-clonazepam//article_em.htm
  9. http://www.webmd.com/mental-health/benzodiazepine-abuse
  10. http://www.narconon.org/drug-abuse/effects-of-benzodiazepine.htm
  11. A very useful tool for comparing benzos: http://www.psychresidentonline.com/Benzodiazepine%20Comparison.htm

Medications Part 2 – Anticonvulsants

Some anticonvulsants are found to have a mood stabilizing effect. These medications are a first or second line treatment in bipolar disorder, with lithium being one of the first. More modern anticonvulsants often have less side effects. For example, Epival (Depakote in the USA) is great for rapid cycling, when lithium is only partially effective.

The three most commonly used are Depakote, Lamictal and Tegretol, or Trileptal (a newer version of Tegretol). If those fail, other meds like Topamax or Gabapentin can help. Gabapentin also works great for anxiety. Dilantin, one of the oldest seizure medications, is used, but not very often anymore. These are the main medications I’m going to cover in this article, and I’ll add some personal experience to them as well.

Why anticonvulsants?
There is a link between bipolar disorder and seizure disorders, but these medications are made to control seizures. Why do they also control mood?

They calm nerves in the brain, making them less excitable1. This evens out the chemical imbalance. They do take a bit to work and have unpleasant side effects at times. Most antivonculsants need to be “titrated up”(2) With medications like Lamictal, this can be very frustrating. Lamictal is approved to treat bipolar depression, as well, but it comes with the potential, 1/3000 odds of getting Steven-Johnson’s Syndrome3, which, for a quick explanation, is a flesh eating rash that is potentially fatal.

I titrated up slowly on Lamictal in the hospital and one day I broke out in a rash. They confirmed it was Steven-Johnson’s Syndrome and took me off the Lamictal immediately and gave me another mood stabilizer, because even if you’ve never had a seizure before, rapid discontinuation of an anticonvulsant can cause seizures, in very rare cases.

Some anticonvulsants need blood work done, but not necessarily to establish a therapeutic level, like with lithium. Depakote needs blood levels done to check on the liver, as it can be hard on the liver.

Depakote
Depakote is usually the first tried, at least with me, anticonvulsant. It is approved for bipolar disorder and helps with rapid cycling more than lithium, or other anticonvulsants. It is also a first-line treatment with seizure disorders. It has some unpleasant side effects4, it should not be taken while pregnant or breastfeeding, it can cause birth defects. Hair loss, liver toxicity, pancreatitis are other side effects, while rare, they do happen, so this medication must be monitored by a doctor. It can also, ironically, make you suicidal.

My experience with Depakote, the first time, well, it made me suicidal, and I attempted suicide. This landed me in the ER chugging charcoal and my psychiatrist refused to see me after that. They just sent me home and told my parents to hide the pills. I was 17. It knocked me out for the first couple of weeks, but I’m on it now, and I don’t have nearly as many problems. Minor side effects are stomach upset, hair loss, both of which I’ve never had problems with. I currently take 1000mg of Depakote a day in my “cocktail” (Depakote, Luvox, Xanax, Abilify and Benadryl). I’d recommend this drug, it is quite helpful.

Tegretol
Tegretol is similar to Depakote. It used to be an off-label prescription, but has been approved for bipolar disorder under a new name. It is good for mixed states and manic states, and is often used if lithium and Depakote fail6. Unfortunately, it can cause other medications (like antipsychotics, antidepressants, birth control, and more) to become less effective. It can also affect white blood cell count. Trileptal is similar, but newer, and has less side effects. It doesn’t require regular blood levels but it can lower sodium levels in the bloodstream. I haven’t taken Trileptal, but Tegretol made me halucinate. It did come in tasty chew tablets, though.

Lamictal
Lamictal is approved to treat bipolar depression and also works as a mood stabilizer. It isn’t an antidepressant, but it has antidepressant effects. It is considered one of the most long term treatments for bipolar disorder7. There aren’t a lot of side effects, but the ones you get can be bad. There is a potential to develop Steven-Johnson’s Syndrome (I did, because I’m damned like that)3. You need to very slowly titrate2 up or you can end up with SJS or another type of rash that isn’t as dangerous. It works best for Bipolar II.

It starts working when you’re in the 200mg-400mg dosage range8. It can begin working very quickly at low doses for depression. It is often considered the best medication for people with bipolar disorder, but does have it’s side effects. There is a risk of mania, because of the antidepressant qualities. There is the risk of “the rash3”, and a lot of anxiety while titrating up. It can impair cognitive functioning a bit and cause drowsiness. If the benefits outweigh the side effects, this is a good drug.

Topamax
Topamax is an anticonvulsant used for seizures and migraine prevention. It is also used for bipolar disorder off-label. It just went generic, so my insurance covers it, and I tried it for about two months, but the nickname “dope-a-max” comes to mind. Titrating up sucked, I was tired all the time. It has one good side effect: weight loss, but it can cause foods to taste differently. Like pop, Coca-cola just tasted off. It comes in pill or sprinkle form.

It has major side effects at times and can effect congitive functioning, kidney stones/damage, glaucoma, extreme sensitivity to heat and making the blood to acidic9. It is a last-line treatment for bipolar disorder.

Gabapentin (Neurontin)
This is another anticonvulsant drug and also helps with neuropathic pain. It is not effective on it’s own for bipolar disorder, but it pretty handy with anxiety. It can cause suicidal thoughts or actions and has a hellish discontinuation syndrome.

“Neurontin has not been shown to be effective in treating acute mania or depression. In other words, if you’re currently experiencing mania or depression, Neurontin will not be effective in stopping the acute mood episode.10”

There are minor side effects, and it can be added on as a treatment for bipolar disorder, but lithium, depakote and lamictal are better first-line treatments.

 

  1. http://abcnews.go.com/Health/BipolarTreatment/story?id=4396044

  2. Titration is starting at a low dose and adding to it until the therapuetic level is reached.

  3. http://bipolar.about.com/od/lamictal/a/Stevens-Johnson-Syndrome-Symptoms.htm

  4. http://www.depakoteer.com/

  5. http://epilepsy.emedtv.com/tegretol/tegretol-for-bipolar-disorder.html

  6. http://blogs.psychcentral.com/bipolar/2008/08/bipolar-disorder-medication-spotlight-tegretol-carbamazepine/

  7. http://lifeloveandbipolar.com/lamictal-for-bipolar-disorder

  8. http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Lamictal

  9. http://bipolar.about.com/od/topamax/a/profile_topamax.htm

Medications Part 1 – Lithium

Lithium was a great med for me. I took 900mg of it per day and it stabilized my moods, I was happier, but I gained weight. I went to my GP to see if he could find a reason for my weight gain, and he figured I had type 2 diabetes.

Well, the good news was I didn’t have type 2 diabetes. I have a rare condition, instead, called diabetes insipidus. Type 1 and Type 2 diabetes effect the pancreas and the way the body handles sugar. Diabetes insipidus is when the kidneys aren’t filtering, and it is also known as “water diabetes”.

Basically, I was thirsty all the time and peeing a LOT. I thought this was a side effect from my medication cocktail. Meds dry you out, so I’d drink a lot of water, juice, etc, and well, urinate a lot as well. Seems like a good explanation.

My doctor immediately pulled me off Lithium, no tapering down or anything and it was time to start looking for a new drug. I take Depakote now, but it’s not the same. And coming off Lithium cold turkey did wonders for my moods. NOT.

I didn’t lose any weight coming off of the Lithium. The diabetes insipidus didn’t go away in three months like they said it would. I have a physical tomorrow and am getting referred to a kidney doctor, and a new psychiatrist, as mine is retiring in 10 days. (Thanks for the short notice, asshole!)

Okay, so back to lithium. It is the only true mood stabilizer. Lithium affects the flow of sodium through nerve and muscle cells in the body(1). Sodium effects mania. Oh, I also craved salt like nothing else when I was on lith. I practically needed a salt lick. (Lithium is a salt by chemical structure)

Image

With lithium, there is a therepeutic dose, found by blood tests, which should be done once a week for the first month or so, then every other week, then every month, every three months, etc. It ranges from 0.4-1.2mmol/L in the blood. Anything lower than 0.4 means lithium isn’t effective, and if you go too high, the lithium doesn’t work either, and you can get toxic from the lithium.

Lithium toxicity has some very unfun symptoms as the following: nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears.

Lithium effects the kidneys and thyroid. Both can be countered with other medications, but if it gets really bad, it’s time to discontinue.

Side effects that put up a red flag to STOP taking lithium (with a doctor’s discretion!) are: extreme thirst/urination, weakness, restlessness, eye pain, blurry vision, restless movements in the eyes, tongue, jaw or neck, pain, cold feeling, discoloration in the fingers or toes, feeling light-headed, fainting, bradycardia, hallucinations, seizures, fevers.

Common side effects are a minor tremor in the hands. Everyone noticed my tremor. They thought I was nervous or in shock. It made soldering in electrical engineering very hard. Sometimes there is weakness or lack of coordination, nausea, and itching. I sometimes got nauseous, but the tremor (and kidney problems) were the main side effects I ended up with. My level was ~0.8, which is a good level.

Lithium doesn’t play well with NSAID’s, it can increase the amount of lith in your body by 150% and send you into toxicity. Doctor’s rarely listened to that when I informed them I was on lith. My pharmacy would catch the interaction, call the doctor, and give me something else. Pain in the ass!

Lithium prevents mania, but studies have shown that it is very effective when combined with an anti-depressant for treating depression.

“Upon ingestion, lithium becomes widely distributed in the central nervous system and interacts with a number of neurotransmitters and receptors, decreasing norepinephrine release and increasing serotonin synthesis.”(2)

If you read my article on glutamate here’s another fun fact:

“The University of Wisconsin researchers found that lithium exerts a dual effect on receptors for the neurotransmitter glutamate – acting to keep the amount of glutamate active between cells at a stable, healthy level, neither too much nor too little.”

I’m full of fun facts tonight:

“For the last 60 years, lithium has been the preferred treatment for bipolar disorder, but little research has been carried out to discover how it impacts the brain and the body clock. New research from the University of Manchester has found that lithium strengthens the body clock’s rhythms, which could lead to new treatments with fewer side effects.”(3)

Lithium has been used for 60 years, one of the oldest psychiatric medications. It is incredibly effective in many people, if they can tolerate the side effects. I loved it, but I need my kidneys.

1. http://www.drugs.com/lithium.html
2. http://bipolar.about.com/od/lithium/a/010312_lithium1.htm
3. http://psychcentral.com/news/2012/03/14/regulating-body-clock-may-be-key-to-treating-bipolar-disorder/35966.html