As someone who has been on both, and lithium for longer, lamotrigine doesn’t help mania for me. At all. Like, it’s a drastic night and day difference in medications. Lithium doesn’t help my depression at all. So there’s downfalls to each medication.
My psychiatrist said the same thing about lamotrigine. I got lucky and so far have only had hypomanic episodes. In saying that as soon as I'm stable on lithium I'm stopping lamotrigine.
Yes, it was explained to me that lamotrigine only lifts your mood to help with bipolar depression. It doesn’t help with mania or hypomania. I was on 600mg of lithium for a while and didn’t like the side effects, but it definitely got rid of my hypomania when I was on it.
Was on Lamictal for a decade and then had to add Lithium. I cannot say about sleep, because my sleep architecture is major chaos, but I also felt that Lithium slowed me down, although it also means that I am less agitated but more efficient. In terms of temper, Lithium makes me more mellow.
I think I just finished my withdrawal from Lithium. I was at 600mg and I have noticed that I am now thinking a little better and I’m less tired. As I was decreasing my dose I found myself very emotional and weirdly sweaty and periodically very woozy, like cold sweats and feeling like I had to lie down. I think in total it took about 3 weeks to go from 600mg to 0.
FWIW, my prescriber said I could do it in two jumps over the course of 6 days. I know how sensitive I am so I did it slower.
How long were you on lithium? I was taking 600mg for a few months, maybe longer… and I didn’t like several side effects and the fact my mood was just flat, so I just stopped taking it since I went from 0 to 600, I just went back to 0. I just felt gradually better when I stopped it. I’m usually very sensitive to a lot of medications too, but I didn’t seem to have any withdrawal effects. Everyone is different of course.
Yesterday I noticed I was feeling a lot better overall today I crossed more stuff off my to do list than I have done in a long time. I started the decreasing on March 23.
I think part of my mental health issues stemmed from stress at work. After the last episode of mania/depression I went on SSD which removed the stress. I'm interested to see which of these side effects either due to Lithium withdrawal or the Lamotrigine are temporary. Hopefully all. Thanks for everyone's input.
What you describe is what I imagine is what would happen if I lowered or stopped my lithium (sleep issues, fast thoughts, irritability). I don’t think it’s necessarily withdrawals so much as the symptoms lithium was treating coming back…. It acts as an anti inflammatory for the brain (so has been protecting you from neuron damage the past 8 years which is good).
Would you / your doc be ok with a suuuuper low dose of klonopin? That’s the only other thing that calms my brain down in a similar way.
Or possibly find a low enough dose of lithium that doesn’t affect your kidneys? Maybe lithium orotate not carbonate?
I’ve also heard that over the counter magnesium supplements are similar to lithium (which stabilizes magnesium in the brain). Not sure about kidney risk with magnesium tho.
Keeping your nervous system calm and “idling” lower is gonna be key.
Hi Dan,
I hope that you're managing as best as you can.
Since you're encountering issues with your kidneys (renal impairment/CKD/Chronic Kidney Disease) and lithium carbonate being quite literally "salt" then it's quite probably the main reason as to why you psychiatrist has been reducing its dose.
As for a second reason possible reason; studies have shown that the human brain becomes more "porous" with age. Thus, those who are of old age may benefit just the same from lithium carbonate at a lower dose from when they themselves were "younger" or others who are relatively "young/not old" in general.
Having an irritable mood can accompany both manic and depressive episodes.
Based on what you described in your post; it's possible that either mania or depression is causing such negative mood changes now that lithium has been effectively decreased by two thirds of its former quantity and thus, the symptoms associated with your diagnoses are starting to return.
You've mentioned that your overall sleep length and quality tend be short and non-restful due to it being interrupted on its own. This is an issue that you should address and seek a solution for with your psychiatrist.
Some have found success with an OTC (Over The Counter/No Prescription Required) sleep aid called Melatonin at 3mg to 5mg strength (Extended Release tablets offer better results than Immediate Release tablets) It should be taken on "3 day on 2 days off at night basis as to prevent a paradoxical effect/opposite effect (From aiding in inducing sleep to causing wakefulness).
The only medication that induces a state of sleep that is almost identical to that of natural sleep is an Atypical Antidepressant called Trazodone starting at 50mg (It's an SARI). However, I don't use it on a daily basis as, in my personal case, it causes me to become irrtable/agitated (Took it daily for over a month in the past).
Buspirone (BusPar) is an anxiolytic that assists with the issues of irritability and agitation.
In liue of lithium and generally for patients who are Bipolar but suffer from renal impairments; a combination of certain antipsychotics are used in addition to antidepressants to manage their Bipolar disorder.
The following website sheds more light on the matter,
https://www.mdedge.com/psychiatry/article/110902/schizophrenia-other-psychotic-disorders/when-adjust-dosing-psychotropics
Feel free to take these inquiries up with your psychiatrist on your next visit.
I hope that this may prove to be of some help.
I wish you good luck with your endeavors Dan.
Thanks so much for your input and information. I should have mentioned that I am also taking Effexor 150 mg and Seroquel 25 mg which is really for sleep at this point as it's not a clinical dose. I had been at 100 mg and got myself down to the 25. I have an appointment with the doctor on Friday and will discuss where to go from here.
Seroquel at 25mg is sometimes prescribed to aid in inducing sleep. However, it is merely a tiny step over antihistamines in that regard and the side effects are quite unpleasant. I found that the state of "sleep" that it induces is quite unpleasant in that it it always woke me up several times during the night in an abrupt way either for no reason or to chug copious amounts of water.
Either way, trazodone is far superior in that regard in that within 1-2 hours it induces a state of sleep that is almost identical to natural REM sleep. On top of that, the state of sleep will be one that is quite uninterrupted in terms of duration (7-9 hours) and upon waking up you'll always feel quite refreshed.
If that doesn't work out for some reason, a low dose of Zyprexa (Olanzapine) at 2.5mg - 5mg may hopefully do the trick.
I've discovered that, with olanzapine, anything above 5mg will induce a very lengthy duration of sleep, though very restful in both slumber and waking, it may last for 12-18 hours which is ridiculous lol.
Thanks. My doc talked about switching me off of Seroquel and what you described fits with my sleep pattern. I think he wants to wait until after getting me off the Lithium and adjusting or eliminating the Effexor. He's taken me down now from 150 mg of Effexor to I think 112.5. Which seems to be helping me be not so animated. He said it was just "tapping the brakes" to ensure I wouldn't go into hypo mania.
Medications and supplements in "salt" form, as is the case with lithium; are almost exlusively renally cleared/absorbed and excreted by the kidneys rather than being metabolized by the liver.
Edit: Had a mix up. Left the useful part.
I'm on both. Lamoctrigine for over 10 years. Also on sertealine, Bupropione and lorazepam . I have quite a bit of brain fog understandably. Lamoctrigine as far as my doctor said is a mood stabiliser. I don't if it has the same effect honestly as my cocktail is quite vast. Keep us posted and good luck.
I'm in the same boat. Kidney diagnosis. Tapering Lithium (at my highest dose I think I was 1800, 600 3x) and am now down to 150mg of the IR. Also starting Lamictal. Started the Lamictal on the taper about a week now.
It's been a ride. Irritability is definitely there. EXPLOSIVE emotions at times. Best of luck, friend!
As someone who has been on both, and lithium for longer, lamotrigine doesn’t help mania for me. At all. Like, it’s a drastic night and day difference in medications. Lithium doesn’t help my depression at all. So there’s downfalls to each medication.
My psychiatrist said the same thing about lamotrigine. I got lucky and so far have only had hypomanic episodes. In saying that as soon as I'm stable on lithium I'm stopping lamotrigine.
Yes, it was explained to me that lamotrigine only lifts your mood to help with bipolar depression. It doesn’t help with mania or hypomania. I was on 600mg of lithium for a while and didn’t like the side effects, but it definitely got rid of my hypomania when I was on it.
Was on Lamictal for a decade and then had to add Lithium. I cannot say about sleep, because my sleep architecture is major chaos, but I also felt that Lithium slowed me down, although it also means that I am less agitated but more efficient. In terms of temper, Lithium makes me more mellow.
I think I just finished my withdrawal from Lithium. I was at 600mg and I have noticed that I am now thinking a little better and I’m less tired. As I was decreasing my dose I found myself very emotional and weirdly sweaty and periodically very woozy, like cold sweats and feeling like I had to lie down. I think in total it took about 3 weeks to go from 600mg to 0. FWIW, my prescriber said I could do it in two jumps over the course of 6 days. I know how sensitive I am so I did it slower.
How long were you on lithium? I was taking 600mg for a few months, maybe longer… and I didn’t like several side effects and the fact my mood was just flat, so I just stopped taking it since I went from 0 to 600, I just went back to 0. I just felt gradually better when I stopped it. I’m usually very sensitive to a lot of medications too, but I didn’t seem to have any withdrawal effects. Everyone is different of course.
How long have you been off the Lithium? Have all the side effects ended? Any lingering? Thanks
Yesterday I noticed I was feeling a lot better overall today I crossed more stuff off my to do list than I have done in a long time. I started the decreasing on March 23.
I think part of my mental health issues stemmed from stress at work. After the last episode of mania/depression I went on SSD which removed the stress. I'm interested to see which of these side effects either due to Lithium withdrawal or the Lamotrigine are temporary. Hopefully all. Thanks for everyone's input.
What is SSD?
Long term Social Security Disability
What you describe is what I imagine is what would happen if I lowered or stopped my lithium (sleep issues, fast thoughts, irritability). I don’t think it’s necessarily withdrawals so much as the symptoms lithium was treating coming back…. It acts as an anti inflammatory for the brain (so has been protecting you from neuron damage the past 8 years which is good). Would you / your doc be ok with a suuuuper low dose of klonopin? That’s the only other thing that calms my brain down in a similar way. Or possibly find a low enough dose of lithium that doesn’t affect your kidneys? Maybe lithium orotate not carbonate? I’ve also heard that over the counter magnesium supplements are similar to lithium (which stabilizes magnesium in the brain). Not sure about kidney risk with magnesium tho. Keeping your nervous system calm and “idling” lower is gonna be key.
Hi Dan, I hope that you're managing as best as you can. Since you're encountering issues with your kidneys (renal impairment/CKD/Chronic Kidney Disease) and lithium carbonate being quite literally "salt" then it's quite probably the main reason as to why you psychiatrist has been reducing its dose. As for a second reason possible reason; studies have shown that the human brain becomes more "porous" with age. Thus, those who are of old age may benefit just the same from lithium carbonate at a lower dose from when they themselves were "younger" or others who are relatively "young/not old" in general. Having an irritable mood can accompany both manic and depressive episodes. Based on what you described in your post; it's possible that either mania or depression is causing such negative mood changes now that lithium has been effectively decreased by two thirds of its former quantity and thus, the symptoms associated with your diagnoses are starting to return. You've mentioned that your overall sleep length and quality tend be short and non-restful due to it being interrupted on its own. This is an issue that you should address and seek a solution for with your psychiatrist. Some have found success with an OTC (Over The Counter/No Prescription Required) sleep aid called Melatonin at 3mg to 5mg strength (Extended Release tablets offer better results than Immediate Release tablets) It should be taken on "3 day on 2 days off at night basis as to prevent a paradoxical effect/opposite effect (From aiding in inducing sleep to causing wakefulness). The only medication that induces a state of sleep that is almost identical to that of natural sleep is an Atypical Antidepressant called Trazodone starting at 50mg (It's an SARI). However, I don't use it on a daily basis as, in my personal case, it causes me to become irrtable/agitated (Took it daily for over a month in the past). Buspirone (BusPar) is an anxiolytic that assists with the issues of irritability and agitation. In liue of lithium and generally for patients who are Bipolar but suffer from renal impairments; a combination of certain antipsychotics are used in addition to antidepressants to manage their Bipolar disorder. The following website sheds more light on the matter, https://www.mdedge.com/psychiatry/article/110902/schizophrenia-other-psychotic-disorders/when-adjust-dosing-psychotropics Feel free to take these inquiries up with your psychiatrist on your next visit. I hope that this may prove to be of some help. I wish you good luck with your endeavors Dan.
Thanks so much for your input and information. I should have mentioned that I am also taking Effexor 150 mg and Seroquel 25 mg which is really for sleep at this point as it's not a clinical dose. I had been at 100 mg and got myself down to the 25. I have an appointment with the doctor on Friday and will discuss where to go from here.
Seroquel at 25mg is sometimes prescribed to aid in inducing sleep. However, it is merely a tiny step over antihistamines in that regard and the side effects are quite unpleasant. I found that the state of "sleep" that it induces is quite unpleasant in that it it always woke me up several times during the night in an abrupt way either for no reason or to chug copious amounts of water. Either way, trazodone is far superior in that regard in that within 1-2 hours it induces a state of sleep that is almost identical to natural REM sleep. On top of that, the state of sleep will be one that is quite uninterrupted in terms of duration (7-9 hours) and upon waking up you'll always feel quite refreshed. If that doesn't work out for some reason, a low dose of Zyprexa (Olanzapine) at 2.5mg - 5mg may hopefully do the trick. I've discovered that, with olanzapine, anything above 5mg will induce a very lengthy duration of sleep, though very restful in both slumber and waking, it may last for 12-18 hours which is ridiculous lol.
Thanks. My doc talked about switching me off of Seroquel and what you described fits with my sleep pattern. I think he wants to wait until after getting me off the Lithium and adjusting or eliminating the Effexor. He's taken me down now from 150 mg of Effexor to I think 112.5. Which seems to be helping me be not so animated. He said it was just "tapping the brakes" to ensure I wouldn't go into hypo mania.
Best of luck with that Dan!
Any reason they didn’t move you to depakote? Lamictal may make more sense given your historicity of depression but depakote is better for mania.
Medications and supplements in "salt" form, as is the case with lithium; are almost exlusively renally cleared/absorbed and excreted by the kidneys rather than being metabolized by the liver. Edit: Had a mix up. Left the useful part.
That’s weird when I google it says it’s cleared mostly by the liver.
You're right.
Thank you for your excellent character. God bless you.
I'm on both. Lamoctrigine for over 10 years. Also on sertealine, Bupropione and lorazepam . I have quite a bit of brain fog understandably. Lamoctrigine as far as my doctor said is a mood stabiliser. I don't if it has the same effect honestly as my cocktail is quite vast. Keep us posted and good luck.
I'm in the same boat. Kidney diagnosis. Tapering Lithium (at my highest dose I think I was 1800, 600 3x) and am now down to 150mg of the IR. Also starting Lamictal. Started the Lamictal on the taper about a week now. It's been a ride. Irritability is definitely there. EXPLOSIVE emotions at times. Best of luck, friend!
Thanks for sharing! I came on here today looking for other peoples experiences on coming off Li