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Lithium Drowsiness and time for total effect?

Talk about meds, side effects, and the 'med-go-round'.

by YogaAbba » Sat Jun 24, 2017 8:01 pm

Hi,

I just started on Lithium 600mg/day total six days ago. The pharmacist said it may make me drowsy for a few days. After six days, I am finding that I am still drowsy, and for me the drowsiness feels a bit like depression. Does anyone have experience with that and, if so, how long did it take to go away.

I am also curious about how long it usually takes to get maximum effect from a given dose. At the moment, it's helping a bit, but not enough. I am wondering how long I should give it before I speak with my doctor about trying a higher dose.

Thanks.
--YA
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by AvantGarde » Sat Jun 24, 2017 10:19 pm

Everyone reacts differently to meds, it's not uncommon for the initial side effects to last a bit longer. For me they last for about a month.

Your doctor is the one who knows how to up the dosage, you need regular bloodwork to check your levels of toxicity with lithium, and to see if it's safe to up it too. If he's not asking for it, you should put some pressure on him. Lithium levels should be controlled regularly.
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by YogaAbba » Sun Jun 25, 2017 5:29 am

Hi AvantGarde,

it's not uncommon for the initial side effects to last a bit longer. For me they last for about a month.


Thanks this is helpful.

However, given that I said
. . . how long I should give it before I speak with my doctor about trying a higher dose


I find it unhelpful that you said:

Your doctor is the one who knows how to up the dosage, you need regular bloodwork to check your levels of toxicity with lithium, and to see if it's safe to up it too. If he's not asking for it, you should put some pressure on him. Lithium levels should be controlled regularly.


Isn't it obvious that I'm working with a doctor and would not increase the dose without checking with him?

I came to this forum because this kind of medication is new to me, it's a bit scary, and I am looking for input (and hopefully reassurance) from other people who have experience with it. To get a lecture about drug safety, and one that casts my doctor's competence into doubt, is unhelpful and invalidating.

If the answer is always going to be "ask your doctor," why not just set up the forum to give that response automatically to every question and no one would have to bother giving substantive responses about their personal experience with these medications?

--YA
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by Spm24 » Sun Jun 25, 2017 6:35 am

I have had no side effects from lithium.

My pdoc told me that it could take up to six weeks to feel the full effects. Just like my Lamictal. Told me that it would take a week for effects with Latuda. He has been spot on for both the later ones. Lithium has only been three weeks that I am on it.

As to questioning your pdoc. AvantGarde was not questioning the validity of your doctor. Some of us have had experiences with pdocs that have no idea what they are doing. There have been many members who have shared their experiences with less than competent pdocs. Many doctors do not test for lithium levels or if they test that one they do not test the thyroid function. So there are people who do not know that these need to be tested on a regular basis.

Yes we tell people to talk to their pdocs. But we do that because some people need that little push to talk with their pdoc. Plus all we can offer is our experiences. Which for some people is not enough. The answer is not always to talk to your pdoc. But once we give experience that we have had the next step is to tell people to talk to their pdoc...
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by AvantGarde » Sun Jun 25, 2017 10:16 am

Yep, what Shawn said.
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by YogaAbba » Sun Jun 25, 2017 1:46 pm

Thank you Spm24 for sharing your experience and explaining.

I would never have imagined that any doctor would possibility prescribe lithium without tracking the blood level. And I actually did not realize that you also have to check thyroid levels, which I will ask my doctor about.

So shouldn't have been so quick to react. Irritability wise, my bad: clearly the medication isn't doing anything for me yet :oops:

Thanks again.
--YA
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by Redwhitblu » Sun Jun 25, 2017 5:02 pm

I was told before abt three days to start working and feeling effects. However, 600 is a lower end dose but there are plenty of people who can only tolerate that and so settle on it. The drowsiness when first starting Lithium wore off mostly in abt two to three weeks in my experience.
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by YogaAbba » Mon Jun 26, 2017 1:32 pm

Redwhitblu wrote:I was told before abt three days to start working and feeling effects. However, 600 is a lower end dose but there are plenty of people who can only tolerate that and so settle on it. The drowsiness when first starting Lithium wore off mostly in abt two to three weeks in my experience.


I am definitely feeling some of the good effects. In my case, this means less frenzied business and feeling a broader range of emotions (in a good way). But the drowsiness seems also to be making my irritability worse.

I'm extremely sensitive to meds and so, yeah, will probably stay at 600 assuming that this side effect does go away. I'm hopeful that I'll start feeling better in 1-2 more weeks (I'm just coming up to the end of week 1).

Thanks for your input. I appreciate it.
--YA
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by Redwhitblu » Tue Jun 27, 2017 8:49 am

I'm sensitive to meds also and usually got by on 600mg even though my blood levels were technically slightly below therapeutic range at that dose. Im never able to tolerate the 900 for very long. There is alway coffee if you are drowsy! Just keep in mind caffeine will effect your Lithium level, lowering it some.

I'm actually weaning off Lithium right now even though I think it's a great medication. Although it helps with some things, it doesn't help me much with dysthymia, which is my main issue. I'd need an AD added to it for that, and would have to be at the more therapuduc, anti manic level of lithium for that. Which I'm unwilling to do bc of the side effects. So I guess it's back to an ol tride and true Atypical Antipsychotic for me.
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by YogaAbba » Wed Jun 28, 2017 7:00 am

Redwhitblu wrote:I'm actually weaning off Lithium right now even though I think it's a great medication. Although it helps with some things, it doesn't help me much with dysthymia, which is my main issue. I'd need an AD added to it for that, and would have to be at the more therapuduc, anti manic level of lithium for that. Which I'm unwilling to do bc of the side effects. So I guess it's back to an ol tride and true Atypical Antipsychotic for me.


So, since you're med sensitive, I'm curious about a few things. First, as I am checking out how I feel on 600 mg lithium for a week, I'm noticing my dysthymia. But I'm not sure how one distinguishes dysthymia from the drowsiness side effect? To me, they feel similar. I guess only time will tell.

As for the Atypical Antipsychotic, I don't fit even the bipolar II diagnosis. For me, it's more the mood instability that goes along with complex PTSD and possibility borderline cyclothymia. So, in theory, the atypical antipsychotics would not be relevant for me. However, one of my medication side effects in general is that my flashbacks get a lot worse: this happened with topamax and sertraline. The psychiatrist I consulted with thought that Abilify might be an option that would help with the flashbacks. But I'm concerned that the side effect profile of these antipsychotics in general is even more of a concern than with the anti-depressants. But it sounds like in your case, you've been able to work with the antipsychotics despite being med sensitive. I'm curious about your experience.

Thanks for your input.
--YA
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by KrisMarie » Thu Jul 13, 2017 8:06 pm

I started lithium 3 weeks ago and I don't get drowsy but I do get nauseated. My pdoc told me it could last months so perhaps it's the same with drowsiness? I think lithium takes 6 or so weeks to be full on working. I'd give it more time If you want take it.
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by YogaAbba » Mon Jul 17, 2017 9:20 am

KrisMarie wrote:I started lithium 3 weeks ago and I don't get drowsy but I do get nauseated. My pdoc told me it could last months so perhaps it's the same with drowsiness? I think lithium takes 6 or so weeks to be full on working. I'd give it more time If you want take it.


Yah it's been four weeks now and still feeling not so much drowsy as sedated. My doctor and therapist are encouraging me to stick with it to get to that 6 weeks mark. I think it's working in the sense that it has reduced my agitation well enough that I can more clearly see the PTSD stuff that's there. But as a result of that, I also feel _more_ irritable. I

Thanks for listening.
--YA
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