Question:
Can anyone tell me about lithium augmentation with SSRIs or SNRIs or whatever? I’m taking 225mg Effexor XR and my doctor has suggested using lithium augmentation to help with some of the more resistant symptoms. I’ve tried a whole bunch of other stuff (mostly SSRIs), but I’m a little worried about trying lithium because of it’s reputation as a "hard" drug. Please let me know about any of the positive/negative aspects of lithium, as well as side effects, etc. Anything at all would be appreciated. Elsa
Response:
> Can anyone tell me about lithium augmentation with SSRIs or SNRIs or > whatever? I’m taking 225mg Effexor XR and my doctor has suggested > using lithium augmentation to help with some of the more resistant > symptoms. I’ve tried a whole bunch of other stuff (mostly SSRIs), but > I’m a little worried about trying lithium because of it’s reputation > as a "hard" drug. Please let me know about any of the > positive/negative aspects of lithium, as well as side effects, etc. > Anything at all would be appreciated. > Elsa
Hi Elsa, I know that lithium is used as an adjunct drug with other meds, though off hand, I cannot tell you which; and it’s important to know that there is not bad interaction and to know the dose, etc. Please excuse me for this rough reply; I am presently going through a drug experience myself, but I am attaching a site you may find useful with many links on lithium info. As for lithium being a "hard drug" – I am not sure what you mean by this. It is the gold standard for bipolar depression. take care Squiggles http://groups.yahoo.com/group/Lithium/
Response:
Welcome to the ng, Here is some info: > Can anyone tell me about lithium augmentation with SSRIs or SNRIs or > whatever? I’m taking 225mg Effexor XR and my doctor has suggested > using lithium augmentation to help with some of the more resistant > symptoms. I’ve tried a whole bunch of other stuff (mostly SSRIs), but > I’m a little worried about trying lithium because of it’s reputation > as a "hard" drug. Please let me know about any of the > positive/negative aspects of lithium, as well as side effects, etc. > Anything at all would be appreciated.
http://www.biopsychiatry.com/lithaug.htm Lithium augmentation in treatment-resistant depression: meta-analysis of placebo-controlled studies by Bauer M, Dopfmer S Department of Psychiatry, Klinikum Benjamin Franklin, Freie Unversitat Berlin, Germany. J Clin Psychopharmacol 1999 Oct; 19(5):427-34 ABSTRACT The addition of lithium to the treatment regimens of previously nonresponding depressed patients has been repeatedly investigated in controlled studies. The authors undertook this meta-analysis to investigate the efficacy of lithium augmentation of conventional antidepressants. An attempt was made to identify all placebo-controlled trials of lithium augmentation in refractory depression. Only double-blind studies that involved participants who had been treated with lithium or placebo addition after not responding to conventional antidepressants were to be included in the meta-analysis. Further inclusion criteria were the use of accepted diagnostic criteria for depression and the use of response criteria based on the acceptable measurement of depression as an outcome variable. Studies were located by a search of the MEDLINE database, a search in the Cochrane Library, and an intensive search by hand of reviews on lithium augmentation. Nine of 11 placebo-controlled, double-blind studies were included in this meta-analysis. Aggregating three studies with a total of 110 patients that used a minimum lithium dose of 800 mg/day, or a dose sufficient to reach lithium serum levels of > or = 0.5 mEq/L, and a minimum treatment duration of 2 weeks, the authors found that the pooled odds ratio of response during lithium augmentation compared with the response during placebo treatment was 3.31 (95% confidence interval, 1.46-7.53). The corresponding relative response rate was 2.14 (95% confidence interval, 1.23-3.70), the absolute improvement in response rate was 27% (95% confidence interval, 9.8%-44.2%), and the number of patients needed to be treated to obtain one more responder was 3.7. Inclusion of six more studies that fulfilled inclusion criteria but which treated subjects with additional lithium for less than 2 weeks or with a lower lithium dose (total, 234 patients) resulted in even higher estimates. Lithium augmentation seems to be the treatment strategy in refractory depression that has been investigated most frequently in placebo-controlled, double-blind studies. The authors conclude from this meta-analysis that with respect to efficacy, lithium augmentation is the first-choice treatment procedure for depressed patients who fail to respond to http://bipolar.about.com/library/weekly/mpreviss.htm Go to site and select from the following: 04/02/01 – Lithium: The First Mood Stabilizer Part 4: Whoa, Fat! We conclude our look at Lithium be examining the possible reasons why so many people gain weight – sometimes a LOT of weight – while taking it. 03/26/01 – Lithium: The First Mood Stabilizer Part 3: Major Precautions and Warnings Important facts about this medication, including salt intake, pre-existing conditions, interactions with other medications and other issues.. 03/19/01 – Lithium: The First Mood Stabilizer Part 2: Tests and Toxicity Tests have to be run before starting lithium therapy to make sure it is safe and appropriate for the patient. More tests have to be done throughout the course of therapy to make sure blood levels are within the safe and effective range, because lithium overdose can be very dangerous. 03/12/01 – Lithium: The First Mood Stabilizer Part 1: History, and a Mystery Solved It took nearly 50 years for scientists to start figuring out how lithium works. In Part 1 of a four-part series, we look at the history of lithium and the ground-breaking research that unlocked its mysteries. antidepressant monotherapy.
Response:
<snip> I’ve used lithium as an augmenting agent, and I must say that I really liked it. It did help my anti-depressant, and it very nicely leveled out the worst of my rapid mood swings from depressed but coping to desperately self-destructive. Did have a couple drawbacks though. I had a persistent hand tremor, usually annoying but tolerable though sometimes bad enough to make handwriting difficult and handling coins a disaster. Ultimately, I had to go off lithium because it was reducing my thyroid function too much. A couple months of thyroid supplements took care of that problem. Bright blessings. Fiona — If we had no winter, the spring would not be so pleasant: if we did not sometimes taste the adversity, prosperity would not be so welcome. – Anne Bradstreet, Meditations Divine and Moral, 1664
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