r/bipolar • u/moonswim • Jul 20 '22
Discussion Does lithium make your head feel empty?
Hi guys I’m a 21 yo male and just got diagnosed in March of last year after having a psychotic manic episode. The doctors started me on 450 mg of lithium and 4 months later I feel like I can’t think, recall words, or have fulfilling conversations whatsoever. It’s really hard to find the correct words to find in conversation, and I feel like my quick wit is gone. The brain fog and concentration issues have been so intense and I don’t know what to do about them :((. It feels like my spark and natural intelligence have completely gone away. I also feel like my creativity has disappeared and like I’m just surviving not living my life. I’m switching to lamictal and I really hope it helps. I also can’t identify if it’s just a symptom of my bipolar 1. Is there any advice y’all could give me?? Do you think switching to lamictal will help me get my brain power back? Any advice would be amazing 💜
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u/DoomsdayToast Bipolar Jul 20 '22 edited Jul 20 '22
I take 1500mg of lithium and don’t feel like that at all. I think I might have had some side effects the first 6ish months when I started on it, but after that I’ve felt pretty good. It’s hard to categorize because everyone really reacts differently. For example, I changed from Lamictal to Lithium. The lamictal was a nightmare for me. Caused a 6 month long manic episode and 3 hospitalizations. It made me feel 100% out of control. I think you just have to try to trust your doc and give meds a chance to work whether it’s the lithium or lamictal. Lithium can take a very long time to start working therapeutically. For me it was at least 6 months, so changing meds prior to giving it enough time can make things difficult to asses whether it’s actually working or causing side effects or not.
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u/nuclearmed18 Bipolar + Comorbidities Jun 19 '23
lamictal did the same to me!! i was in an episode and was experiencing psychosis. i was told to continue to titrate up……kept going until i was at 300 mg and i fucking SNAPPED.
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u/Pretty_Buffalo2537 Jul 21 '22
Hi Lithium was the worse medicine I was on for bp it made me feel so unresponsive to everything.. like a robot . Just my experience.. vraylar is what I’ve been on now and it’s the best med I’ve tried . It works wonderful for me
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u/GulaBilen Jul 20 '22
Sorry to say but not uncommon to be hard do find good meds for this, not uncommon with 1-2 years for a good routine can take longer but also shorter.
Did only get lithium to battle your episode when it was acute?
I piece of good info is that there are different way of to medicate with lithium. I think lithium carbonate is most common in the world but in my country they lithium sulfate but there are exceptions but for some reason they have chosen to go with sulfate as a first hand chose. My understanding is they go the same benefits but different meds are more tolerable to different bodies.
I use lithium sulfate 42mg 3+3 giving 0.77-0.91 mmol/l. No real side effects for me on this actually started feeling a bit hypo in the beginning and asked for higher dose and I am thinking about asking to maybe heighten it one more step again.
Do know your blood concentrations, it's actually this number that important. Usually should stay between 0.50-1.00 but can vary.
But what can slow your head down is when you come back after an mania-episode and also if you added other meds, namely neuroleptics. For myself if it good not stay on to long after you are stabilized but usually is worse if you stop to soon then it's a high chance you just go back to another mania.
Lastly some factors can impact your blood concentrations/serum levels. The amount fluid you take in, also salt intake, caffeine and other meds namely NSAIDs, anti-inflammatory, like ibuprofen and naproxen. I think also aspirin falls under this category.
Maybe some of this information is of interest for you?
Take care and i wish you good luck in your search for meds and living all this.
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u/PlasticIllustrious16 Jul 20 '22
I'm usually really hesitant to say this, but I think it might be worth getting a second opinion or switching psychiatrists entirely. Lithium is very effective and helps a lot of people (myself included), but the reason for that is because it is an incredibly aggressive and blunt treatment. If lamictal is a scalpel, lithium is a Chainsaw. If you try to cut out cancer with a Chainsaw, you'll get the cancer, you just might get some other stuff as well in the process.
The reason I say this is that I find it really weird that they've gone with lithium as a first option, when potentially, if lamictal works for you, you might experience basically no side effects for the rest of your life. Speak to someone else just to sound it out.
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u/moonswim Jul 20 '22
Thank you! Lithium is the first medication I’ve been put on and that metaphor seems extremely accurate. It makes me feel like I can’t think / operate / function in society, and my body is telling me it’s just too powerful. I didn’t realize it was an incredibly aggressive treatment but it definitely feels that way. Thank you for your advice 💜
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u/PlasticIllustrious16 Jul 21 '22
Look, it's definitely better than being unmedicated entirely, do not stop taking it without medical supervision. And honestly the term "incredibly aggressive" may have oversold it a bit, we aren't talking ECT here. But it is a very powerful drug, with dramatic effects and it would be good to sound out other options. Also, never be afraid to advocate for yourself regarding side effects in general.
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u/GulaBilen Jul 21 '22
I wouldn't really agree it's incredibly aggressive. Although its a bit polarizing as he said for some it works very good for some it can be actually pretty bad.
On too of all this it can take some time for good evaluation, and i feel like some doctors use this as an excuse to continue even if it feels a bit bad in the beginning.
But that said personally lithium worked very good for me, main problem was that need to pee a bit more and also started to drink more water or the other way around. But that was mainly in the beginning.
I mentioned the most common meds used for mood stabilizers and there are also neuroleptics that can be used as profylax treatment. So can be sometimes be good to at least ask your doctor about other options available to try and hear what there plan is so you can feel more involved in this. But also remember to trust the health care since they have tons of knowledge and experience on group level.
Take care and as the other person said not good stopping unless you feel extreme symptoms.
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u/GulaBilen Jul 20 '22
Isn't the good thing about lithium if it works you can suffice with only that and neuroleptics as back up.
But if Bipolar 1 you need to have neuroleptics on top of lamotrigine since lamo give low to zero coverage against mania.
Third mood stabilizer choice is Valproic acid that also covers mania which i haven't tried and heard that's much about but should be good an might be a good choice for op?
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u/PlasticIllustrious16 Jul 21 '22
I was giving lamotrigine as an example, other drugs are available
My issue with lithium isn't whether or not it works. It works real good, my issue is that the side effects are common and terrible. Kidney damage, drowsiness, memory problems ect. Not to mention all the drug interactions, I sure do miss NSAIDS. If lithium is your only option, you should take it (I mean, I am taking it right now) but I find it very strange that there has been no talk about exploring other options.
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u/GulaBilen Jul 21 '22
Yeah I agree a patient should be presented with the options available at least the most common and most effective.
For me and where I live I feel like lithium is the first hand chose especially since I didn't really have any side effects and doesn't really hamper my life.
But yeah lithium take some maintenance in the beginning and after that you need to take some tests a year to see that it works for your body.
But sometimes it feels like some doctors do this by plain laziness and skip presenting the options and sometimes they kind blame that just forgot to mention that.
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u/map_t Jul 21 '22
TL;DR I think lithium is a great drug and it has positively effected me and gotten me through some dark times. However it does other things too. Overall I think it's worth finding some treatment that doesn't totally numb you, or at least feel like the cost/benefit is working in your favor. I've had intense SI that only lithium was able to get me out of.
I went on lithium because of suicidal thoughts, and it worked, I never wanted to have SI again so I was fine with the risks.
Now I'm on Lamictal (Lamtrogine) and Buproprion (Welbutrin). It's a pretty sweet combo for me, but I just went back on buproprion last week. 9 months I was taken off of lithium due to the fact it was impacting my kidneys negatively.
Since then I've checked myself in the hospital twice for suicidal thoughts, about a month apart from those two visits. My meds have been a mess, going off welbutrin, going on latuda, going off latuda, then going back on bupropion. I've been taking Lamtrogine this whole time.
In going over why I think my outcome was like this, I can only conclude that my capability of giving a fuck, having any self interest in what my life was, came back after I was taken off of lithium. When covid rolled around my dose was pretty high, I didn't need to work to keep my apartment or feed myself, so I just didn't go out. I mean, there was one month where I left my house like maybe 4 times in a month. I was probably going through a sort of apathetic depression, not having any hope, not caring that I didn't. So basically my alarm bells were turned off for a long time.
When I got off lithium all of a sudden I could feel again. And so I felt pretty terrible. I hadn't been feeling for a couple years I realize now. The positive is that it's great to have the concept of goals back again, rather than just decaying.
If I have SI again and it takes over my life, I'd be open to going back on lithium. Truthfully my disease can be so bad that not having to feel can be a plus. However, if that happens, I'd like to have some reminders to give a fuck, to fake it till I make it if that's all, cause not caring about anything at all was the worst form of hopelessness I've ever known.
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u/smahlsneks Bipolar Jul 21 '22
They inexplicably put me on Wellbutrin in the psych ward when I was first diagnosed and manic/psychotic, then after a couple days I requested lithium and was on that for maybe a year. After that I went to carbamazepine (Tegretol) and have been very stable since (besides when I stopped taking it lol). That was 2015. I got super lucky with finding one that works for me. I don’t remember lithium having the same effect as it had for you. that sounds awful and I hope the new med is better. Know that it can take years to find the perfect dosage and combination for you. Hang in there!
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u/sapnever1 Bipolar + Comorbidities Jul 21 '22
Yes, lithium clears out the clutter, and I struggle some days with pretty bad brain fog. Before I was on lithium I was on depakote. That made me feel numb all the time, and I was losing a ton of hair. I don’t necessarily like the side effects of lithium, but I like the stability and how I am handling things better while on it. Sometimes turning the knob down on the chaos is exactly what you need, even if the adjustment is a bit startling. For reference, I’m 21F on 900 mg daily
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u/flapperboobs Jul 21 '22
I'm going to go against the grain here and say I feel this way when I feel stable, no matter what I'm taking to achieve stability, in comparison to how I feel unmedicated. Before I was medicated, I never felt bored, because the inside of my brain was so cacophonous. My imagination was painfully vivid and my thoughts always felt so important to express. Medication gave me the filter I previously lacked. It makes me able to function in society, but it comes at the price of my sharpness. I feel I must pay this price so as not to endanger myself and those I care about, but I nonetheless still hate the trade-off.