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Tobin S.

(10,418 posts)
Fri Oct 19, 2012, 05:24 AM Oct 2012

I have an appointment with my psychiatrist today.

I'm going to ask him if I my illness might be in remission and see if we can scale back my meds a bit to see what happens. I take ziprasidone, lithium, and bupropion for my bipolar disorder. The lithium has long been a joke. I take a minimal does of it (600 mg) and when I get blood work done to check for levels of it in my blood they are always very low and last time they were undetectable even though I take the medication every day. It's been that way for years and hasn't been adjusted because I feel good.

The bupropion is an anti-depressant that I take a minimal dose of as well (150 mg). It's generic Wellbutrin, the same stuff they give smokers to help quit tobacco. I don't think this drug is having much of an effect on my state of mind either.

The ziprasidone is a different story. That's a drug that I take at the maximum recommended dosage. I want to quit taking the other two, but this one I just want to scale back a bit for now. I have taken this drug at a lower dosage before by mistake and done well.

I've got a feeling the doctor is not going to go for this. But I've done a lot of interior work since I've been prescribed those meds and I'm thinking that I might have sufficiently dealt with things to the point that I don't need a drug cocktail and might possibly be able to phase out the ziprasidone.

I'll let you know how it goes.

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HopeHoops

(47,675 posts)
4. Please do. I've had good luck cutting back doses of some meds, others not so much.
Fri Oct 19, 2012, 10:22 AM
Oct 2012

Fortunately my GP is very receptive to working with me such things.

marzipanni

(6,011 posts)
5. If your sense of well being and self-knowledge comes across as clear
Fri Oct 19, 2012, 10:41 AM
Oct 2012

to your psychiatrist as it does here, I think he'll consider your request.
Good luck!

Tobin S.

(10,418 posts)
9. It's all a part of my master plan ;)
Fri Oct 19, 2012, 06:45 PM
Oct 2012

That is to get people to think about and talk about this issue...and to educate. I hope you're doing alright this evening.

hedgehog

(36,286 posts)
12. Thank you - you didn't know this, but my MIL just passed away in another city.
Fri Oct 19, 2012, 06:59 PM
Oct 2012

My husband is on his way there now. Your kind words help a lot!

Tobin S.

(10,418 posts)
8. UPDATE: The doctor said he wouldn't advise it.
Fri Oct 19, 2012, 06:43 PM
Oct 2012

But he'll reevaluate after I get some more blood work done to see where those lithium levels lie. He's probably right, but I may decide to get a second opinion. It's hard to argue with a doctor who's been there with you since the beginning though. I've been seeing this guy for ten years.

CaliforniaPeggy

(149,712 posts)
10. Thanks for the update!
Fri Oct 19, 2012, 06:56 PM
Oct 2012

I think his caution is probably a good idea.......He does have street cred, after all!

hedgehog

(36,286 posts)
11. IIRC, there was one theory that if you go off a medication, it may
Fri Oct 19, 2012, 06:58 PM
Oct 2012

not be as effective if you need to go back on it. Something about the nerve cells realigning. This info is about 10 years old, so it may be out-of-date. But if what you're on is working within a tolerable limit of side effects, it may be safer to stay on it. There is strong societal pressure not to "depend on pills". That's why i always compare chronic depression or bi-polar disease to diabetes - you can treat it, and you can help yourself with some life style changes, but it's not going away.

UTUSN

(70,744 posts)
13. (I'm ignorant) I heard that lithium is in the water/dam at El Paso Tx & is the reason
Fri Oct 19, 2012, 09:36 PM
Oct 2012

that locals are chilled. I mean NO disrespect anywhere/anyhow.

UTUSN

(70,744 posts)
15. The original info dates back to 1971, Google shows more links
Sat Oct 20, 2012, 04:22 PM
Oct 2012

Perhaps this has been discredited or never proved, but it was out there.

*************QUOTE*************

http://www.time.com/time/magazine/article/0,9171,905404,00.html

[font size=5]The Nation: The Texas Tranquilizer – TIME[/font]

(subscription needed. It’s quoted in the link below this one. )



http://www.nytimes.com/projects/magazine/ideas/2009/#1-2

[font size=5]Lithium in the Water Supply[/font]

America has been adding fluoride to its public water supplies for decades, based on overwhelming evidence that even low levels of the substance can significantly reduce tooth decay, with no major side effects. Now research from Japan suggests expanding the list of aqueous additives — namely, to lithium.

Lithium often occurs naturally, in trace amounts, in water supplies, particularly in areas with a high concentration of granite. In The British Journal of Psychiatry earlier this year, the neuropsychiatrist Takeshi Terao and other researchers showed that communities in Japan's Oita Prefecture with higher levels of naturally occurring lithium in their water supplies had fewer suicides than those with lower levels. The amounts range between 0.7 and 59 micrograms per liter. Lithium in prescription doses (say, 600 to 900 milligrams) helps reduce mood swings in patients with bipolar disorder, but Terao and his colleagues speculate that drinking even small amounts over time has a cumulative effect, building up a resistance to the onset of mood swings in the first place. The researchers note that more work is needed before public-policy makers can consider adding lithium to water supplies. Lithium, after all, can be toxic, and though the levels in the Oita study are too low to have an immediate effect, the element can affect kidney function and cause long-term health problems. "I think we need to be wary of introducing something across the board, because it does take time to work out what the side effects are," says Sophie Corlett, director of external relations at Mind, a British mental-health organization.

Nevertheless, Terao and his team contend that the lithium levels in their study are low enough not to cause significant side effects, and that in any case the benefits outweigh the risks. In a follow-up paper, they even posited that adding lithium to drinking water could "potentially offer an easy, cheap and substantial strategy for worldwide suicide prevention." But Corlett remains wary. "Mass inoculations of one sort or another always seem to be the easy answer, but we shouldn't assume that's the case," she says — especially because "lithium isn't a very friendly drug." CLAY RISEN


(Below is a Comment to the 3 paragraphs linked immediately above: )

Here's an article about lithium in the El Paso water supply, entitled "The Texas Tranquilizer" from Time Magazine's archives, dated October 4, 1971:

" By legend Texans are a grandiose breed with more than the natural share of megalomaniacs. But University of Texas Biochemist Earl B. Dawson thinks that he detects an uncommon pocket of psychological adjustment around El Paso. The reason, says Dawson, lies in the deep wells from which the city draws its water supply.

" According to Dawson's studies of urine samples from 3,000 Texans, El Paso's water is heavily laced with lithium, a tranquilizing chemical widely used in the treatment of manic depression and other psychiatric disorders. He notes that Dallas, which has low lithium levels because it draws its water from surface supplies, has "about seven times more admissions to state mental hospitals than El Paso." But state mental health officials point out that the mental hospital closest to Dallas is 35 miles from the city, while the one nearest El Paso is 350 miles away—and the long distance could affect admission figures.

" But FBI statistics show that while Dallas had 5,970 known crimes per 100,000 population last year, El Paso had 2,889 per 100,000. Dallas (pop. 844,000) had 242 murders, El Paso (pop. 323,000) only 13. Dr. Frederick Goodwin, an expert on lithium studies for the National Institute of Mental Health, doubts that "lithium has these magical properties in the population." Others are not so sure. If lithium does have anything to do with the relative peace in El Paso, what would it do for other cities like New York and Chicago?"

*************UNQUOTE*************

Tobin S.

(10,418 posts)
16. There are misconceptions in both articles about how lithium works
Sat Oct 20, 2012, 04:39 PM
Oct 2012

In the first it says that consuming lithium at very small quantities over a long period of time will have a cumulative effect on the brain which seems highly unlikely to me. I take what's considered a minimal dose of lithium for therapeutic effect and that's 600 mg a DAY. I have to take that amount EVERY day for therapeutic levels to remain constant in my blood. In other words, if lithium had that great of a cumulative effect, at the dosage I take I would quickly become poisoned by the drug.

The second article doesn't define "heavily laced with lithium." I'd bet that the amount is similar to that in the first article and and can be measured in double digit micrograms per liter. It also says lithium is a tranquilizer which it is not.

UTUSN

(70,744 posts)
17. As I said, I don't have the credentials to vouch for the topic, just knee-jerked to
Sat Oct 20, 2012, 05:26 PM
Oct 2012

the keyword "lithium" and posted the articles just to show I didn't make it up out of whole cloth. I didn't click into any more of the links in the Google results, but there might be a conclusive bunking or debunking in there somewhere, so if somebody can post a conclusive bit, I'd appreciate it so that I can try to remove the topic from my mind's cache.

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