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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Roslynn on October 19, 2010, at 11:36:12
Hi everyone,
My doc asked me to reduce my lithium dose from 600mg per day to 300mg because I have a coarse lithium tremor. That was 7 days ago. The tremor has cleared slightly, but I'm feeling more irritable and down than I have in a while. Could that small of a reduction make that much of a difference, or is it "all in my head" as they say?
Will my brain adjust to this new dose?Thanks for any help!
Roslynn
Posted by morgan miller on October 19, 2010, at 22:39:55
In reply to can a small lithium reduction make you feel worse?, posted by Roslynn on October 19, 2010, at 11:36:12
I think that reduction could cause you to feel the way you are. Hopefully you will adjust to the dose and start to feel better.
You might want to ask your doctor what they think about adding a small dose of depakote(hopefully that won't give you tremors also). I have read of people having success combining lithium and depakote.
I have also read that fish oil combined with vitamin E might help reduce symptoms like tremor. This was just one source and one doctor though. I think it is worth a try if you are not doing it already.
Posted by SLS on October 20, 2010, at 5:46:24
In reply to can a small lithium reduction make you feel worse?, posted by Roslynn on October 19, 2010, at 11:36:12
Hi Roslynn.
> is it "all in my head" as they say?
Of course! That's where the affected organ is located.
:-)
> Will my brain adjust to this new dose?
I doubt it. For some drugs however, there is a phenomenon known as rebound relapse that can occur as the result of a dosage reduction or abrupt discontinuation.
> Thanks for any help!Just a simple thought experiment:
For anyone taking any drug and experiencing success with it, there must be some lower dosage that becomes ineffective before the dosage reaches zero. Common sense.
For you, 600mg of lithium will be better than 0mg. You have already seen this for yourself. Perhaps 600mg is the minimum effective dosage for you. If so, the slightest dosage reduction will allow for relapse. Since you still experience tremors at the lower dosage, what other purpose would it serve to remain there and struggle?
Perhaps propranalol would help mitigate tremors. I haven't looked into its use with lithium, though. It might only work when there are disturbances in the autonomic nervous system.
- Scott
Posted by Phillipa on October 20, 2010, at 10:20:23
In reply to Re: can a small lithium reduction make you feel worse? » Roslynn, posted by SLS on October 20, 2010, at 5:46:24
I've seen the tremor and can see how annoying it must be. The two people I knew had to stop to get rid of it. Also one had diarrhea. Hope you figure this out. Phillipa
Posted by Roslynn on October 20, 2010, at 10:26:53
In reply to Re: can a small lithium reduction make you feel worse?, posted by morgan miller on October 19, 2010, at 22:39:55
Thank you all for your feedback. My tremor has cleared slightly. It's been 8 days on the lower dose of lithium.
Does anyone know if Seroquel interacts with lithium? If Seroquel increases lithium's strength, I could reduce my dose of Seroquel rather than cutting back on the lithium.
Posted by SLS on October 20, 2010, at 11:48:58
In reply to Re: can a small lithium reduction make you feel worse?, posted by Roslynn on October 20, 2010, at 10:26:53
> Thank you all for your feedback. My tremor has cleared slightly. It's been 8 days on the lower dose of lithium.
>
> Does anyone know if Seroquel interacts with lithium? If Seroquel increases lithium's strength, I could reduce my dose of Seroquel rather than cutting back on the lithium.I think that you should work with your doctor on this and set up a plan. Here, it is all guesswork. Although there is ultimately some degree of experimenting through trial-and-error, your doctor should have a better feel for what protocol actually works with the patients he sees.
- Scott
This is the end of the thread.
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