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Lithium March 13, 2010

Posted by Crazy Mermaid in mental illness, Mental Illness and Medication, Psychiatrists, Weight Gain and Mental Illness.
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Lithium Carbonate has many different uses, both in the industrial fields of glass-making and cement as well as in the pharmaceutical field. .  Used as a mood stabilizer, it treats the symptoms of depression and mania in bipolar disorder.

But from the pharmaceutical standpoint, there’s one giant problem with lithium carbonate: it’s almost free. There’s no money in it.  Because it couldn’t be patented (it’s a naturally occurring element), its use started in the 1870’s but died out, completely disappearing until 1949, when it was rediscovered by an Australian psychiatrist named John Cade. He got the idea to use lithium salts on mentally ill manic patients from an experiment he did on mice.  He tried it out, and it worked.  At that point, lithium carbonate (lithium salt) became the first drug used to successfully treat mental illness (again).

Unfortunately, many people died because the wrong dose was administered, or because a different type of lithium was substituted for lithium carbonate.  But through research, the right dosages were found, and we learned not to substitute one kind of lithium for another. It’s still tricky to prescribe the right dosage, though, because every patient reacts differently.

Because lithium has many unpleasant side effects, many people who were (and are) prescribed it refuse to take it.  They believe that their quality of life without medication is better than their quality of life with it, so they either stop taking it entirely, or they never start. They determine that they would rather suffer with depression or schizophrenia than lose the ability to walk or grasp anything, because by far the biggest side effect is something called ataxia.

Boiled down to brass tacks, ataxia is a lack of physical coordination.  It means that you can barely walk, and when you do you walk so stiffly and with such a shuffle that not only is it difficult to cover any ground, but anyone watching thinks you have a disease like Parkinson’s. It means that swimming or any sport is out of the question, since you drag your legs behind you like a beached whale. It means that you can’t peel a banana because you can’t grasp and hold on to objects. Many everyday tasks that we all take for granted, like opening lids and brushing our teeth, become difficult or impossible.

Running a close second behind ataxia is the tremors.  Tremors mean that your hands shake.  You can’t write because your hand shakes too bad, and you can’t use the computer because your hand shakes too much to touch the individual letters on the keyboard. Hands become almost useless when they’re shaking that bad.

Weight gain is one of the more famous side effects of not only lithium but almost every other drug associated with controlling mental illness symptoms.  Not only does your appetite increase, but the drugs also slow down your metabolism, which means that you’re hit with a double whammy, so it’s almost impossible not to gain weight on lithium. Some people gain 100 lbs, others gain 20 or 30 lbs, but almost everyone gains weight.

Those three side effects were by far the worst that I had that were lithium-related, but there were others that I fortunately didn’t experience, like alopecia (the loss of all of your hair), polyuria (loss of bladder control), and a host of others that I won’t go into here.  As if all of that isn’t enough of a problem, those side effects don’t always go away once the dosage is decreased.

Having said all of this, it’s important to note several important facts. Fact one: When mental illness is initially diagnosed, lithium is typically prescribed at a higher dose and then the dosage is backed off. Fact two: There are second generation drugs like Geodon that take the place of lithium nowadays, so sometimes lithium is never even given to a patient. Fact three: Most importantly, life with my mental illness more or less under control is so much better than life without it.

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