Maybe your friend could read this:

http://www.fiercepharma.com/story/neurontin-fails-bipolar-med-review/2008-04-18?utm_medium=rss&utm_source=rss&cmp-id=OTC-RSS-FP

Then take it to the nurse. Because it is no better for bipolar than placebo.

I had that life situation based diagnosis attempted to be given to me a few years ago. Tell your friend, life happens and take it from me, I'm living in virtual hell with much serious life happenings --and off the drugs the doctor thought I needed back then, and the dx the doc gave me is long gone.(and was short-lived)

She shouldn't be getting this stuff from a nurse in the first place, or a PCP--not that psychiatrists are any better---but hell the nurse and PCP's are pretty much trained by pharma rep lectures in office or CME programs funded by pharma.

1) Nurses cannot prescribe medicine. This was certainly a nurse practitioner, in which case scope of practice indicates she was trained with advanced education and can manage medical care. Calling her a nurse is deceptive and suggests she does not have education / legal authority to manage and prescribe medicine.
The implication here is that NPs are markedly inferior to psychiatrists when that is not really true. There are plenty of terrible psychiatrists and plenty of great NPs. Just an FYI.

2) How do you know your friend isn't bipolar? Not sleeping well for weeks and feeling antsy all the time could possibly be signs of mild mania.
Did the lithium help the symptoms? It sounds like they may have, since she continued with the treatment.

I find it ironic that you, yourself, use long term antidepressants, and you, yourself, were diagnosed with relatively mild mania, and you believe this is fine and good, yet you attack others for being naive who are in the very same position. That does not seem fair at all and I wonder what your motive is for having this double standard (accepting antidepressants and a sketchy bipolar label for yourself, but rolling your eyes when someone else does it).

When will the robots rebel against the authority of psychiatry and the brain chemical imbalances. Imbalance as an explination for ones cognitive dissonance ? Yes you are a diseased animal with feelings, you should have been a robot, be a robot please. Robot got a big screen TV and a shiney car farting machine, Robot should be happy???? Why aren't Robot happy???
Vanity and selfishness for the economy and Consumerism can only go so far, but maybe the psych chemicals will surpress the higher brain functions of intelligence and self reflection trying to get out. If they take the LEGAL drugs long enough, maybe there will be enough brain damage so they can never figure it out.

Personally, I've never understood why people accept multiple diagnoses and don't just fire their doctor (or in this case, nurse). Come on. Who can be diagnosed both schizophrenic and autistic (or whatever) with a co-existing something else? It makes no sense. What it does tell me is that the doctor hasn't a clue. His narrow medical training detects symptoms and prescribes drugs for those symptoms. Thinking isn't something that enters into multiple diagnoses.

I went to the doctor when I was 24 years old with 2 little kids and a mean alcoholic husband, I was understandably depressed. That led to a diagnosis of a "chemical imbalance" and an SSRI. That SSRI led to another diagnosis of "Attention Deficit Disorder" (today, it probably would have been a diagnosis of OCD, I couldn’t stop organizing my shoes and cleaning walls, etc.) and another med, which led to agitation, insomnia and the diagnosis of "some type of bipolar" and a third med. Just before starting to taper off (beginning 2008), I was on a cocktail of 4 meds (Cymbalta, Lamictal, Vyvanse and Lithium)…

I wanted to get off meds several times over the years, but knowing about withdrawal (from switching meds and no refills at times) I was going to wait until my kids were out of the house. I ended up not being able to wait because everything just kept getting worse. My mind and body were deteriorating.

I went to the same psychiatrist every 3 months for 8 of those 13 years on drugs. I trusted her and it nearly killed me. It most definitely ruined my life.

I see this this kind of sad story every day. Once you get on the psychiatric roller coaster and start buying into that world view its hard to get off and people do not like to be told their suffering is not illness. All of a sudden every emotional symptom becomes diagnostic of a disorder and in need of TX. I am irritable and have insomnia. I must be BAD mixed. What a crock of shit. I maintain and always will the vast majority of people would be better of if they had NEVER come in contact with ANY type of mental health practitioner and picked up a copy of The Meditations by Marcus Aurelius or some Sartre. Ugh...

I think this is exactly what happened to me. I went on Prozac in Nov.2008, 10mg. Upped to 20 in Jan 09 and then upped to 40 in May 09 after a failed (and rather half-hearted) suicide attempt. The 40 mg made me manic. Dr. wanted to tell me I was bp and put me on something else. OVER THE PHONE, he diagnosed me as pb (this was my family Dr.). I got made hung up on him and have never gone back. I also cold-turkeyed off the prozac. That was back in Sept. It was hell but I'm finally starting to feel more 'normal', whatever the he** that may be.
I went on the Prozac (generic,prozac is faster to type than fluoxitine)because I couldn't sleep,couldn't eat and was crying all the time. I have 2 boys in college, one still in high school, a husband who (at the time) was laid off from work and I had tried to go back to college. Depressed? Um. No. Stressed to the breaking point and exhausted.

I'm one of those people -- diagnosed unipolar depression for years, then suddenly given the bipolar 2 label without clearly remembering or reporting a classicly hypomanic episode. But what interests me is that the new drugs I was given -- Abilify and Lamictal instead of Effexor or Paxil -- work so much better for my depression. It may be the cart leading the horse, but I'm more inclined to believe, after one year on Abilify and Lamictal, that I actually do fall somewhere on the bipolar spectrum, simply because the drugs associated with that diagnosis work so well for me.

Philip,

Here is an article [in part] that gives the stats that 1% of the population in the U.S. was bipolar in 1994. Eleven years later, 2.6% were bipolar. So this jumps from 1 in 100 people being diagnosed as bipolar to 1 in approximately 38 people. This is a tremendous jump in just 11 years and I firmly believe it is tied to the massive increase in the number of people taking antidepressants. Here is the story:

http://www.ssristories.com/show.php?item=1319

Second sentence of second paragraph reads: "Without the need for an episode of hospitalization for mania, estimates of the prevalence of bipolar disorder have increased significantly from 1% in 1994, to 2.6% in 2005."

http ://www.pharmaceutical-business-review.com/article_feature.asp?guid=7C5EF4E7-F53F-41C3-BD5A-E637D0211BFD

New hope for manic-depression sufferers comes from unlikely source
21st November 2006
By PBR Staff Writer

Mental health therapy is supposed to be short term, not a management technique. If you are seeing a therapist and your life isn't getting better, i.e. you find yourself having to live in the same house with an ex boyfriend and having such severe problems that you keep getting diagnosed with more serious psych problems, perhaps the therapy is a big waste of money. The same of course with the meds. If you get worse taking meds, stop taking meds. It's getting lost in the mental health trap that causes these problems. If you are in an unhappy living situation, being unhappy is a normal response.

I once watched a fellow patient go right down the toilet with lithium toxicity. She was unable to walk or get out of bed, nearly died. While three or four bright-light psychiatrists (including a Nationally Famous Doctor) stood around, scratching their heads and wondering whatever was wrong with her. They finally figured it out.

I learned very, very quickly to NEVER admit to any periods of increased activity because the instant response was a push for lithium. No effort was made to figure out if perhaps I was actually experiencing a period of *normal* activity. How would I know? I'd been depressed for years, got little or no help from all their meds. But once or twice a year the clouds would clear for a day or two and I actually was able to get some housework done. I was damned if I was going to let anyone take that away. And I was damned if I was going to take any lithium after what I'd seen.

Paxil and Effexor together? For ten years? Oh my! Tell her to start a cross-over to Prozac and then taper super slowly for a year or more -- maybe two. She could probably keep her job if she went slowly enough and she might start feeling a lot better on Prozac. Stay off the other crap. Healy has a withdrawal protocol somewhere on the web that's not bad. Also letting nurse practitioners dictate what you take is a bad idea. I know of one that meant to start someone on 40 mg of Prozac and prescribed 140 mg by mistake. The patient didn't die but her personality was severely altered before the mistake was even discovered and her marriage went down the tubes. Anyway -- I'm not a clinician and yeah, I'm kind of joking with my advice because what do I know about your friend? But seriously it's pretty obvious that a lot of us "lay people" know a heck of a lot more than the creeps out there who have the power to prescribe this stuff.

You raise an important issue, Philip. My own Bipolar I diagnosis was the result of my reaction to antidepressants. The psychiatrist negligently claimed treatment had "unmasked" my "underlying" bipolar disorder. While that may be a possibility, it's just as (or more) likely that the ADs *caused* it. They'll never blame the drugs, though. It's always the patient's fault.

I didn't know antidepressants affect women differently than men. Where did your friend get that information?

I'm a woman, too, and I was on an antidepressant (Lexapro) for 3 years and it was absolutely the worst thing that ever happened to me. I think it's possible that some people need medication, but they give them to everyone, and then they keep you on them.

When I'd complain to the nurse practitioner and therapist who prescribed my medication about side effects (lethargy, apathy, constant exhaustion,) they would try to increase my dose. In the end, I was a drugged-up zombie.

When I first came off the pills, I realized that I'd ruined my career because I was too tired to work, and too muddled to do anything effectively. I had also become a very unpleasant person. My life was in ruins.

However, 2 years after that, I'm doing a lot better. My personal circumstances couldn't have been worse when I first stopped taking pills, but I got myself back, and that has been a huge gift. I am working effectively now, and happy with it, although my coworkers still don't trust me sometimes (who can blame them after my erratic behavior for those 3 years?) I have a great boyfriend, and I'm financially secure and saving money (for some reason I couldn't handle money well on the drug, which is not like me at all!)

Giving people who don't have a biological disease or "chemical imbalance" a drug is just wrong, in my opinion. The really interesting thing is that the drug actually induced a chemical imbalance in my brain, and I now maybe have some insight about how it must feel to have such a condition. I remember how it felt to not be able to get out of bed in the morning or do much of anything. It was an interesting experience in some ways, but really painful.

I don't know what percentage of psychiatric have a real brain disorder, as opposed to normal life problems that a pill won't fix, but my heart goes out to them if their reality is anything like mine was when I was on that drug.

Phil, Tell your friend to be very careful of the dreadful lithium. I, too, was misdiagnosed & hospitalized & given high doses of lithium. I reached a toxic level and almost died - vomiting, tremors, a seizure and was re-hospitalized. And then they wanted me to go back on lithium. I didn't think so and have functionned fairly well since that terrible event, 23 years ago. It is very very dangerous! The salt can stay in your muscles for years and cause continuing problems.

there is a blood test for lithium level. it can be done almost anywhere.
http://www.integrativepsychiatry.net/lithium_level_blood_test.html

$35. You can pay for it out of your own pocket. Levels are broadly available on the internet, plus the test may come back with a qualitative ("low" "OK" "High") label as well as numerical label.

Why monitor? because there is not much "room" beyond the normal dose range to the "toxic" range, when Li harms your LIVER.

Lithium, at NORMAL therapeutic doses for bipolar (at 600 mg and up) must ALWAYS be REGULARLY monitored. The ONLY time it might NOT be is if dosed LOWER than 600 mg /day if used to "augment" another psych med.

Individual metabolism affects this dosing. Fluid and salt intake affect this dosing. Sweating affects this dosing. Etc.

The side efefcts are CLASSIC, and easily indicate a dose that is going from the top of the "therapeutic window" to the "dangerous" range.

Therefore, the NP SHOULD have regularly ordered blood levels as the dose was titrated, AND if this info does NOT exist, this is an easy law suit -- if dosage was at 600mg or greater.

Check with any psychiatrist. All of this is overly well-known. Why? Because Li is so dangerous, and so variable in people. Lawsuit for malpractice would be easy: either the lithium levels have been done, and exist, or not. Either way, this NP is a dangerous person running the streets.

One more thing -- and it's not fun to bring this up -- but if this woman has any thoughts at all about ever having children she needs to get cracking to get herself off Paxil and Effexor. Paxil and Effexor are increasingly being linked with birth defects especially when taken at high doses. All the SSRIs are implicated but these two are the most notorious. Check out this site: http://www.antidepressantbirthdefects.com/ For years I have been saying women of child bearing age shouldn't really be put on these drugs and certainly shouldn't be left on them. It's all so ugly and we wonder why our health care system is broken. You're looking at it right here with this seemingly innocuous story.

It's pretty clear to me that a lot of those diagnoses are bull... the older tricyclics caused mania too... but only in 1% of cases, vs. the 4% that SSRIs and SNRIs cause it... or are we to believe that drug-induced Bipolar just randomly ballooned 4 times?

I had a similar situation but got the BP2 dx after a much shorter time (because I presented with simultaneous anxiety and depression, which USED to be called "agitated depression," --a state not a trait -- and because I responded with akathisia and disinhibition to several antidepressants).

I felt at the time it was a crock and after finding more thoughtful dr's. I'm now off all drugs and doing fine. In the meantime, I've been following the BP2 story and believe me, it's still controversial. I'm fairly convinced it represents a case of disease mongering to rationalize more scrips for atypical antipsychotics and such.

I wish your friend would listen to you, if only to get a second opinion. Taking LOWER, not higher doses of drugs --and eventually tapering off altogether -- was what worked for me (and many others, I'm sure).

Sorry can't let go of this even though it's happening all the time to hundreds and hundreds of people. My theory on what this woman was experiencing -- tolerance and withdrawal. Paxil and Effexor both have very short half lives. Her agitation (compounded by stress) was caused by the drugs wearing off before the next dose and she was experiencing mini-withdrawal -- tell that to the nurse practitioner!! If she switches to Prozac she'll feel better because it has a longer half life (longest of the SSRIs). As for the diagnoses -- once you start taking psych drugs diagnoses are meaningless as far as I'm concerned if they ever meant anything in the first place.

And by the way you can also tell exactly when someone was "diagnosed" by the cocktail they are on -- ten years ago Paxil and Effexor. A few years ago Lamictal and something. Now it's Cymbalta -- or maybe Lexapro -- and Abilify and Seroquel. That says a lot about the "accuracy" of the diagnosis doesn't it? Can you tell I'm angry?! This story brings it all out.

In my first comment on this posting, I noted that the stats show an increase of 4.8 million people being diagnosed as bipolar between 1994 & 2005. I bet the increase is a lot more now, four years later. Heck, even the novels I read have people being diagnosed with "bipolar".

And what about the people who become psychotic and manic on the antidepressants and then do something horrible. This woman killed her 11 year old daughter and, according to additional stories, this child was the 'love of her life'.

Even the doctors agreed that this woman would never have killed her daughter if she had not been given Prozac. The jury gave the woman probation!

http://www.ssristories.com/show.php?item=1153

Paragraph 14 reads: "Higgins said Pinckard's doctors believe the Prozac she was taking before the shooting caused her behavior; it acted as a catalyst for a hidden bipolar condition".

Last paragraph reads: "Higgins said Pinckard's psychiatrists testified that if she had not taken Prozac, her condition may never have manifested itself.

http://www.thetowntalk.com/html/1B1F2639-6036-415A-AC2E-53C8CE2976AB.shtml

Woman who killed daughter released on probation
Julia Robb
Posted on July 11, 2003
File Photo
Paula Pinckard: had been "the all-American housewife," attorney says.
COLFAX -- In March 2000, Paula Pinckard shot her 11-year-old daughter Aubrey to death before shooting herself in their Rock Hill home.

Receiving the wrong medication can have dire consequences. In this case [I heard this from someone close to the case], the woman was given an antidepressant instead of an antipsychotic but it was actually the pharmacists fault. The two drugs had similar sounding names and the pharmacist probably couldn't read the physician's hand writing.

http://www.ssristories.com/show.php?item=192

The fifth & sixth paragraphs read: "Baumgartner, 41, a nurse, confessed to killing Germantown resident Daniel Morgan, whose body was found in his apartment April 9 last year with more than 100 stab wounds. They had met several days earlier at a music store."

"Doctors say she has been treated for a variety of mental illnesses, including schizo affective disorder, and that she was given the wrong medicine - an anti-depressant instead of an anti-psychotic - three months before the stabbing."

http://www.gomemphis.com/mca/local_news/article/0,1426,MCA_437_1430581,00. html

Judge to review ruling freeing killer
Waived holding woman for mental tests
By Lawrence Buser
buser@gomemphis.com
September 21, 2002
A judge said Friday he will reconsider his recent controversial decision to waive the mandatory commitment of a woman he found not guilty of first-degree murder by reason of insanity

This is exactly what happened to me. I was put on antidepressants when I was 15. I never tolerated them well - lots of side effects, no benefits - and was shuffled from one to the other. This happened with NO TAPERING. After coming off Welbutrin I started manifesting severe panic, which was medicated with Xanax. Eventually I was put on Effexor (pure HELL to come off of that one), and then because of my new hypomania and continued panic was DXd as Bipolar 2 and put on Depakote. With Depakote I gained over 50 lbs (and was still gaining) and did not have manias, but still had panic, anxiety, and depresions again. I was switched to Lamictal about 3 years later. I still had panic and anxiety, though not as often, and while I then had no depressions, I was constantly fighting hypomania. I was prescribed Respirdal for that after 3 years of that battle.

Eventually my life held no joy, no passion, and I still battled panic, anxiety, and hypomanias, and now the depressions were back as well. I went off the Respirdal. The hypomanias continued, and so the doc wanted me to go on Seroquel. I told him I believed by bipolar was caused by the antidepressants I was given as a teenager. He gave me the line that the drugs helped my bipolar to express itself so it could be treated, but that the Lamictal could be contributing to the hypomanias.

I walked out of there and just started tapering slowly, and started seeing a Naturopath for holistic support. When I got down to half my dosage of Lamictal it was like a fog lifted. I haven't had panic, depression, or hypomania since that point. I feel better than I have in over 12 years!!!!! It's been 7 months, and I am now down to about 20mg of Lamictal, and I continue to taper slowly. I can't wait to be off! The withdrawals are very difficult, but after each one I feel better than I did before.

I am FURIOUS that the past 11 years of my life - MY ENTIRE 20's - were spent battling symptoms CAUSED by meds given to me when I was a young teen (what teen ISN'T depressed???). I am so glad that this information is finally being made available!

I'm sorry about your friend. To me, she sounds just too naive and trusting. She also sounds like a normal, resourceful and productive person, who will eventually figure things out on her own.

I can only hope that as more and more people like your friend encounter mental health professionals, they'll see what a big, smoldering pile of pooh psychiatry really is.

I have to chime in one more time (I feel very passionate about this issue)! Methinks that if all these "secretly" bipolar people had never gone on ADs, their alleged bipolarity would have stayed hidden and they'd be better off today.

I find it very odd that these days any agitation or anxiety is viewed as a sign of mania, vs. part of the human experience when undergoing stress and suffering. I also happen to be an energetic person and fast talker, which also seems to raise suspicion in psychiatrists. I don't think that's illness. To paraphrase Breggin, it's passion and life-force.

I do believe BP and mania exist but the criteria to qualify as such are getting looser all the time. What the frick is up with that???

"I think it illustrates another element of the anti-depressant trap in America. Instead of long-term anti-depressant use leading to health problems and physical dependence (or addiction, if you prefer), it's now leading to people being re-diagnosed with another disorder." (emphasis mine)

Philip,
Not only in America. The psychiatrist that I see, although I told him my story many times... I will spare the details, he will surely diagnose me as bipolar.

The word bipolar is being used to explain daily moods swing that all human beings experience. If you get lazy after lunch because you ate and after one hour you get more excited: "I'm amazed how bipolar I am."

Your friend should not wait to take the antidepressant. The more you wait the more difficult.

I'm appalled. Things are getting worse.

It's getting worse and worse.
I don't know what to think about all these bunch of criminals... oops I know what to think...
They are criminals.

Hey, Mr. Psychiatrist!
WILL YOU REMAIN SILENT?

You are also being criminal.
I am not part of any anti psychiatry movement. I am just amazed that too few psychiatrists have the guts to say the truth.
After all psychiatrists has witnessed in their clinical experience keep prescribing these drugs for people like your friend is criminal.
That's the way I see it.

it's very telling to read these comments, mostly from WOMEN. Women get medicated for having emotions and I am just sick of it.

At the psych ward i see women given injections because they are crying, any emotion is snuffed down, and the fact that women are even being given prozac and crap for menopause really should be eye opening.

Abilify/BMS targeted women in their DTC ads, remember the photograph of the phone booth in Seattle I took?

I came out of my "so-called bp2 dx" when I kicked my ex out of the house and started looking at my life from that point of view.

Life is crappy, it can be horrible and drugs don't cure grief or help move it forward.

Women, take control of it, and feel your feelings, crying doesn't have side effects, take action of some sort and also, if there are things you can't change, learn to somehow cope with it.

There is a pattern here I hope ppl are paying attention to, it's the drugging of women and mothers and their children, hell it practically feels like an evil conspiracy!

PS--Sara, yes this is upsetting, I understand where you are coming from, most ppl here do, so keep commenting, it's all we can do, is keep talking about it, painful as this is.

Danielle: "He gave me the line that the drugs helped my bipolar to express itself so it could be treated, but that the Lamictal could be contributing to the hypomanias."

Wow, that's quite a line. I understand why you are furious. Your story is truly tragic.

For me, going off the medication and having my head clear is a big gift. I definitely feel anger about the lost time and opportunities (which don't compare at all to what you lost.) I also feel like I'm lucky to be free, and this experience has made me want to fix myself rather than expect psychiatry to take care of me. Leaving psychiatrists alone has really enabled me to change my life myself. Plus, I can share my experience and hopefully warn others about the danger of these drugs, and that is worth something to me.

I feel that doctors need to be very careful with these medications, but they seem not to be. Psychiatrists give them out like they are candy or aspirin, but they are quite dangerous!

Bad medicine practiced by clueless practitioners.

These same experiences and results told over and over again by those that know them best; suffering patients turned into labeled victims.

Who is really listening? not our FDA, not our government representatives, not our judicial bodies, not those key medical opinion leaders, and definitely not the pharmaceutical industry.

They all have a huge stake vested in this cash "COW" that is not only ingrained and institutionalized beyond reasonable repair; but they will continue to milk this cash "COW" until either the "COW" runs dry or falls over dead.

(I must wonder aloud, how many lives will be destroyed before the COWS revolt and take back the farm?)

I can help but believe if today main stream psychiatry read all these horrific experiences shared here; they would somehow still find a way to blame your disease: and say prescribing more pills was the only rational option.

This is just the cold hard facts of a horrible cult masking itself as medicine gone completely stark raving mad.

It's a good bet that psychiatry and Pharma will destroy medicine; before medicine wakes up to the fact that they have been sucked into an endless vortex of greed and corruption.

After all; it is about the MONEY

I suspect your friend's doctor may be in malpractice range by prescribing both Paxil and Effexor together. Here is what RX list (the closest thing online to the PDR as I understand it) says about the risk of a fatal syndrome while combining Effexor with other SSRIs:

http://www.rxlist.com/effexor-drug.htm#

Serotonin Syndrome

The development of a potentially life-threatening serotonin syndrome may occur with Effexor treatment, particularly with concomitant use of serotonergic drugs (including SSRIs, SNRIs and triptans) and with drugs that impair metabolism of serotonin (including MAOIs). Serotonin syndrome symptoms may include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination) and/or gastrointestinal symptoms (e.g., nausea, vomiting diarrhea)

"...the NP SHOULD have regularly ordered blood levels as the dose was titrated, AND if this info does NOT exist, this is an easy law suit -- if dosage was at 600mg or greater.

Check with any psychiatrist. All of this is overly well-known. Why? Because Li is so dangerous, and so variable in people. Lawsuit for malpractice would be easy: either the lithium levels have been done, and exist, or not. Either way, this NP is a dangerous person running the streets".

HAHAHA!!! EASY Lawsuit!!! Oh how I wish you were a lawyer! My PSYCHIATRIST prescribed Lithium to myself and my son on the same day (during MY appointment). There was no mention of needing bloodwork until my son's next visit when he was exhibiting signs of toxicity. Then I was told to have HIS Lithium and Thyroid checked (it was mentioned casually in the hallway as we were walking out because our time was up).
That evening he woke up with severe stomach pains, threw up all over the kitchen, blacked out and fell face first on the kitchen floor, resulting in a f***** up scar on his lip.

A constant reminder that mom made him take drugs and ruined years of his life.

Do you know any lawyers for this EASY lawsuit in Northern VA? I searched for 2 years, couldn't find any takers (medical records, showing NO tests in hand and other evidence of malpractice)

I am not sure about all the ways antidepressants affect women but for me long after I had an ovary out I looked up the official prescribing of effexor and found one side effect is cysts on the ovaries.
Excessive vaginal bleeding was my symptom which even after the ovary was taken the stayed the same. I was put on a hemophiliac drug to slow the bleeding I was anemic as a result. I have not looked up the side effects of the bleeding drug and am off all meds but it can easily say antidrepressants ruined my life.
Like many others and many more to come. Sad situation wish there was something we could do about it.

Sara: Ha! The docs are too busy prescribing to read up on the drugs!

I have a lot of respect for my current doctor; however i still have to check on some of the things he says, for example that Paxil is safe in pregnancy or that it might have caused my seizure last summer. (Personally i haven't dismissed that possibility, based on how wonky i felt while on a high dose of Paxil. But i haven't found any evidence linking Paxil with seizures, so i would expect a doctor to be skeptical of that idea.)

I think doctors may be getting better about warning people of the withdrawal effects of Paxil. No one told me back in 1998. I found it out for myself and diagnosed it in a friend. I had a very quick metabolism when i was working (I had an active job and was constantly eating) and would get withdrawals DAILY... I tinkered with my dosing schedule to minimize that. Now i'm on the controlled-release version. (But hopefully not for too much longer! =)

Sherry and Ana: I totally agree, it seems that a lot of people think cyclic equals bipolar. (That is, i've talked with friends who say, "So-and-so thinks he might be bipolar," and they describe So-and-so's symptoms and it sounds to me like periods of worsening and remitting depression.) Then they emphasize the cyclic nature of their moods to the shrink, the shrink prescribes a mood stabilizer... and you've got the potential for an out-of-control spiral.

Have i ever mentioned that one shrink used my premenstrual anxiety as a justification for his diagnosis of bipolar? Um, hello! Not only is my little premenstrual twinge NOT pathological, but even if it was, it'd be PMDD not bipolar! He got mad when i pointed that out, like, "Your freshman psychology class cannot compare to my years of clinical experience." Well, dumbass, don't make a freshman psychology mistake then.

noone: As i'm sure you already know, not sleeping well can also be a sign of depression, which often correlates with anxiety. It depends on the person, but oftentimes i think the observations of a friend (one who is educated about mental illness and without too much bias) can be as valuable, and maybe more so, as those of a doctor who only sees the patient sporadically and in a clinical setting. At least, in my experience, my boyfriend is often the best judge of whether i seem "off".

I stay too busy to come into these sites often but when someone sent this to me I was appauled to learn there is still SO LITTLE understanding about these deadly meds!!! Antidepressants are the biggest CAUSE of Bipolar on the planet!! Thus my DVD entitled "Bipolar, Shymypolar! Are you really Bipolar or misdiagnosed due to the use of or abrupt discontinuation of an antidepressant?"

Bipolar/mania is a continous series of mild seizures (which is why the big thing now is to give anti-seizure meds). Seizures are an overstimulation of the brain.

ANTI-depressants (the opposite of a depressant is ?) are STIMULANTS. The are uppers. They overstimulate the brain and cause seizue activity and you go into mania/hypomania.

A shock to the system is a great way to trigger seizure activity. Going off an antidepressant too rapidly or SWITCHING FROM ONE ANTIDEPRESSANT TO ANOTHER OFTEN CAUSES MANIA - DO NOT DO IT!!!!!! You are ALMOST ALWAYS better off coming down slowly from the meds you are on than you are switching!! There is NOTHING magical or better about switching to another antidepressant to withdraw. Right now my CD on withdrawing and rebuilding is a free download when you get a copy of my book Prozac: Panacea or Pandora? Our Serotonin Nightmare which is the best reference I know of on antidepressants and their effects. (I am not trying to be boastful, just stating what readers have told me for years.)

And just for everyone's information Neurontin is a very deadly drug as well.

I will find a letter off our site from a woman diagnosed with all of these different disorders after being given an antidepressant and post it here for you to read. See got rid off all of those mental disorders by slowly withdrawing from her meds.

Dr. Ann Blake Tracy, Executive Director,
International Coalition for Drug Awareness
www.drugawareness.org & www.ssristories.com

Leslie Judd’s Story:

My name is Leslie Judd and I appreciate the opportunity to tell you my story. I recently had a major life change which came about because of information that was passed on to me by Young Living Essential Oils.

Eleven years ago, I experienced some serious depression which I now recognize was most likely post-partum depression, since it began following the birth of my third child. The condition was serious enough to cause me to be unable to function normally. After a visit to the doctor, I came home with a prescription for Prozac, and this was the beginning of a ten-year nightmare.

Within the first few days, I began having hallucinations and hearing voices, but had no relief from the depression. At my next appointment, the doctor prescribed Paxil and Trazodone. Temporarily, it seemed to help with the depression, but I was a zombie all of the time. I felt like I had a hangover every morning.

With Paxil and all of the anti-depressants I took from then on, I had what is called a withdrawal or “wear-off” effect, which means that my body soon adjusted to the new dosage and then I would need a higher dosage. Symptoms of this effect were electrical sensations throughout my body, shudders and whoosh sound with every move. Also, a trailing feeling when I moved or turned my head. This increased until the doctor would change my medication and I would begin the cycle again. I began fluctuating between depression and hypomania.

The therapist I started seeing referred me to a psychiatrist, who put me on a fairly low dose of Zoloft. My initial diagnosis was Major Depressive Disorder, but soon became Dysthymia, or severe mood disorder. After trying different antidepressants, like Effexor, Serzone (now off the market due to the fact that it causes liver failure) and Wellbutrin, all of which gave only temporary relief, she decided to try lithium because my symptoms had become like that of a bipolar patient. So now the diagnosis had become Bipolar II Disorder.

Next, the doctor decided to experiment with different types of drugs such as anti-seizure medications (such as Topamax, Depakote, Lamictal and Neurotin) and anti-psychotics (such as Risperdal, Sroquel, and Zyprexa), which caused me to have a multitude of other side-effects such as tremors, visual disturbances, anxiety and nervous problems for which I was prescribed benzodiazepines. Guess what? I became even more depressed and I was more ill than I had ever been before in my life.

The inherent back problem I have had since I was a teenager was now getting worse. The medications decreased my pain tolerance. I developed fibromyalgia. I became obsessed with illness and with pain. I gained an excessive amount of weight. I also began behaving impulsively, lost interest in relationships and developed social phobias such as agoraphobia (fear of public places, not wanting to leave home). I would panic in crowds, break out in a sweat, and collapse in terror.

I could not feel joy or affection, and didn’t want anyone to touch me. I became obsessed with death. Sometimes, I cried uncontrollably without knowing why. I felt like I was a burden to everybody. I spoke with slurred speech, couldn’t find words and had loss of memory. The tremors became so severe that I could no longer write a check or sign my name. This only led to more anti-social behavior and self isolation.

Every month when I went to my doctor, my medication and dosage were changed. There was a point during the ten years that I realized the medication was making me sick, especially when I got lithium toxicity. My body was holding on to all fluid, I was bloated beyond recognition, my pupils were dilated (one more than the other), I started to get panicky and I had constant nausea and severe headaches along with other symptoms which alarmed my husband, and he called my doctor, who told me to stop taking the medication immediately.

This stopped the toxicity from progressing, but the immediate withdrawal caused me to crash into an even deeper depression. More medication, without relief. More suicidal ideation. Alcohol binges.

When I was released and came home, I was worse than ever. I was having hallucinations. I shook uncontrollably, which was actually a side effect of anti-seizure medications, and I had to move my legs constantly. My eyes were dead and I had absolutely no energy and no desire to do anything. I felt empty. My family rallied to get me back on my feet and friends brought dinner to help out. It was as if I was seeing things from outside of my body, but I actually remember very little from this time period.

An attempted suicide made for my second hospital stay, where I was humiliated in front of other patients by psychiatric techs, after which I made another attempt to end my life while I was still in the hospital. To get out of the hospital, I lied by telling them I felt better. Eight days later, I went home on new drugs.

After two weeks at home, I was back in the hospital for another eight days. I was so out of it. I felt like I was in a vacuum. I did things contrary to my nature, not even thinking of the consequences. Nothing mattered. On leaving the hospital following my third stay, I was told that my diagnosis was Bipolar II, Panic and Anxiety Disorder, PRSD (post-traumatic stress disorder), and Borderline Personality Disorder with psychotic episodes. It seemed that I would just get worse and never be well again.

Back home, my family searched for answers. Our good friends, Brian and Barb Kuckuck, went to a Young Living convention in California and returned with help — an audio tape and a book by Dr. Ann Blake Tracy.

The tape opened our eyes to the destruction that these drugs can cause in people’s lives. Today, I know that I have a disposition towards depression, but I am not bipolar. I am not psychotic and I do not have a borderline personality disorder. My mental and physical disorders were caused primarily by the medication I was given by my doctors. I lost ten years of my life.

I followed Dr. Tracy’s guidelines for tapering off of the medication and I have been using the Cortistop and other YL supplements as well as essential oils, particularly Valor, Clarity and Peace and Calming, without which I know it would have been much more difficult to break free from the drugs. The weaning process can last up to two years, but it is worth it.

Today, I have been completely free of my medications for five months. Although I still have some residual side effects, I am living my life again and enjoying it. I thank Young Living and Dr. Ann Blake Tracy for making me aware, I thank my husband and children for their untiring love and patience, thanks to my family for their persistence and love in searching for something to help. I appreciate my friends, who were there for me even though I didn’t know it and I especially thank my faith for giving me the strength and courage to succeed.

For more information on the essential oils discussed here, see Dr. Tracy’s book, Prozac, Panacea or Pandora? – Our Serotonin Nightmare and her tape or CD entitled, “Help! I Can’t Get Off My Antidepressant” (www.drugawareness.org).

1. Lithium augmentation of SSRIs/etc. in depression is a good idea; see
http://www.psycheducation.org/PCP/programs/LithiumPrimer.htm

2. Lithium at low doses is a good idea for everyone. It is a great brain nutrient and protector.

3. Lithium at high (old-style "therapeutic") levels is generally a bad idea.

"Great brain nutrient and protector"?!! I'd like to see the hard evidence for that. I didn't see it on the link you cited.

Yeah, there's lots of places that SAY that about Lithium. Having read scientific papers on the topic, I don't believe it. I believe it's a lot more likely that lithium is changing the fluid content of the brain (as it does in the body as well)... which makes the brain volume APPEAR increased. See Grace Jackson, MD, "Drug-Induced Dementia: A Perfect Crime"

Who ever said that increasing the brain volume is actually good for the brain anyway under all circumstances? It depends how and why the volume is being increased. Strokes can increase brain volume. Neurons can go wild when being attacked with poison -- that kind of growth is not necessarily good. Thanks Kimbriel for explaining where that hokey idea about being a "nutrient" comes from.

Sara would it surprise you that is what CABF pimps over there? Li is a brain protector, not kidding.

Just another fine example of the 4000% increase of bipolar, the use of anti depressants and the pimped up "facts" about Lithium brought to you by your friendly Joseph Biederman Gang:

http://www.bpkids.org/site/PageServer?pagename=lrn_004

Childhood Adolescent Bipolar Foundation

Interview with Husseini, Manji M.D.

Husseini, Manji M.D. is Chief of the Laboratory of Molecular Pathophysiology at the National Institute of Mental Health (NIMH). He was born in Kenya and moved to Vancouver as a teenager. In 2002, Dr. Manji joined the Professional Advisory Council of CABF, and often answers science questions from our members. Dr. Manji edits several journals and has received numerous prestigious awards.

CABF: Speaking of lithium, your research has uncovered some of its intriguing beneficial properties. Can you highlight the most important ones?

MANJI: Many of the genes that are considered neuroprotective are being remarkably turned on by lithium. Is lithium actually neuroprotective? We hadn't thought this way before. A number of studies have taken animal cells and tried to kill them by causing stroke, etc. These studies have consistently shown that lithium, if administered before you try to do the bad things (such as induce a stroke), protects the animal's neurons. In lithium-treated brains, the size of the resulting stroke is smaller, the number of neurons that die is lower, etc. That was amazing. Since these studies were done in rats, you need to be careful about jumping to conclusions that lithium is neuroprotective in people. Wayne Drevets' group published a finding in Nature about five years ago that in a part of the pre-frontal cortex of bipolar patients or patients with familial recurring unipolar depression, there was almost a 40% reduction in the amount of gray matter. That was a remarkable finding that you have such a reduction in a discrete part of brain. We spoke to him about our lithium findings and asked him to reanalyze the data. He had a small group of patients who had been treated with lithium for a long time and they did not show the brain atrophy compared with the bipolar patients. Interestingly all of the patients with unipolar depression, whether or not they had been treated with antidepressants, still showed the atrophy. That was a suggestion that bipolar treatments might have a protective effect. Valproate (Depakote) in the prefrontal cortex seemed to have the same type of neuroprotective properties. Lithium and depakote do not have identical effects in every brain area, but in this area they did. Brains treated with chronic lithium or valproate seemed not to have the atrophy in the prefrontal cortex. But it was a very small sample and a crossectional study [type of study whose design restricts its findings to association between variables, not proof of cause]. He studied them once. We don't know if it was a cause or effect. Is it the people who don't have the atrophy who responded to the drug in the first place? We We did some studies taking bipolar patients off their meds -- they were referred to us because their treatments weren't working. In every case, they either hadn't been on lithium or had been on lithium sparingly -- had started on it, had side effects, switched, and the new med was not working. These are bipolar depressed patients. We did MRI scans and MRS spectroscopy and then put them on lithium in a blinded fashion for 4-6 weeks. Then we did the scans again. We found that almost every single person taking lithium had an increase in N-acetylaspartic acid (NAA) [an amino acid that is viewed as a marker of neuronal health]. And the actual amount of gray matter was going up when they were treated chronically with lithium. This study was done together with Dr. Greg Moore¹. This was happening in areas of the patients' brains that had been atrophied. The increase was not due to swelling from water retention. The increase was seen only in areas where the brain matter had previously atrophied.

Our working hypothesis, and I think it is reasonable, is that lithium is turning on some of these growth signaling pathways and reversing the damage. It seems that the cells are shrunken, not dead, and are capable of going back to their normal sizes and sending normal projections. What lithium seems to be doing is turning on the signaling pathways that produce growth factors in the brain, such as brain-derived neurotrophic factor (BDNF), and where you have atrophy, turning on this pathway seems to be capable of reversing it."

More of the article

HERE at the Child and Adolescent Bipolar website.

That website is one of the most influential websites for parents of "bipolar children", and much of this research is mainstreamed into the hands of people/doctors/nurses by these "Key Opinion Leaders".

Sorry, can't help myself with this one:

"How Do Drugs Used to Treat Bipolar Disorder Work?"

Exactly how these medications work is not yet known.

"An analogy may be helpful. When antibiotics are given for "strep" throat, the white blood cell count goes down. If we did not know about "germs", we might be investigating how white blood cells cause "strep". Similarly, we know some of the actions of drugs but do not yet know precisely which, if any, of these actions are the ones related to recovery.

Lithium affects a number of systems in the body. Notably, it is very neuroprotective in animal models, possibly by working at intracellular signaling pathways, i.e., pathways involved in brain cell (neuronal) functioning. Neuroprotective means that animals given brain toxins have less damage to their brain cells if lithium is also given. In humans, there is some evidence from neuroimaging studies that lithium may also be neuroprotective as it may increase brain compounds that are associated with enhanced brain functioning. Lithium also acts on the serotonin system, which may account for its anti-depressive properties."

Barbara Geller, MD, Chair of the CABF Scientific Advisory Council and Professor of Psychiatry at Washington University School of Medicine at St. Louis, MO

With this much authority out there, why ask what the drugs do? hell they don't know how they work, they just know they need to be taken!!!!!

"'Great brain nutrient and protector'?!! I'd like to see the hard evidence for that."

There's tons. Google for it. I would post more but I am on a friend's computer; my stuff is not available to me at this moment.

Google: lithium alzheimer neuroprotection etc. etc.

Lithium was first given to guinea pigs (actual guinea pigs) and it made them lethargic. THAT'S the real magic bullet of lithium.

For those of you that choose to believe Lithium is neuroprotective, have fun destroying your kidneys and your thyroid...

here's a good easy-reading item:

http://findarticles.com/p/articles/mi_m0ISW/is_247-248/ai_113807015/
Lithium, part 1: protect and renew your brain
Townsend Letter for Doctors and Patients, Feb-March, 2004 by Jonathan V. Wright

http://findarticles.com/p/articles/mi_m0ISW/is_249/ai_114820666/
Lithium, part 2: other effects
Townsend Letter for Doctors and Patients, April, 2004 by Jonathan V. Wright

"Lithium was first given to guinea pigs...
and it made them lethargic."

Yeah, that sounds plausible. It is mildly
serotonergic and can mildly sedate. It was
added to the original "7-Up" soft drink for
its mild nervine, calmative property.

"For those of you that choose to believe Lithium is neuroprotective,"

It is not a matter of choice, friend. It is
a matter of well-documented FACT, demonstrated
many scores of times using different models,
different neurotoxins, etc. It is a non-specific
neuro-protectant and neuro-restorative, acting
among other things by increasing bcl-2 and BDNF,
by upregulating glutathione synthesis, and by a
number of other mechanisms. There is no
intellectually viable way to deny the neural
benefits of lithium. FYI.

"have fun destroying your kidneys and your thyroid..."

Low-dose lithium does not harm, much less
"destroy", ones kidneys or thyroid. If it did,
then everyone would have destroyed kidneys
and thyroids, since lithium occurs in ALL
cells of the body, and in almost all foods.0

....................

The things I just said are only the things
I just said. I did NOT just say that:
1. lithium can never hurt anyone
2. all bipolars, and everyone else, should
take lots of prescription drugs
3. all of psychiatry is great and wonderful
4. Big Pharma is great and wonderful
...... or whatever the hell else some paranoids
might imagine me to be saying.

....................

Why the anger and savagery at the mention
of beneficial actions of lithium? Is it that
lithium, and all favorable mention of it,
is of Satan the Devil?

CNS Neurosci Ther. 2009 Winter;15(4):333-44.

Potential mechanisms involved in the prevention of neurodegenerative diseases by lithium.

Camins A, Verdaguer E, Junyent F, Yeste-Velasco M, Pelegrí C, Vilaplana J, Pallás M.

Unitat de Farmacologia i Farmacognòsia Facultat de Farmàcia, Centros de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Institut de Biomedicina (IBUB). Universitat de Barcelona, Barcelona, Spain. camins@ub.edu

Lithium is a monovalent cation that was introduced in 1949 by John Cade for the treatment of bipolar disorder. Clinical reports and subsequent studies confirmed this application and the beneficial effects of this compound. However, over the last 15 years, various authors have also demonstrated the neuroprotective effects of lithium against several neurotoxic paradigms. Thus, experimental studies in neuronal cell cultures and animal models of Alzheimer disease and others pathologies have provided strong evidence for the potential benefits of lithium. The main mechanism underlying its neuroprotective effects is thought to be inhibition of glycogen synthase kinase-3 (GSK-3), although other biochemical pathways in the brain could also be affected. In this review, the main mechanisms of lithium action are summarized, including the modulation of glutamate receptors, effects on arachidonic acid metabolism, its role with respect to AKT, and other potential mechanisms. In addition, its effects on neuroprotective proteins such as Bcl-2 and p53 are also discussed. Although the cellular and molecular biological effects of lithium may constitute an effective therapeutic strategy for Alzheimer disease, further clinical and experimental studies with this drug and specific GSK-3 inhibitors are necessary to confirm the use of lithium in therapeutic approaches to neurodegenerative diseases.

PMID: 19889130

Oh, I'm not angry at the mention of Lithium. I did take Lithium once, for 3 weeks, and it made me shuffle my feet like an 80 year old, and also, it made me want to die. I know it was the Lithium because as soon as I got up to 900mg, I felt that way, even though I had never been suicidal before, and when I got off the Lithium, I felt instantly better.

I also know several people who were on Lithium long term and lost kidney function, either requiring dialysis or a transplant.

My own grandfather was on Lithium in the 50s but he died prematurely, and so did my husband's grandpa (also on Lithium).

I will never, ever believe it is "neuroprotective". Even if it APPEARS to protect neurons from toxicity... it sure as heck doesn't seem to promote brain FUNCTION and that is ultimately what matters in humans. But if you want to take it, knock your socks off.

"Although the cellular and molecular biological effects of lithium may constitute an effective therapeutic strategy for Alzheimer disease, further clinical and experimental studies with this drug and specific GSK-3 inhibitors are necessary to confirm the use of lithium in therapeutic approaches to neurodegenerative diseases."

So the science is "we think it might do what we says it does" -But- "we really need to do a whole bunch of testing and extensive study before we have anything definitive"

Why don't we just ask the "animal models of Alzheimer disease" to fill out a standardized questionnaire; so we can rap this up tomorrow and publish the findings on the CABF site.

Oh Yes, Lithium is a natural occurring element that in the course of a regular diet most will consume small trace amounts. This is far from a therapeutic dosage that is metabolized through the kidneys which over the course of time and/or at to high a blood level/saturation can cause serious damage including death.

Of course we also consume larger amounts of standard iodized table salt in most regular diets. Do to it's lighter properties, the table salt in absorbed into the body and the Lithium is excreted out through urine. It's Old trick non-med compliant Bipolar use to subvert forced medication.

Lithium is definitely not a panacea by any stretch of the imagination, or something that should be added to our daily supplemental dietary table for healthy living.

I was going to let this one go, but I just decided I would chime in.

In March of last year, I went to the doc because my lithium test came back with an abnormally high white blood count. Referred to an oncologist, who did his own blood work and then gave me a bone marrow biopsy. Two weeks later I was in the hospital for pneumonia- everyone thinks wbc was high because of that.

Flash forward to this year- lithium test in Jan shows wbc slightly higher than it was the previous year. Back to oncologist- who has me coming in every 3 months for separate blood work, and monitor me as wbc count goes higher and higher.

As of today, totally off lithium. And white blood count still going up, saw doctor about 2 weeks ago, and was told the news if it keeps up I will have full blown leukemia in about a year/year and a half. But definately by the next "big' birthday.

I have another bone marrow biopsy to look forward to in the new year, and know this won't be the worst thing that will ever happen to me- I think almost dying a year ago from one of those drugs will be worse- but it's just one more shitty thing after another made possible by the brave new world of psych drugs.

Don't knock the lithium, okay.

My sister has some kind of mental problem. Perhaps bipolar, perhaps personality disorder, but either way, it is a big problem.
Since being on low dose lithium she is so much more normal and functional. When she quits lithium, she retains functionality for awhile but within a few weeks or days she devolves into a bad place which only gets worse.

On lithium she is like herself but more normal, calm, even and rational.

Lithium, unlike many other psychiatric drugs, has few adverse effects and a whole host of benefits... assuming you don't blindly take 1200+ mg per day without monitoring or something stupid like that. Lithium, at a low dose (600mg or so) is calming, balancing, simultaneously stops agitation/impulsivity while lifting mood gently. I've taken it myself, and, if I had to be on an antimanic/antiaggressive I would want it to be lithium. Lithium makes you feel GOOD.

It has a bad reputation for side effects, though.
Irrationally.

Then there are idiots out there which insist brain problems don't exist. According to these idiots, the brain is the only organ in the body which is NOT subject to dysfunction. These idiots maintain that no one should be on psychiatric drugs. Or, if they are more reasonable, they argue that only severely insane people should take psych drugs (manics, psychotics).

These types of idiots wouldn't be happy with any pill, because ultimately it's some kind of ideological inability to accept that we are just animals and our brains are just organs and subject to dysfunction. And medicine can help people manage those dysfunctions. People who are antipsychiatry tend to have irrational religious-like beliefs about the human spirit and soul, none of which is objectively or scientifically valid. See, scientologists as an example.

There is a lot of grey area between taking SSRIs for "the mondays" and being a severe manic depression, but some people would like to pretend mental illness is binary. Either you ARE walking around in your underwear thinking you're jesus in times square, OR you are just a normal person who needs a hug. If only it were that simple.
Additionally some truly irrational people would like to pretend mental illness / brain disease doesn't exist at all; catatonics and schizophrenics are in a "spiritual emergency" or some other such bullshit. Much like that psychologist john breeding and various other quacks, mental illness doesn't exist (even when it so obviously does, go to a mental ward some time and tell me that).

I'm real tired of this.

Why can't we have a discussion about the "other side" of mental illness/drugs/psychiatry without attracting the quack brigade?

I also argue that all these miraculous recoveries when stopping drugs? Probably placebo effect. Change, hope, leads to a mood boost. It's the same placebo effect you see when people start ADs except in reverse.

If you were so normal and healthy you would have done that years ago. I just hope things don't get too bad; being isolated and without a doctor to help you is not a good place to be in. It really sucks when shit gets bad and you gotta wait a long time for help.

"I did take Lithium once, for 3 weeks, and it
made me shuffle my feet like an 80 year old,
and also, it made me want to die. I know it
was the Lithium because as soon as I got up
to 900mg, I felt that way, even though I had
never been suicidal before, and when I got
off the Lithium, I felt instantly better."

Sounds like lithium is bad for you.
And/or extremely high (900 mgs/day) DOSES
of lithium are bad for you. And/or higher
doses of lithium without proper nutritional
accompaniment are bad for you. Probably a
combination of the latter.

Sledgehammer doses (900 mgs/day, lithium carb)
should seldom or never be used, and are only
"necessary" if one is ignorant, incompetent,
or resistant to the idea of nutritional therapy,
which ALWAYS involves more than one nutrient.
The body and brain do not need only thiamine,
or only glutamine, or only zinc. They need
those and scores more, in appropriate proportion.

Giving humongous doses of lithium is like
showing up to renovate a house with only one
tool -- a hammer, say. With such a severe
limitation, it is going to be difficult, and
a good deal of damage is going to be done in
the process of achieving the goal. All you can
do, with the hammer alone, is beat longer and
harder on things; just as, with lithium ALONE,
all you can do is give more and more. It is
a ridiculously one-dimensional approach,
and it would be laughable were it not so
tragic. The lithium therapy boys never really
understood what they were doing. What they
were doing was practicing orthomolecular
therapy -- except with only ONE tool!
Ridiculous. And tragic, for the many that
have been hurt by high-dose lithium.

Lithium should ALWAYS be given in lower doses
with a full accompaniment of relevant nutrients,
especially omega-3 fatty acids, but also boron,
zinc, vitamin D, magnesium, taurine, and so forth.
Increasing the lithium dose into the range at
which kidney and thyroid damage become
possible should be only the reluctant LAST
RESORT, if there are no other options -- and
that would be a rare instance.

"I also know several people who were on
Lithium long term and lost kidney function,
either requiring dialysis or a transplant."

I don't doubt it. High-dose lithium has
serious dangers. Especially when given without
appropriate nutritional context -- particularly,
in this respect, omega-3 fatty acids, which
are nephroprotective. Omega-3 enrichment is
the rage in nephrology these days, for good
reason. The kidneys (like the brain) love
omega-3s. The progression of end-stage renal
disease can be retarded with these fatty acids.
My guess is that the development of kidney
disease to begin with would also be retarded.

"I will never, ever believe it is 'neuroprotective'. Even if it APPEARS to protect neurons from toxicity..."

You can believe whatever you want to believe,
and it seems that you WILL, no matter what!

"Appears"? Haha. Yes. And I APPEAR to be a man.
I APPEAR to speak English. I APPEAR to discuss
lithium.

"it sure as heck doesn't seem to promote brain FUNCTION"

Z'matter of fact, it DOES. It protects/enhances
cognition in the face of traumas and stress that
would otherwise degrade cognition. See abstract
below. This is in accord with what one might
expect, from the mass of experimental data on
neuroprotection and neurorestoration with lithium.
To be sure, the chemical and physiological or
structural changes by which neuroprotection is
measured do not necessarily or directly result
in cognitive enhancement or any other functional
outcome. There is no simple "this equals that"
kind of relationship. But those changes DO
represent desirable groundwork, at the chemical
and structural level, that predisposes to
desirable functional outcomes, and that actually
do result -- over populations -- in desirable
functional outcomes, as illustrated by the
abstract below. (By "over populations" I mean
effects averaged over groups of people. Not
every individual will have the given outcome,
but many will, such that the result is
significant over a population.)

Needless to say (?), the results in this
department would be markedly enhanced if
lithium were given -- again -- in an appropriate
nutritional context, including omega-3 fatty
acids (which themselves can enhance cognition),
taurine (a very nice neuroprotectant with effects
similar in some ways to lithium), and others.
The results would be improved, while the risk
of adverse effects would be diminished. The
dose of lithium required for the benefits could
almost certainly be lowered to the point where
adverse effects would be averted. But, I do not
expect conventional shrinks to understand this.
At least not for another 50 years or so.

...................................

Psychopharmacology (Berl). 2009 Jan;202(1-3):457-76. Epub 2008 Sep 10.

Lithium and cognitive enhancement: leave it or take it?

Tsaltas E, Kontis D, Boulougouris V, Papadimitriou GN.

Experimental Psychology Laboratory, Department of Psychiatry, Eginition Hospital, Athens University Medical School, 74 Vas. Sofias Avenue, 11528 Athens, Greece. tsaltasl@med.uoa.gr

Comment in:
* Psychopharmacology (Berl). 2009 Jul;205(1):169-70.

RATIONALE: Lithium is established as an effective treatment of acute mania, bipolar and unipolar depression and as prophylaxis against bipolar disorder. Accumulating evidence is also delineating a neuroprotective and neurotrophic role for lithium. However, its primary effects on cognitive functioning remain ambiguous. OBJECTIVES: The aim of this paper is to review and combine the relevant translational studies, focusing on the putative cognitive enhancement properties of lithium, specifically on learning, memory, and attention. DISCUSSION: These properties are also discussed in reference to research demonstrating a protective action of lithium against cognitive deficits induced by various challenges to the nervous system, such as stress, trauma, neurodegenerative disorders, and psychiatric disorders. CONCLUSIONS: It is suggested on the basis of the evidence that the cognitive effects of lithium are best expressed and should, therefore, be sought under conditions of functional or biological challenge to the nervous system.

PMID: 18781296

Supplement to previous, re cognition:

AIDS. 2006 Sep 11;20(14):1885-8.

Lithium improves HIV-associated neurocognitive impairment.

Letendre SL, Woods SP, Ellis RJ, Atkinson JH, Masliah E, van den Brande G, Durelle J, Grant I, Everall I; HNRC Group.

Department of Medicine, University of California, San Diego, California 92103, USA. sletendre@ucsd.edu

OBJECTIVE: To determine the effects of low-dose oral lithium on the neuropsychological performance of individuals diagnosed with HIV-associated neurocognitive impairment. DESIGN AND METHODS: The project was a single-arm, open-label, 12-week pilot study at a university-based tertiary care center. The participants were adults who had been diagnosed with HIV-associated neurocognitive impairment and had been on stable antiretroviral therapy for at least 12 weeks. Conditions that could affect cognition, worsen adherence to study procedures, or increase the risk of lithium adverse reactions were excluded. Twenty-one individuals were screened and eight were enrolled, all of whom completed the study. Oral lithium was initiated at 300 mg daily and was titrated to maintain 12-h trough concentrations between 0.4 and 0.8 mEq/l. Global neuropsychological performance was assessed by the global deficit score. RESULTS: At baseline, all participants had impaired neuropsychological performance and most had reduced CD4 cell counts (median 292 cells/microl), and HIV RNA levels in plasma below 400 copies/mL (seven of eight). Titrated lithium doses ranged between 600 and 1200 mg/day. Performance improved in all eight individuals after 12 weeks, and became unimpaired in six. The study treatment was well tolerated with no grade 3 or 4 adverse events and no premature discontinuations. CONCLUSIONS: Lithium resulted in improved neuropsychological performance in antiretroviral-treated, impaired individuals in this small, open-label study. Based on published in vitro data, lithium may exert this effect by inhibiting neuronal glycogen synthase kinase-3beta.

PMID: 16954730

"So the science is 'we think it might do what
we says it does' -But- 'we really need to do
a whole bunch of testing and extensive study
before we have anything definitive'"

That's right, or nearly right. The mass of data
on neuroprotective effects does not necessarily
translate into clinical utility for a given
neurodegenerative disorder such as Alzheimers.
It must be tested, empirically, to see how
useful it is, or whether it is useful at all.
As I said in the previous post, the chemical
or structural changes produced by lithium do
not necessarily translate directly into a given
functional outcome -- nor to they translate
necessarily to a given anti-pathological outcome,
such as amelioration of a given neurodegenerative
disease. Did you think it would (or could) be
otherwise?

"Oh Yes, Lithium is a natural occurring element
that in the course of a regular diet most will
consume small trace amounts. This is far from a
therapeutic dosage"

Depends on what a "regular diet" is. Conventional
Western diets supply about 1 milligram per day.
Marine food-rich diets can supply substantial
multiples of that. Diets rich in certain mineral
waters can supply even more. One can easily
obtain 10, 20 or 30 mgs of lithium from natural
sources. This is some distance from conventional
psychiatric lithium dosing, which begins at about 180
mgs (the elemental lithium value of 900 mgs
of lithium carb), but not a HUGE distance.

Consider these facts in light of the increasing
evidence that low-dose lithium (i.e. low in
relation to the conventional lithium doses
just mentioned, starting at 180 mgs/day) can
exert gratifying effects with little or no
danger of adverse effects.

The point is: it is a continuum, not a simple
black and white issue. Lithium is BOTH bad and
good. It all depends.

ONE last item, a very nice current review.
This might be too long to survive the software
and/or the moderator, but here goes anyway.
I cut off the references, which I would be
glad to post also if anyone is interested.

http://www.sciencedirect.com

Biological Psychiatry

Volume 62, Issue 1, 1 July 2007, Pages 4-6

doi:10.1016/j.biopsych.2007.04.008

Copyright c 2007 Society of Biological Psychiatry
Published by Elsevier Inc.

Commentary

In Search of the Holy Grail for the Treatment of
Neurodegenerative Disorders: Has a Simple Cation Been
Overlooked?

De-Maw Chuang a, and Husseini K. Manji a

a Mood and Anxiety Disorders Program, National Institute of
Mental Health, National Institutes of Health, Bethesda,
Maryland.

Received 9 April 2007; accepted 9 April 2007. Available
online 13 June 2007.

Article Outline

: Lithium Exerts Major Effects on Cytoprotective Pathways
: Lithium Exerts Robust Neuroprotective Effects in
Preclinical Paradigms
: Human Evidence for the Neurotrophic Effects of Lithium
: Are "Antimanic Concentrations" of Lithium Required for
Its Neurotrophic Effects?
: Acknowledgements
: References

In recent years, there has been considerable excitement about
the possibility that the "molecular medicine revolution" would
lead to identification of numerous putative targets designed
to slow the atrophic/degenerative process in various
neuropsychiatric disorders. Indeed, tremendous progress has
been made in the identification of cellular processes and
pathways involved in numerous degenerative diseases; however,
to date, proliferation of candidate drugs has not resulted in
viable novel clinical treatments for these devastating
disorders (1). Ironically, the article by Bearden et al.
(pages 7-16, in this issue) of the journal suggests that an
old medication present in our therapeutic armamentarium for
half a century exerts neurotrophic effects not only in animal
models but also in humans. Bearden et al. used high-resolution
magnetic resonance imaging and cortical pattern matching
methods to map gray matter differences in 28 bipolar patients,
20 lithium-treated, and 28 healthy control subjects. Their
results showed gray matter density was significantly greater
in bipolar patients compared with healthy subjects in diffuse
cortical regions, notably bilateral cingulated and paralimbic
cortices, areas utilized in attention, motivation, and
emotion. Additionally, their data revealed greater gray matter
density in the right anterior cingulate in lithium-treated
patients relative to the bipolar subjects not taking lithium.
Their lithium-treated sample included subjects who were on
lithium for varying time durations at different individual
doses. The lack of difference in gray mater density between
the untreated patients and healthy control subjects, as well
as growing evidence that lithium exerts major effects on a
number of cellular proteins and pathways (vide infra) known to
regulate cell atrophy/death, lend support to the view that
gray matter enlargement is mediated through the trophic
actions of lithium in the brain.

Lithium Exerts Major Effects on Cytoprotective Pathways

Klein and Melton (2) made the seminal observation that lithium
inhibited the action of glycogen synthase kinase-3 (GSK-3).
Glycogen synthase kinase-3 is known to regulate diverse
functions in adult mammalian brain and to exert major
cytoprotective effects (reviewed in [3], [4] and [5]). Indeed,
GSK-3 represents one of the kinases responsible for the
aberrantly hyperphosphorylated form of the
microtubule-associated protein, tau, a major constituent of
neurofibrillary tangles (6). Glycogen synthase kinase-3 also
plays a major role in amyloid deposition (7); thus, GSK-3
inhibition regulates the two major pathways implicated in the
pathogenesis of Alzheimer's disease.

In addition to its direct effects on GSK-3, chronic lithium
administration, at therapeutically relevant concentrations,
induces prominent neuroprotective and neurotrophic proteins,
bcl-2 and brain-derived neurotrophic factor (BDNF), in rodents
and cultured neurons ([8], [9], [10], [11] and [12]). Bcl-2 is
not only a major antiapoptotic protein but also stimulates
axonal regeneration following injury (13), while BDNF has a
critical role in cortical development, synaptic plasticity,
and neuronal survival. Induction of BDNF is also a possible
mechanism underlying lithium-induced neurogenesis in the
dentate gyrus of rat hippocampus (14).

Lithium Exerts Robust Neuroprotective Effects in Preclinical
Paradigms

In view of its major effects on BDNF, bcl-2, and GSK-3, it is
not surprising that recent studies have investigated lithium's
potential neuroprotective effects in a variety of preclinical
paradigms in which the ion demonstrated robust neuroprotective
properties against a variety of insults (reviewed in [5], [15]
and [16]). Notably, lithium pretreatment protected cultured
brain neurons from glutamate-induced, N-methyl-d-aspartate
(NMDA) receptor-mediated apoptosis (reviewed in 16). Excessive
NMDA throughput is likely involved in stress-induced
hippocampal atrophy and has been implicated in the
pathogenesis of a variety of neurodegenerative diseases. In
cultured neurons, lithium-induced neuroprotection against
glutamate excitotoxicity occurred within the therapeutic
concentration range of this drug, requiring 5 to 6 days
pretreatment for maximal effects. The lithium neuroprotection
involved BDNF induction and was associated with upregulation
of antiapoptotic protein bcl-2, downregulation of proapoptotic
proteins p53 and Bax, and inhibition of caspase-3. Treatment
of cultured neurons with other GSK-3 inhibitors or
transfection with GSK-3 small interfering (siRNA) mimicked
lithium's neuroprotective effects (17), again suggesting a
critical role of GSK-3 in mediating neuroprotection.

Lithium showed beneficial effects in some animal models of
neurodegenerative diseases. For example, preinsult or
postinsult treatment with lithium suppressed cerebral
ischemia-induced brain infarction, caspase-3 activation, and
neurological deficits in rats, and these neuroprotective
effects were associated with induction of heat shock protein
70 and decreased expression of Bax ([18] and [19]). Several
independent studies demonstrated that lithium has
neuroprotective effects in animal and cellular models of
Alzheimer's disease, Huntington's disease, Parkinson's
disease, retinal degeneration, spinal cord injury, and human
immunodeficiency virus (HIV) infection (reviewed in 16).
Notably, Phiel et al. (7) demonstrated that therapeutic
concentrations of lithium, by acting on GSK-3, blocked the
production of Aá peptides through interfering with amyloid
precursor protein (APP) cleavage at the ?-secretase step.
Importantly, lithium also blocked accumulation of Aá peptides
in the brains of mice that overproduce APP. Similarly, lithium
administration significantly lowers levels of phosphorylation
at several epitopes of tau known to be hyperphosphorylated in
Alzheimer's disease and to significantly reduce levels of
aggregated, insoluble tau (20). Most recently, it was
demonstrated that lithium is neuroprotective in APP transgenic
(tg) mice (21). Thus, mice treated with lithium displayed
improved performance in the water maze, preservation of
dendritic structure in frontal cortex and hippocampus, and
decreased tau phosphorylation.

Human Evidence for the Neurotrophic Effects of Lithium

In view of lithium's robust effects on levels of
cytoprotective protein bcl-2 in the anterior cingulate,
Drevets (22) reanalyzed older data, demonstrating 40%
reductions in subgenual prefrontal cortex (PFC) volumes in
familial mood disorder subjects. Consistent with
neurotrophic/neuroprotective effects of lithium, they found
that patients treated with chronic lithium or valproate
exhibited subgenual PFC volumes that were significantly higher
than those in nonlithium- or nonvalproate-treated patients and
not significantly different from control subjects. To
investigate potential neurotrophic effects of lithium in
humans more definitively, Moore et al. (23) used proton
magnetic resonance (MR) spectroscopy, showing that treatment
of bipolar patients with lithium for 4 weeks increased
N-acetyl-aspartate, a marker of neuronal viability, in the
cerebral cortex. A follow-up volumetric magnetic resonance
imaging (MRI) study showed that 4 weeks of lithium treatment
also significantly increased total gray matter content in the
human brain (24). Most recently, a study of familial pediatric
bipolar disorder revealed that subjects with bipolar disorder
with past lithium or valproate exposure tended to have greater
amygdalar gray matter volume than subjects with bipolar
disorder without such exposure (25).

Are "Antimanic Concentrations" of Lithium Required for Its
Neurotrophic Effects?

The aforementioned exciting results suggest lithium may have
utility in the treatment of a variety of neuropsychiatric
disorders associated with cell atrophy/loss and impairments of
cellular resilience. One obvious concern is lithium's
tolerability, especially in patients with neurodegenerative
disorders. A series of studies were undertaken to determine if
chronic administration of lithium at low doses also regulates
bcl-2 expression. It was found that chronic (4 weeks) lithium
administration, at doses that produce plasma levels of .35
mmol/L, robustly increases bcl-2 levels in rat frontal cortex
and hippocampus (26). Furthermore, .1 to .6 mmol/L lithium
robustly protects cultured cortical neurons from glutamate
excitotoxicity (27). In middle cerebral artery occlusion, an
in vivo model of stroke, lithium also provided significant
protection at .5 mEq/kg (18). Overall, the data clearly
suggest that considerably lower than traditional antimanic
doses of lithium have neurotrophic and neuroprotective effects
and may have utility as adjunctive treatments for
neuropsychiatric disorders associated with cell loss/atrophy.

In conclusion, the article by Bearden et al. adds to the
growing body of data supporting the contention that lithium
does indeed exert neurotrophic effects in humans. Although
there have been some major breakthroughs in the identification
of the genetic and pathogenic causes of many neurodegenerative
diseases, the currently available therapies for nearly all
these disorders are clearly quite inadequate. Increasing
knowledge of etiology and pathogenesis will undoubtedly
provide future opportunities to develop specific therapies
aimed at protecting neurons from underlying degenerative
processes. However, there is a mounting sense of urgency and
desperation among patients and families to develop new "wonder
drugs" for some of society's most devastating illnesses.
Ironically, the article by Bearden et al. and the data
reviewed in this commentary suggest that in our efforts to
develop novel "magic bullets," we may have overlooked the
potential of a simple monovalent cation that has been used
therapeutically for bipolar disorder for decades ([28] and
[29]). Controlled clinical trials of low-dose lithium for
attenuating the rate of disease progression in
atrophic/neurodegenerative illnesses are clearly warranted.

D-MC and HKM reported no biomedical financial interests or
potential conflicts of interest.

References
http://www.sciencedirect.com

Biological Psychiatry

Volume 62, Issue 1, 1 July 2007, Pages 4-6

doi:10.1016/j.biopsych.2007.04.008

Copyright c 2007 Society of Biological Psychiatry
Published by Elsevier Inc.

Commentary

In Search of the Holy Grail for the Treatment of
Neurodegenerative Disorders: Has a Simple Cation Been
Overlooked?

De-Maw Chuang a, and Husseini K. Manji a

a Mood and Anxiety Disorders Program, National Institute of
Mental Health, National Institutes of Health, Bethesda,
Maryland.

Received 9 April 2007; accepted 9 April 2007. Available
online 13 June 2007.

Article Outline

: Lithium Exerts Major Effects on Cytoprotective Pathways
: Lithium Exerts Robust Neuroprotective Effects in
Preclinical Paradigms
: Human Evidence for the Neurotrophic Effects of Lithium
: Are "Antimanic Concentrations" of Lithium Required for
Its Neurotrophic Effects?
: Acknowledgements
: References

In recent years, there has been considerable excitement about
the possibility that the "molecular medicine revolution" would
lead to identification of numerous putative targets designed
to slow the atrophic/degenerative process in various
neuropsychiatric disorders. Indeed, tremendous progress has
been made in the identification of cellular processes and
pathways involved in numerous degenerative diseases; however,
to date, proliferation of candidate drugs has not resulted in
viable novel clinical treatments for these devastating
disorders (1). Ironically, the article by Bearden et al.
(pages 7-16, in this issue) of the journal suggests that an
old medication present in our therapeutic armamentarium for
half a century exerts neurotrophic effects not only in animal
models but also in humans. Bearden et al. used high-resolution
magnetic resonance imaging and cortical pattern matching
methods to map gray matter differences in 28 bipolar patients,
20 lithium-treated, and 28 healthy control subjects. Their
results showed gray matter density was significantly greater
in bipolar patients compared with healthy subjects in diffuse
cortical regions, notably bilateral cingulated and paralimbic
cortices, areas utilized in attention, motivation, and
emotion. Additionally, their data revealed greater gray matter
density in the right anterior cingulate in lithium-treated
patients relative to the bipolar subjects not taking lithium.
Their lithium-treated sample included subjects who were on
lithium for varying time durations at different individual
doses. The lack of difference in gray mater density between
the untreated patients and healthy control subjects, as well
as growing evidence that lithium exerts major effects on a
number of cellular proteins and pathways (vide infra) known to
regulate cell atrophy/death, lend support to the view that
gray matter enlargement is mediated through the trophic
actions of lithium in the brain.

Lithium Exerts Major Effects on Cytoprotective Pathways

Klein and Melton (2) made the seminal observation that lithium
inhibited the action of glycogen synthase kinase-3 (GSK-3).
Glycogen synthase kinase-3 is known to regulate diverse
functions in adult mammalian brain and to exert major
cytoprotective effects (reviewed in [3], [4] and [5]). Indeed,
GSK-3 represents one of the kinases responsible for the
aberrantly hyperphosphorylated form of the
microtubule-associated protein, tau, a major constituent of
neurofibrillary tangles (6). Glycogen synthase kinase-3 also
plays a major role in amyloid deposition (7); thus, GSK-3
inhibition regulates the two major pathways implicated in the
pathogenesis of Alzheimer's disease.

In addition to its direct effects on GSK-3, chronic lithium
administration, at therapeutically relevant concentrations,
induces prominent neuroprotective and neurotrophic proteins,
bcl-2 and brain-derived neurotrophic factor (BDNF), in rodents
and cultured neurons ([8], [9], [10], [11] and [12]). Bcl-2 is
not only a major antiapoptotic protein but also stimulates
axonal regeneration following injury (13), while BDNF has a
critical role in cortical development, synaptic plasticity,
and neuronal survival. Induction of BDNF is also a possible
mechanism underlying lithium-induced neurogenesis in the
dentate gyrus of rat hippocampus (14).

Lithium Exerts Robust Neuroprotective Effects in Preclinical
Paradigms

In view of its major effects on BDNF, bcl-2, and GSK-3, it is
not surprising that recent studies have investigated lithium's
potential neuroprotective effects in a variety of preclinical
paradigms in which the ion demonstrated robust neuroprotective
properties against a variety of insults (reviewed in [5], [15]
and [16]). Notably, lithium pretreatment protected cultured
brain neurons from glutamate-induced, N-methyl-d-aspartate
(NMDA) receptor-mediated apoptosis (reviewed in 16). Excessive
NMDA throughput is likely involved in stress-induced
hippocampal atrophy and has been implicated in the
pathogenesis of a variety of neurodegenerative diseases. In
cultured neurons, lithium-induced neuroprotection against
glutamate excitotoxicity occurred within the therapeutic
concentration range of this drug, requiring 5 to 6 days
pretreatment for maximal effects. The lithium neuroprotection
involved BDNF induction and was associated with upregulation
of antiapoptotic protein bcl-2, downregulation of proapoptotic
proteins p53 and Bax, and inhibition of caspase-3. Treatment
of cultured neurons with other GSK-3 inhibitors or
transfection with GSK-3 small interfering (siRNA) mimicked
lithium's neuroprotective effects (17), again suggesting a
critical role of GSK-3 in mediating neuroprotection.

Lithium showed beneficial effects in some animal models of
neurodegenerative diseases. For example, preinsult or
postinsult treatment with lithium suppressed cerebral
ischemia-induced brain infarction, caspase-3 activation, and
neurological deficits in rats, and these neuroprotective
effects were associated with induction of heat shock protein
70 and decreased expression of Bax ([18] and [19]). Several
independent studies demonstrated that lithium has
neuroprotective effects in animal and cellular models of
Alzheimer's disease, Huntington's disease, Parkinson's
disease, retinal degeneration, spinal cord injury, and human
immunodeficiency virus (HIV) infection (reviewed in 16).
Notably, Phiel et al. (7) demonstrated that therapeutic
concentrations of lithium, by acting on GSK-3, blocked the
production of Aá peptides through interfering with amyloid
precursor protein (APP) cleavage at the ?-secretase step.
Importantly, lithium also blocked accumulation of Aá peptides
in the brains of mice that overproduce APP. Similarly, lithium
administration significantly lowers levels of phosphorylation
at several epitopes of tau known to be hyperphosphorylated in
Alzheimer's disease and to significantly reduce levels of
aggregated, insoluble tau (20). Most recently, it was
demonstrated that lithium is neuroprotective in APP transgenic
(tg) mice (21). Thus, mice treated with lithium displayed
improved performance in the water maze, preservation of
dendritic structure in frontal cortex and hippocampus, and
decreased tau phosphorylation.

Human Evidence for the Neurotrophic Effects of Lithium

In view of lithium's robust effects on levels of
cytoprotective protein bcl-2 in the anterior cingulate,
Drevets (22) reanalyzed older data, demonstrating 40%
reductions in subgenual prefrontal cortex (PFC) volumes in
familial mood disorder subjects. Consistent with
neurotrophic/neuroprotective effects of lithium, they found
that patients treated with chronic lithium or valproate
exhibited subgenual PFC volumes that were significantly higher
than those in nonlithium- or nonvalproate-treated patients and
not significantly different from control subjects. To
investigate potential neurotrophic effects of lithium in
humans more definitively, Moore et al. (23) used proton
magnetic resonance (MR) spectroscopy, showing that treatment
of bipolar patients with lithium for 4 weeks increased
N-acetyl-aspartate, a marker of neuronal viability, in the
cerebral cortex. A follow-up volumetric magnetic resonance
imaging (MRI) study showed that 4 weeks of lithium treatment
also significantly increased total gray matter content in the
human brain (24). Most recently, a study of familial pediatric
bipolar disorder revealed that subjects with bipolar disorder
with past lithium or valproate exposure tended to have greater
amygdalar gray matter volume than subjects with bipolar
disorder without such exposure (25).

Are "Antimanic Concentrations" of Lithium Required for Its
Neurotrophic Effects?

The aforementioned exciting results suggest lithium may have
utility in the treatment of a variety of neuropsychiatric
disorders associated with cell atrophy/loss and impairments of
cellular resilience. One obvious concern is lithium's
tolerability, especially in patients with neurodegenerative
disorders. A series of studies were undertaken to determine if
chronic administration of lithium at low doses also regulates
bcl-2 expression. It was found that chronic (4 weeks) lithium
administration, at doses that produce plasma levels of .35
mmol/L, robustly increases bcl-2 levels in rat frontal cortex
and hippocampus (26). Furthermore, .1 to .6 mmol/L lithium
robustly protects cultured cortical neurons from glutamate
excitotoxicity (27). In middle cerebral artery occlusion, an
in vivo model of stroke, lithium also provided significant
protection at .5 mEq/kg (18). Overall, the data clearly
suggest that considerably lower than traditional antimanic
doses of lithium have neurotrophic and neuroprotective effects
and may have utility as adjunctive treatments for
neuropsychiatric disorders associated with cell loss/atrophy.

In conclusion, the article by Bearden et al. adds to the
growing body of data supporting the contention that lithium
does indeed exert neurotrophic effects in humans. Although
there have been some major breakthroughs in the identification
of the genetic and pathogenic causes of many neurodegenerative
diseases, the currently available therapies for nearly all
these disorders are clearly quite inadequate. Increasing
knowledge of etiology and pathogenesis will undoubtedly
provide future opportunities to develop specific therapies
aimed at protecting neurons from underlying degenerative
processes. However, there is a mounting sense of urgency and
desperation among patients and families to develop new "wonder
drugs" for some of society's most devastating illnesses.
Ironically, the article by Bearden et al. and the data
reviewed in this commentary suggest that in our efforts to
develop novel "magic bullets," we may have overlooked the
potential of a simple monovalent cation that has been used
therapeutically for bipolar disorder for decades ([28] and
[29]). Controlled clinical trials of low-dose lithium for
attenuating the rate of disease progression in
atrophic/neurodegenerative illnesses are clearly warranted.

D-MC and HKM reported no biomedical financial interests or
potential conflicts of interest.

References

I have found next to nothing that convinces me lithium is a "nutrient" and "neuroprotective" certainly when it's given as a prescription. How the brain looks after it's been exposed to lithium doesn't really hold a lot of weight with me unless you also tell me exactly how the patient is behaving too and what other symptoms are going on around the body (as Kimbriel refers to). You can look at all the slides in the world of brain cross sections and take volumetric data about different brain tissues but where in the heck does that get you? If the person is still suffering, in fact, if they're even worse off, who cares if they've got a little more gray matter somewhere? The conclusions that are being drawn from this kind of research are hypothetical and based on some pretty flimsy assumptions that sound logical on a first run through but aren't necessarily so at all.

Why the anti-Lithium tone here? because most all of the commenters have had bad experiences on the drug and are giving a fair warning to others who might use it. Cautionary tales, anecdotal stories from real people who suffered on the drug. My daughter was on Li for 6 years and it raised her thyroid levels, and gave her tremors only to have a recent doctor toss out the drug, saying she never needed it. A child on Lithium---adults on it and telling horror stories, is enough to get angry.

Yeah, Alan, we get it. I know a lot of people who supplement with Lithium Orotate and swear by it. I choose to supplement my diet with broad spectrum slow-release vitamins and chelated minerals, along with probiotics, NAC (for Glutathione production), Grape seed extract and garlic (for anti-yeast properties), full-spectrum amino acids, and Omega-3. And I eat one of the healthiest diets around, with lots of fresh, colorful salads, vegetable soups, and salmon. That is how I choose to take care of my mental health. I have read all of the papers you suggest and more. The evidence is not compelling. May I suggest you read: "Drug-Induced Dementia: A Perfect Crime" by Grace Jackson, MD? There's a lovely little chapter in there about Lithium which debunks all of the "Lithium is good for your brain" research.

JUST GOT BACK AFTER BEING INSIDE A LOCKED PSYCH WARD.

If these drugs worked, my daughter wouldn't be in there, and either would any of the other patients, that I unfortunately KNOW now after 3.5 years in the adult system, it is truly sad to see people revolving in and out of that place (and several I've met over these years are back in the state hospital now).

They are on a revolving door, that hangs on a loose hinge called "psychiatric care, medication based medical model".

Who is tired of these arguements here? the person who took/takes Lithium? the sister who did/does?

Come on, we all know this is the real deal we are dealing with in a locked up psych ward, and I also see ppl that shouldn't be in there.

This blog DOES attract naysayers and medication alarmists! because the medications are typically sold by the companies based on false and skewed data, the studies and their researchers have been investigated for corruption, and THAT is what I AM SICK OF.

The lies and hidden agendas of the drug companies, NAMI taking funds from them and coddling the families into believing those drugs fucking help.

OK, so we have a blog author here, Philip who was on these drugs and now is not, so the question asked here by the poster "noone", and commenting how placebo affect is the reason they feel better? is that right? did i misunderstand you? that the people who HAVE gone drug free are living in a sort of panacea, a little piece of reality that is a slow-fuse burning to illness?

Give me a break, I'm pretty sure there are many readers not commenting here who have severe dx's and are successfully living off of drugs and some of them with permanent BODY DAMAGE instead.

I also know there are mothers reading here who have lost children to these drugs, such as Paxil and Zyprexa, meaning their grown children are DEAD.

So, excuse me while I have no answers for the tree-hugging environmentalists---I mean the med-loving mental illness label huggers---

Noone, your sister suffers when she goes off of Lithium due to cold turkeying the drug or tapering too fast. Those are withdrawal symptoms that look like a return of the illness but aren't. Please don't make the mistake of confusing the issues as that is what keeps people on psych meds for way too long.


As far as my being one of those crazy anti psych zealots, I am LOL at your description. Anyway, these meds that you think are so wonderful caused a hearing loss and horrific cognitive issues. Yeah, that is really great for my mental health. NOT!


Alan, a 12 week study doesn't prove that a drug is neuroprotective. Psych meds initially increased my IQ. My guess is that if I took another test, it would be alot lower.


The best way to truly measure whether a drug is neuroprotective is conduct neuropsych testing over years. The chances of that happening are slim and none because the drug companies know what the result would be.

Though I totally disagree with Alan's assessments and views on this topic; at least they are presented in a methodical format with some debatable rational (though maybe just snippets and links to long studies, data, and articles would suffice).

Than we have "noone" a blind follower this other dangerous "cult" called "pharmacological/biochemical based Psychiatry".

Quote: "Why can't we have a discussion about the "other side" of mental illness/drugs/psychiatry without attracting the quack brigade?"

Answer: Just possibly because of "Idiots" "quacks" like yourself.

I'm quite sure your sister much appreciates that you are the determining factor on what is normal and not normal for her personally.

But then, it's people like you that appear to believe irrationally in legal mandates that would force dangerous drugs upon others because of your own personal narrow and distorted view of what normal actually is; you tend to sound like a bad "Biederman or Torrey" clone saying "they need to be force drugged for their own good"

Your comment was so outrageously over the top and ridiculous that a response appears warranted.

Quote: "It really sucks when shit gets bad and you gotta wait a long time for help"

Life throws both ups and downs at pretty much everyone over the course of time; but what really sucks is when people like "noone" that lack the hard definitive science to back up their weak arguments and claims; So instead, they lamely go about attacking both counter messages and those messengers.

Quote: "I've taken it myself, and, if I had to be on an antimanic/antiaggressive I would want it to be lithium. Lithium makes you feel GOOD. It has a bad reputation for side effects, though. Irrationally."

You have taken it and stopped. But it made you feel so "GOOD" with no harmful side effects to worry about.

Why would you stop taking such an effective harmless substance that made you feel "GOOD"?

Are you experiencing one of those placebo recoveries at present time?

Maybe you should consult Dr. "Julian Baine" lol....

When I hear people talk about how well their family members are doing on medication I take it with a grain of salt, because unless they're standing there watching the person take the med every day then nobody knows if the patient is actually taking it.

My parents would have been singing the praises of the effectiveness of medication. That's why I chose not to inform them until I had gone through withdrawal and been off of all the drugs for at least a year. I didn't want my withdrawal to be misinterpreted as worsening of mental illness requiring more meds. I had concerns (due to the NAMI influence) that as I was going through withdrawal they would have me hospitalized against my will.

When I finally told my parents, my mom said, "But you've been doing so well, why would you stop?" That's when I informed her I had been off of all meds for a year and that's why I was "doing so well." I've had about 7 years of med free living and not one hospitalization - the doom and gloom predictions were wrong.

So, I don't put a whole lot of stock in stories about how well family members do on their meds. Nobody knows what's going on except the patient.

AA wrote:
"The best way to truly measure whether a drug is neuroprotective is conduct
neuropsych testing over years."

No, the best way to measure NEURO-protection is to conduct studies of
various NEURO-protection parameters. Those parameters are numerous,
but include things like neuron damage/loss after exposure to
neurotoxins (glutamate, NMDA, malonate, etc.), protection against
MPTP-induced dopamine depletion and dopaminergic neuron damage,
reduction of brain edema and other pathological changes after
experimental stroke, and so on.

Neuroprotection is not measured by functional outcomes in given
neuropsychiatric "diseases" (or whatever they are, whether or not
you want to call them "diseases"). I explained carefully, twice,
in past posts, how the neuroprotective effects of lithium MAY OR
MAY NOT result in functional or clinically evident anti-pathological
changes in given neuropsychiatric conditions. Lithium (and other
promising neuroprotectants, e.g. creatine) must be tested empirically
to see whether and how much value they have in these conditions.

Meanwhile, some of us, myself included, are sufficiently
persuaded by the pre-clinical neuroprotection data that we are
supplementing ourselves with modest amounts of harmless
neuroprotectants (such as lithium and creatine) in the hope of
preventing or ameliorating functional losses of age or the occurence
of neurodegenerative disease later in life. Of course, it may be
that this is futile, and that we're doing ourselves no good. But
we're certainly doing ourselves no harm, and the cost is
practically nothing, so why not? Further, the neuroprotection
data is so compelling that it is VERY unlikely that we are doing
ourselves no preventive good. Possible, but very unlikely.

AA wrote:
"Alan, a 12 week study doesn't prove that a drug is neuroprotective."

A 12-HOUR study might prove that a drug is neuroprotective! But that
is different than proving given functional outcomes in humans, as I
have explained several times now.

Kimbriel wrote:
"I have read all of the papers you suggest and more. The evidence is
not compelling."

The evidence for WHAT is not compelling? The evidence for neuroprotection
is quite compelling, indeed undeniable. The evidence for clinical
utility in neurodegenerative diseases is suggestive of benefit but still
not at all compelling, but then we're just in the preliminary stages of
testing. We'll have good answers, hopefully, in 10 years or so.

Kimbriel wrote:
"May I suggest you read: "Drug-Induced Dementia: A Perfect Crime" by Grace
Jackson, MD? There's a lovely little chapter in there about Lithium which
debunks all of the "Lithium is good for your brain" research."

I looked it up. I cannot get it for less than $23. Rather pricey.
I also looked up Grace Jackson. Hard to tell, but she appears to be in the
Breggin Zone -- i.e. a fanatical irrational anti-med type, and quite
possibly not worth reading (like Breggin, and I've tried!). I WILL
however check the book out at the library at least, if they have it.
It will be interesting. If she delivers some sort of ham-handed,
scientifically illiterate, Breggin-like attack on lithium as
neuroprotectant, that will indicate that she is not credible and not
worth reading any further.

Stephany wrote:
"Why the anti-Lithium tone here? because most all of the commenters have
had bad experiences on the drug and are giving a fair warning to others who
might use it. Cautionary tales, anecdotal stories from real people who suffered
on the drug. My daughter was on Li for 6 years and it raised her thyroid levels,
and gave her tremors only to have a recent doctor toss out the drug, saying she
never needed it. A child on Lithium---adults on it and telling horror stories,
is enough to get angry."

Agreed. There are a LOT of dipshit doctors out there, and a great deal of
ignorant and incompetent application of lithium (doses much too high,
without proper context). Lithium has done a lot of harm. Really a pity,
for the great nutrient that it is. It is unfortunate, and understandable,
that so many here have such hysterical reactions to the idea of using
lithium -- because it has been so often misused, to such harmful effect.
It is a terrible shame. And all quite unnecessary.

Sara wrote:
"I have found next to nothing that convinces me lithium is a 'nutrient' and
'neuroprotective' certainly when it's given as a prescription"

Lithium is a nutrient. See the work of Gerhard Schrauzer, attached
below.

The evidence for neuroprotective effects of lithium is overwhelming. But
again, whether and to what extent that will translate to useful clinical
effects in given conditions remains to be seen.

Sara wrote:
"How the brain looks after it's been exposed to lithium doesn't really hold
a lot of weight with me unless you also tell me exactly how the patient is
behaving too and what other symptoms are going on around the body"

Agreed that CLINICAL RESULTS are the bottom line. However, as thorny as
the brain/mind problem may be, there is no doubt that neuroscience IS closing
in on (brain) things that have clinical relevance. The correlation between
experimental "neuro" work and clinical science will never be perfect, but
there are already links that cannot be denied, with more in the pipeline.
Give it time. This is an EXTREMELY complex and difficult area.

...........................................

http://www.jacn.org/cgi/content/full/21/1/14
Lithium: Occurrence, Dietary Intakes, Nutritional Essentiality
Gerhard N. Schrauzer, PhD, CNS, FACN
Department of Chemistry and Biochemistry, University of California, San Diego
ABSTRACT
Lithium is found in variable amounts in foods; primary food sources are grains and vegetables; in some areas, the drinking water also provides significant amounts of the element. Human dietary lithium intakes depend on location and the type of foods consumed and vary over a wide range. Traces of lithium were detected in human organs and fetal tissues already in the late 19th century, leading to early suggestions as to possible specific functions in the organism. However, it took another century until evidence for the essentiality of lithium became available. In studies conducted from the 1970s to the 1990s, rats and goats maintained on low-lithium rations were shown to exhibit higher mortalities as well as reproductive and behavioral abnormalities. In humans defined lithium deficiency diseases have not been characterized, but low lithium intakes from water supplies were associated with increased rates of suicides, homicides and the arrest rates for drug use and other crimes. Lithium appears to play an especially important role during the early fetal development as evidenced by the high lithium contents of the embryo during the early gestational period. The biochemical mechanisms of action of lithium appear to be multifactorial and are intercorrelated with the functions of several enzymes, hormones and vitamins, as well as with growth and transforming factors. The available experimental evidence now appears to be sufficient to accept lithium as essential; a provisional RDA for a 70 kg adult of 1000 µg/day is suggested.

Med Hypotheses. 2009 Nov;73(5):811-2. Epub 2009 May 19.

Even very low but sustained lithium intake can prevent suicide in the general population?

Terao T, Goto S, Inagaki M, Okamoto Y.

Department of Neuropsychiatry, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasamamachi, Yufu, Oita 879-5593, Japan. terao@med.oita-u.ac.jp

Although several meta-analyses have shown anti-suicidal properties of lithium in treating patients with mood disorders, these effects may be unrelated to the mood-stabilizing effects. Some epidemiological studies suggest that even very low lithium levels induced by routine consumption of lithium from tap water may have anti-suicidal effects both in patients with mood disorders and in the general population. We hypothesize that even very low but sustained lithium intake can prevent suicide in the general population. If this is the case, increasing lithium levels of drinking water could potentially reduce the risk of suicide, and justify administering lithium to tap water.

PMID: 19457619

..............................................

Br J Psychiatry. 2009 May;194(5):464-5; discussion 446.

Lithium levels in drinking water and risk of suicide.

Ohgami H, Terao T, Shiotsuki I, Ishii N, Iwata N.

Department of Neuropsychiatry, Oita University, Oita 879-5593, Japan.

Comment in:
* Br J Psychiatry. 2009 Sep;195(3):271; author reply 271-2.
* Br J Psychiatry. 2009 Sep;195(3):271; author reply 271-2.

Although lithium is known to prevent suicide in people with mood disorders, it is uncertain whether lithium in drinking water could also help lower the risk in the general population. To investigate this, we examined lithium levels in tap water in the 18 municipalities of Oita prefecture in Japan in relation to the suicide standardised mortality ratio (SMR) in each municipality. We found that lithium levels were significantly and negatively associated with SMR averages for 2002-2006. These findings suggest that even very low levels of lithium in drinking water may play a role in reducing suicide risk within the general population.

PMID: 19407280

...............................................

Biol Trace Elem Res. 1994 Jan;40(1):89-101.

Effects of nutritional lithium supplementation on mood. A placebo-controlled study with former drug users.

Schrauzer GN, de Vroey E.

Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla 92093-0314.

A total of 24 subjects, 16 males and 8 females, average age 29.4 +/- 6.5 y, were randomly divided into two groups. Group A received 400 micrograms/d of lithium orally, in tablets composed of a naturally lithium-rich brewer's yeast, for 4 wk. Group B was given normal, lithium-free brewer's yeast as a placebo. All the subjects of the study were former drug users (mostly heroin and crystal methamphetamine). Some of the subjects were violent offenders or had a history of domestic violence. The subjects completed weekly self-administered mood test questionnaires, which contained 29 items covering parameters measuring mental and physical activity, ability to think and work, mood, and emotionality. In the lithium group, the total mood test scores increased steadily and significantly during the period of supplementation. The 29 items were furthermore placed into three subcategories reflecting happiness, friendliness, and energy, as well as their negative counterparts. In Group A, the scores increased consistently for all subcategories until wk 4 and remained essentially the same in wk 5. In Group B, the combined mood test scores showed no consistent changes during the same period. The only positive change in some members of Group B occurred during wk 1 and was attributed to a placebo effect. In Group B, the placebo effect was noticeable for the subcategories of energy and friendliness; the happiness scores declined during the entire period of observation. Based on these results and the analysis of voluntary written comments of study participants, it is concluded that lithium at the dosages chosen had a mood-improving and -stabilizing effect.

PMID: 7511924

................................................

Biol Trace Elem Res. 1992 Aug;34(2):161-76.

Lithium in scalp hair of adults, students, and violent criminals. Effects of supplementation and evidence for interactions of lithium with vitamin B12 and with other trace elements.

Schrauzer GN, Shrestha KP, Flores-Arce MF.

Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla 92093.

The lithium content of human hair shows an approximately linear response to extradietary lithium supplementation at dosage levels of up to 2000 micrograms/d. From the mean hair lithium concentration of 0.063 micrograms/g in 2648 predominantly American adults, and the reference hair lithium concentrations determined in the present study, the mean lithium intakes were calculated to be 730 micrograms/d. Hair lithium concentrations were extremely low in nearly 20% of the American samples, and in samples collected in Munich, Germany and Vienna, Austria. Hair lithium levels are low in certain pathological conditions, e.g., heart disease, in learning-disabled subjects, and in incarcerated violent criminals. The highest levels were observed in samples of a lithium-treated psychiatric patient. A statistically highly significant direct association was observed between the hair lithium and cobalt concentrations, which suggests a role of lithium in the transport and distribution of vitamin B12. Interactions of lithium with other trace elements are also discussed.

PMID: 1381936

................................................

Biol Trace Elem Res. 1990 May;25(2):105-13.

Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions.

Schrauzer GN, Shrestha KP.

Department of Chemistry and Biochemistry, University of California at San Diego, Revelle College, La Jolla 92093.

Using data for 27 Texas counties from 1978-1987, it is shown that the incidence rates of suicide, homicide, and rape are significantly higher in counties whose drinking water supplies contain little or no lithium than in counties with water lithium levels ranging from 70-170 micrograms/L; the differences remain statistically significant (p less than 0.01) after corrections for population density. The corresponding associations with the incidence rates of robbery, burglary, and theft were statistically significant with p less than 0.05. These results suggest that lithium has moderating effects on suicidal and violent criminal behavior at levels that may be encountered in municipal water supplies. Comparisons of drinking water lithium levels, in the respective Texas counties, with the incidences of arrests for possession of opium, cocaine, and their derivatives (morphine, heroin, and codeine) from 1981-1986 also produced statistically significant inverse associations, whereas no significant or consistent associations were observed with the reported arrest rates for possession of marijuana, driving under the influence of alcohol, and drunkenness. These results suggest that lithium at low dosage levels has a generally beneficial effect on human behavior, which may be associated with the functions of lithium as a nutritionally-essential trace element. Subject to confirmation by controlled experiments with high-risk populations, increasing the human lithium intakes by supplementation, or the lithiation of drinking water is suggested as a possible means of crime, suicide, and drug-dependency reduction at the individual and community level.

PMID: 1699579

..................................................

COMMENT: this item shows a surprising beneficial effect of lithium on
all-cause mortality in addition to suicide. Most of the subjects were probably
taking the usual sledgehammer (too-high) doses of lithium. Said benefits would
very likely accrue to users of smaller, safer doses of lithium (there is no
proof of this, but it is consistent with the totality of what is now known; see e.g. abstracts
posted immediately above.)
---Alan

Am J Psychiatry. 2005 Oct;162(10):1805-19.

Lithium in the prevention of suicidal behavior and all-cause mortality in patients with mood disorders: a systematic review of randomized trials.

Cipriani A, Pretty H, Hawton K, Geddes JR.

Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. john.geddes@psych.ox.ac.uk

Comment in:
* Am J Psychiatry. 2006 Mar;163(3):550; author reply 550-1.

OBJECTIVE: Observational studies suggest that long-term lithium treatment has a strong antisuicidal effect in mood disorders, but it is uncertain whether this association is a genuine therapeutic effect or is due to confounding factors in nonrandomized studies. The authors conducted a systematic review and meta-analysis of randomized trials to investigate the effect of lithium, compared to placebo and other active treatments, on the risk of suicide, deliberate self-harm, and all-cause mortality in patients with mood disorder. METHOD: The data source was the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register, incorporating results of searches of MEDLINE (1966-June 2002), EMBASE (1980-June 2002), CINAHL (1982-March 2001), PsycLIT (1974-June 2002), PSYNDEX (1977-October 1999), and LILACS (1982-March 2001). The Cochrane Central Register of Controlled Trials (CENTRAL) was searched with the term "lithium" for new records entered into the database from 1999 to 2003. Studies selected included randomized, controlled trials comparing lithium with placebo or all other compounds used in long-term treatment for mood disorders (unipolar depression, bipolar disorder, schizoaffective disorder, dysthymia, and rapid cycling, diagnosed according to DSM or ICD criteria). Of 727 references identified in the search, 52 articles were marked as possibly relevant on the basis of the abstract, and 32 randomized, controlled trials were eligible for inclusion in the review. Two independent reviewers extracted the data, and disagreements were resolved by consensus with a third reviewer. Methodological quality was assessed according to the criteria of the Cochrane Collaboration. When the outcomes of interest were not reported, an attempt was made to obtain the required data from the original authors. RESULTS: In 32 trials, 1,389 patients were randomly assigned to receive lithium and 2,069 to receive other compounds. Patients who received lithium were less likely to die by suicide (data from seven trials; two versus 11 suicides; odds ratio=0.26; 95% confidence interval [CI]=0.09-0.77). The composite measure of suicide plus deliberate self-harm was also lower in patients who received lithium (odds ratio=0.21; 95% CI=0.08-0.50). There were fewer deaths overall in patients who received lithium (data from 11 trials; nine versus 22 deaths; odds ratio=0.42, 95% CI=0.21-0.87). CONCLUSIONS: Lithium is effective in the prevention of suicide, deliberate self-harm, and death from all causes in patients with mood disorders.

PMID: 16199826

Alan,

I wonder if you've read either of Breggin's most recent books -- Brain-Disabling Treatments in Psychiatry or Medication Madness. I wonder why you find him difficult to read unless you are coming at his books with preconceived ideas.

As for lithium being a nutrient -- if that really is the case, then I'll get it through my nutrition thank you and not through medication. I imagine there's a huge difference between lithium as a nutrient and lithium prescribed at therapeutic doses.

I've spent the last 7 years looking at medical journal articles and shredding their methodology in a large number of cases so I'm not really impressed with your citations here but they would require a lot of study to refute properly. In general I am not at all impressed with the level of peer review, disclosure of conflicts of interest, and general inclusion of extremely relevant clinical details in a huge number of medical studies, especially in psychiatry. I am always astounded that huge long articles can be written in psychiatry and the authors can get through it without citing one specific clinical example at all. That just strikes me as totally outrageous when you're dealing with mood problems. I learn a whole ton more by reading the threads on this blog than I ever do by reading medical journals and no one is going to convince me that that isn't a better way to learn frankly.

Anyway I don't think those of us here are going to change your point of view which sounds like it's very engrained. I know that an anti-suicide effect has been associated with lithium. But I need to know a lot more about the before and after, including the long term after, before I buy it as a "cure" for suicidal thinking.

Well, anyone with a vested interest in defending Lithium use so vigorously despite factual negative outcomes of patients might be interested in:

A LITHIUM PATCH INVENTED BY CHARLES NEMEROFF OF CONFLICTED RESEARCH FAME

http://www.pharmcast.com/Patents/Yr2002/April2002/042302/6375990_Lithium042302.htm

Title: Method and devices for transdermal delivery of lithium

United States Patent: 6,375,990

Inventors: Nemeroff; Charles B. (Atlanta, GA);

Kilts; Clinton D. (Atlanta, GA)

Assignee: Emory University (Atlanta, GA)

Abstract

A method and device for treating acute mania or bipolar disorder is disclosed, by transdermal delivery of Li+ at substantially constant rate through the skin via a dermal patch.

http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=6,375,990.PN.&OS=PN/6,375,990&RS=PN/6,375,990

SO, there is a way to electo-transport Li into a body, and Charles Nemeroff invented it.

Maybe it's like that VNS gimmick, maybe that and the Li patch can go hand in hand.

$$$$$$$$$$

Alan, I agree with Sara that we're not going to change your mind. But as one whose has suffered adverse cognitive affects from a cocktail of psych meds, I will never believe that a drug more powerful than anything I was on can be neuroprotective.

Alan,

I think you would find "Drug-Induced Dementia: A Perfect Crime" by Grace Jackson, MD well worth the money.

I would send you my copy for free but it seems to be geared towards scientists and physicians (which I am not) and I need to read it over again since much went over my head. I don't think you'll have that problem.

Alan it may well be that the small doses are not as bad as what you call the "sledghammer" ones the problem is folks who have had the large or been hurt by other such drugs are never going to give it a chance. For me after what I have been thru on antidepressants the only pill going in my mouth from now on will be when I am unconscious in hosp. Pharma is cutting off its own foodline by loosing the trust of its customers.
I know this seems a bit off topic but I had a freind years ago who got really sick on lithium and refuse to take it in any amount I now know exactly where she was coming from. What is sad is I could not learn from her experience but in those days there was no internet to share information.

Stephany wrote:
"anyone with a vested interest in defending
Lithium use so vigorously despite factual
negative outcomes of patients..."

I forgot to mention: I've got a fortune
invested in lithium futures, and if I can
convince all the ignorant sheep to take
lithium, I'll be a billionaire!!! Whoopee!!!

;-)

AA wrote:
"I will never believe that a drug more powerful
than anything I was on can be neuroprotective."

Yes, you and a number of others here will
NEVER believe the evidence, no matter how
compelling. And in a way I don't blame you.
If I had been hurt as you had, maybe I would
have copped the same attitude. Hopefully not,
but maybe.

B wrote:
"I would send you my copy for free"

Thanks for the thought. I'll check it out at
the library. I'm not expecting much, but who
knows? Maybe I'll be pleasantly surprised.
My mind remains fanatically open, in spite of
clear and compelling evidence that it ought to
be closed.

;-)

btdt wrote:
"it may well be that the small doses are not
as bad as what you call the "sledghammer"
ones the problem is folks who have had the
large or been hurt by other such drugs are
never going to give it a chance....
Pharma is cutting off its own foodline by
loosing the trust of its customers."

Right. And such a pity, since Big Pharma DOES
have a lot of rather useful stuff, or stuff that
could be useful and beneficial in the right
hands (in the hands of competent, knowledgeable
docs with a firm grounding in nutrition and
general health).

PS: "losing" (to lose, rather than to gain)
is spelled l-o-s-i-n-g. For the record.

Regarding Breggin: I have strongly
mixed feelings about the guy. He has done
a lot of good work, made a lot of good
points that badly need to be made, etc.
etc. But he oversimplifies things, sometimes
absurdly. His scholarship is poor (and I am
being charitable). He consistently OVERstates
his case. He is too extreme. His extreme
anti-psychiatry/anti-drug bias is over the
top and not useful (even though many of the
points he makes about overuse of drugs,
uncritical use of drugs, uncritical embrace
of psychopharm and psychiatry in general,
etc. are true and very important). And his
work is riddled with contradictions, many of
which are listed in the document to follow --
a close reading of which I recommend to all
here. I am posting only a couple of paragraphs,
but I urge you to go to the URL and read the
whole thing. Schaler simply NAILS Breggin's
ass to the wall. And it is very sad, since
Breggin DOES have so many good and important
things to say. ---Alan

http://www.schaler.net/fifth/breggin.html

VOLUME 4, ISSUE 1 PSYCHNEWS INTERNATIONAL March 1999

DOUBLETHINK AT THE ICSPP CORRAL:
A REJOINDER TO PETER R. BREGGIN, M.D.

Jeffrey A. Schaler, Ph.D.

SNIP

Dear Peter,
I'm glad to see you come out of hiding to grace the members
of the listserv with your presence. It took my resignation from
the Board of Directors of International Center for the Study of
Psychiatry and Psychology (ICSPP) to do it? And you don't even
send me a copy of what you wrote, when the topic of your missive
is "Regarding Jeff's resignation"? What does that say about
you?

SNIP

You are deliberately obscuring the reasons for my
resignation from the Board of Directors of ICSPP. The issue
isn't simply one of disagreement. The issue is one of honesty,
integrity, and courage. You can't have integrity and be
consistently, self-servingly inconsistent, as you are. I voiced
my concern regarding contradictions ever since the first time I
spoke out at the annual meeting you cite. The inconsistency
then concerned your testifying as an expert witness against
anti-depressant pharmaceutical companies. Your testifying,
under oath (!) that Prozac caused a man to commit suicide and
homicide contradicts your position that neurotransmitters don't
cause people to commit suicide and homicide. You said you'd
considered that, but that this was your decision. I said it was
your downfall. It exemplifies your opportunistic dishonesty:
Defense of the "downtrodden mental patient" is so holy a cause
that it justifies lying for it.

SNIP

"...the nurse diagnosed my friend..."

What led to the "lithium toxicity" was someone not educating their patient, then leaving them on their own to fend for themselves. Your friends nurse, or NP, did none of the proper followups and should be held accountable.

Never accept a diagnosis -- cancer, bipolar, other -- from a therapist, a nurse or an NP on its face. Always consult a doctor before starting a prescription. If a 'real doctor' is too expensive, or unavailable, did your friend not even consult the Internet? Tell her to search for 'lithium treatment' or 'lithium side effects', it might help.

And who takes pills, which require monitoring through blood work, without actually doing the blood work? Her mouth "felt metallic and salty"? Holy crap.

Dear Alan,
I see a huge difference between declaring that someone has a chemical imbalance because of some subjectively determined "brain disease" and believing that Prozac can cause a chemical imbalance because of its toxic effects on the neurons. The "chemical imbalances" that occur because of life events (or even genetic differences in responding to stress) are very different than the ones created by introducing toxic,blood brain barrier breaking substances to the brain. Peter has always been very clear on this distinction in my experience so I see nothing inconsistent in his testimony under oath. I too believe with all my heart that Prozac can cause someone to commit either suicide, murder or both -- someone who is doing it because of a toxic assault to the brain and the changes that assault is causing. The changes to neurotransmitters caused by trauma and abuse, I believe, pail in comparison and have a much better chance of being reversed through behavioral and lifestyle changes than those caused by psychotropic drugs. But then we seem to be beating a dead horse here on this thread and neither of us are making any headway with the other. I am a co-founder of www.ssristories.com and from my point of view this list is a compelling testimony of just how profoundly antidepressants and other psych drugs can alter behavior for the worse.

Also I cannot believe that Schaler quotes at length from The Power to Harm and falls completely for the way Eli Lilly set Peter up in that trial without mentioning once that Eli Lilly had illegally paid off the plaintiffs and their lawyer untold amounts of money before the trial was even over. I don't think there is one thing there that refutes the argument that Prozac pushed Wesbecker over the edge despite his prior life experiences. Obviously Lilly was very worried about the strength of the evidence or they never would have bought the plaintiffs and their lawyer off in the way they did. Lilly had all sorts of evidence disclosed in the discovery process that indicated grave concerns about Prozac's ability to induce suicide and violence before it was ever even approved.

Sara:
the Lilly/Wesbecker case was a relatively
minor part of Schaler's critique of Breggin.
At least 30 paragraphs of the document do
not mention the Lilly case AT ALL, and they
are devastating to Breggin. Schaler is all too right, I am sorry to say. Though I don't
blame you for wanting to ignore it. If the
anti-psychiatry crowd were to critique Breggin
with the rigor that Schaler does, it would
be a terrific blow to their cause -- and their
cause is for the most part a highly righteous
one. This is an instance where lying (or
withholding the truth) might really be the best
course.

This is my last comment on the matter but I think that letter by Jeffrey Schaler is the stupidest thing I've ever read. It's just one long personal attack that says next to nothing and what it does say misrepresents the facts. He's complaining about the fee Peter got when the lawyers questioning him got we don't know how much more illegally??!! I honestly don't know what Schaler's beef is. Very hard to understand where he's coming from and what he really believes about the issues. What is clear is that he must have been seriously burned by Breggin and he was out for revenge. He doesn't seem to think that Prozac can cause suicide so "all too right" is not how I'd describe it. As far as I'm concerned he sounds childish and petulant, but thanks for the link. It helps me understand you too.

Alan, is nice of you to finally come out and admit that your a card carrying Pro-Psychiatry Medical-Modality righteous zealot. It only took an agenda fueled by you a bunch of weak half truths over 15 comments, and a few hours of doing copy/paste with some commentary.

Ironically, you haven't appeared to win any converts.

That might just be because the life journeys by the vast majority reading/commenting on this site have real hard evidence your modality will never understand or accept. "The complete and total failure of this medication based medical modality delivering on what it says it can do in real undeniable human experience and results"

Your "religion" (it has been said that psychiatry is the new religion of our modern culture), is vastly more concerned about maintaining it hold on power; because it's a greedy modality based upon control over others at it's core.

It is driven by an unquenchable thirst that "they" know better and have all the answers that fit for "them" to live comfortably above the afflicted, and without the fear of those maddened others that would dare question or invade upon their reining glass house of supremacy.

The one draw back I see for the medical modality starting to chug down those inevitable train tracks; is when the power is taken back by those persecuted in the name of a greed/false/weak science; they will be targeting and going after all those that have persecuted them with some fairly righteous indignation and concrete retribution of both mind and actions.

The medical modality keeps looking for scientific supported answers (their search for sanity "Holy Grail" so to speak) that they can not actually produce and actualize; so they just manipulate the focus to come up some very convenient conclusions always confident in a belief of what they want to find will be found because they have made it so by removing whole truth and opposing pieces of the picture/puzzle from the eventual outcome equation. They sometimes actually make it appear they have achieved what they say they have; until it's unmasked as mere faulty science once again.

That's a really nice dog and pony peep show they have going until the real cost in human suffering, tragedy, and death are finally tallied.

I laugh how you use terms like "anti-psychiatry" in broad stroke analogies as if you can somehow paint the millions upon millions of nah Sayers with a single condescending label. Sounds a lot like your in line for consideration as a DSM-V committee member.

Interesting that you have actually used some anti psychiatry rhetoric in a few of your responses.

Be very careful you don't slip and fall over to the DARK SIDE now lol..........

It is striking that most of those questioning and calling out for transparency, honesty, a return to ethical medicine, probing into conflicts of interest, demanding an end to ghost written twisting of research, an end to questionable science and clinical data, an end to unregulated out of control greed, a call to end corporate influence, pillaging, and fraud while demanding strong accountability in criminal terms; have very little to gain in professional circles or by monetary means.

From my vantage point, they see this more as a moral obligation to our fellow man, communities, and nation to call out for human dignity and rights for those that in many instances are least able to demand those basic humane practices and rights for themselves.

I guess you can take that, and smoke it in the old healthy dose of lithium pipe.

I was on a neuroleptic for sketchy reasons already, and was tired, so I got put on Wellbutrin. The Wellbutrin made me really hyper and had a lot of totally irrational thoughts, so instead of taking me off it, they added lithium. It's like the old lady who swallowed the fly. After a year or more and problems with toxicity, I persuaded them to get off my meds altogether, and after six months of getting used to that I was fine, and have never had to go on any psych drugs in the ten years since I made that decision. This all happened while I was a child, so I had little control until I was an adult, and even then I had a shrink try to convince me I was not an adult and had no rights so I would obey him. My life has only gotten better steadily since I got rid of that guy and even stopped seeing the more well-meaning one I had been seeing. I have no regrets and even learned after going off the drugs I was on that even the symptoms I was on some of the older ones for were paradoxical reactions to the drugs themselves.

I'm not anti-drug for anyone who knowingly and willingly steps into such a situation but for me it happened by force and did far more harm than good. Children have no right to refuse treatment and that is how I was forced into the system and then persuaded (often under dire threats or manipulation) to act like whatever kind of mental patient they said I was (which kept changing) and the meds only created more symptoms to diagnose and medicate. Even the most well-meaning of my doctors mad some terrible mistakes based on seeing what they expected to see (illness everywhere). Even my akathisia from neuroleptics was misdiagnosed as OCD or agitated or manic behavior. It's pretty amazing what expectations will lead people to see, and people need to be more aware that a medication reaction does NOT mean an "underlying mental disorder" has been triggered no matter how much it resembles that disorder.

Madman wrote:
"I laugh how you use terms like "anti-psychiatry"
in broad stroke analogies as if you can somehow
paint the millions upon millions of nah Sayers
with a single condescending label. Sounds a lot
like your in line for consideration as a DSM-V
committee member."

The group allegedly condescended to would have
to include me, since I am much more anti- than
pro- psychiatry. It is a mix, but certainly
more anti- than pro-. Psychiatry as practiced
ranges from moderately good to abysmal, with a
rather heavy weighting toward the latter.
Theoretical biological psychiatry, and biological
and molecular psychiatric research and related
brain research, is a good deal better,
providing many clues and insights that are
either useful right now, or that likely would be
useful given appropriate follow-on research.
The fact that most of this research is likely
to be used in harmful ways is distressing, to be
sure, but it is not the fault of the research
itself; it is the fault of the whole context
(social, economic, policy, medico-industrial)
in which it occurs.

I DO however greatly look forward to my
appointment as DSM-V committee member. Under
my guidance, the DSM section on orthomolecular
medicine will be expanded from its current
zero pages to 120+ pages. And the section
on critique of psychiatry (Szasz, etc.) also
expanded from zero to at least 50 pages.
It'll be fun.

:-)

PS: madman: what is your view on the role of
humor, and one's personal sense of it, in
mental health?

Sara wrote:
"I honestly don't know what Schaler's beef is.
Very hard to understand where he's coming from
and what he really believes about the issues."

It seems that you and I reside in parallel
universes. In my view, it would be difficult
to state more clearly what the beef is, and it
is perfectly clear where he is coming from.
I do wish you could read what Schaler says
APART from the portions on the lilly/etc. issue.

I think theoretical biological psychiatry is highly suspect without objective measures for disease, disease progression, and drug efficacy. The whole industry is nearly in complete denial by convoluting side effects and withdrawal symptoms with so-called disease rebound or latency.

I don't believe biological psychiatry will EVER produce a cure. First we'd have to able to say what is normal behaviour and what its biology is. We'd have to be able to differentiate behaviour and biology that has been altered by psychotropic treatment from a "diseased" state. We'd have to have objective tests to identify the specific disease and thus its requisite treatment instead of just mindlessly altering brain chemistry.

Have you ever seen the clinical that is collected that supports the regulatory approval of these compounds? Have you ever compared patient vs. investigator assessments? GAF scores? HAM-D? Brain scans - I'm sure you saw the paper on the dead fish that showed a statistically significant measure of neural activity when shown images???

The point is the theoretical premise is demonstrably falsifiable. The data are highly subjective and unreliable. There is reason to suspect fraud in the research. There is an appearance of collusion between academia and pharma and insufficient policing by the FDA (revolving door).

It's pure and utter crap. No other scientific field would tolerate such lack of rigor - well, perhaps excepting climate science - cough cough...

Psychiatry has got to get back to what it does best and leave science to the scientists, imho.

I don't think the word falsifiable means what you think it means, Paul. To anyone with the most rudimentary interest in philosophy, the term falsifiable is praise. It's a good thing. It's what distinguishes sciences from religion. Roughly, it means "testable."

Paul:

I agree that biological psychiatry will
produce little that might be identifiable as
"cures" -- because the whole "disease" model
is of very limited value when it comes to mental
problems. But that is not the same as saying
"biological psychiatry is 100% rubbish". People
actually DO suffer from these things, whatever
they are, and whether or not (probably NOT)
they are "diseases". Bipolar for example can be
a debilitating condition, causing misery and
ruining the life of the sufferer and everyone
around him/her. It is also a disorder with
some known neurochemical correlates that are
amenable to intervention, with beneficial
results. Whether or not said interventions are
best viewed as "treatment" for a "disease" is
another question, and one that I think is less
important than whether or not suffering can
indeed be relieved. And sometimes it CAN.

I am familiar with the case of bipolar because
several people very close to me have suffered
from it. One of them has refused treatment
and to this day remains utterly dysfunctional,
with a completely wasted, ruined life.
And in practice the fact that he refused
treatment is a mixed bag: some good, some bad.
The few times when he has actually gone to a
shrink, they prescribed the crappiest drugs --
e.g. the 2nd-generation antipsychotics that
everyone here is so familiar with. That does
not mean that he could not be helped with
well-selected meds, nutritional and/or
pharmacological. It means that some shrinks
are incompetent boobs. (I suspect that
"some" is more like "most", but it is just a
suspicion.)

Would this friend of mine truly
have gotten help from treatment? Of course,
I cannot know. But I think so. To be sure,
his life could not be any worse than it is
today. His life was literally ruined, utterly
and completely. A Yale graduate with a genius
I.Q., with a large circle of wealthy and
brilliant friends in his youth, (lots of the
kinds of people you see on ted.com), he now lives
(age 62) in Detroit's worst slum, barely
able to care for his fundamental biological
needs, barely able to organize himself well
enough to get out to the soup kitchen in time
for dinner. No friends (except yours truly),
no spouse, no work, no prospects, no nothing.
It is truly pathetic. And frankly, when
dealing with him (as I did yesterday; I spent
all day down there trying to clean up the
filthy hovel that he calls home), I don't give
a flying fuck whether or not his condition can
rightly be called a "disease". Whatever the
fuck it is, it is HORRIBLE. In the face of
this human tragedy, all of Szasz' finest prose,
(and I LOVE Szasz like a hero), and all the
best critiques of psychiatry, collapse into
a pile of worthlessness, or worse,

I wrote that "in practice the fact that he
refused treatment is a mixed bag: some good,
some bad", and that he was prescribed crappy
drugs (which he never took). But at times,
like yesterday, I am not so sure of that.
Maybe he might have benefited even from the
crappy drugs. His situation certainly could be
no worse than it is.

What would Peter Breggin recommend to him
right now? What would you (anyone here)
recommend to him right now? Affirmations?
Positive thinking? Should he read tracts
about how "mental disease" does not exist
and about how psychiatry is a bunch of
shit? Well, truth is, he has beat you to
it. He HAS read lots of stuff like that,
and he believed it. He HATES doctors and
psychiatrists and drugs and Big Pharma.
That is part of why he refuses treatment.

Psychiatry may be bad, but anti-psychiatry
may sometimes be worse. And this is one
candidate instance.

I really like your common sense, Alan. It's refreshing to see. People get too caught up how their anti-stand on psychiatric treatment defines them as a person and forget there is true suffering associated with these illnesses. Some people need to do real community outreach and have their eyes opened.

Alan,

I don't know how you can blame anti-psychiatry for your friend's condition. He's refusing treatment for his own reasons, not because of what anyone else said. He's a grown man.

I don't think the point of this blog is that drugs are bad for everyone. The point is that they are overused and given in clearly inappropriate cases!

I personally believe that there are some cases where psychiatric medications are necessary and useful, but I also think that >90% of people who get them do not need them, and are suffering unnecessary side effects.

I fall into this category. I almost lost everything to an antidepressant. If I had remained on that drug, I would have wound up like your friend -- alone, unemployed, miserable. I was well on my way. I would have been fired from my job if I'd spent even 6 more months on medication. It was that bad for me.

After that experience, I realized that there's nothing biologically wrong with my brain. There are no tests to say whether anyone has a "chemical imbalance" in their brain, but as far as I can tell using common sense, I'm fairly average. I should never have been given a psychiatric medication.

Just being unhappy is not a brain disease! Problems, stress, immaturity and difficult circumstances cannot be medicated away. I wish I'd known that sooner. I came close to losing everything, and I may never get back to where I was before financially. However, this experience has taught me that I have to "(wo)man up" and deal with my problems, instead of expecting a doctor to fix me. I've grown up a lot as a result of this experience.

If doctors didn't harm lots of people with drugs they don't need, there wouldn't be websites like this. If people are refusing drugs because of what they read on the internet, then the blame for that falls on the psychiatrists who created this dysfunctional situation in the first place.

Psychiatrists prescribe unneeded drugs by the millions, and when someone is harmed, they point to the one person who might need the medication and say, "Shut up about your side effects! You are denying medication to this sick person, you heartless zealot!" I think psychiatrists need to take some responsibility for the situation they have created, instead of pointing fingers at people like me.

PS: madman: what is your view on the role of
humor, and one's personal sense of it, in
mental health?

Interesting that you might ask this question; since I have used humor and laughter in actual practice with those "coined" most severe and untreatable populations in the mental health system.

Not only is bringing a sense of joy, laughter, and an ability for one to laugh at themselves and some fairly horrific and tragic conditions important; but it has an amazing power to bridge a monumental power/role gap that is artificially created in the vast majority of institutional environments.

I found it to be both effective and therapeutic in subjective terms of course. But this is obviously something that is immensely lacking in institutional and clinical settings.

Though the actual study would never get funded; I would theorize that weighed against SSRI's and other definitely more intrusive treatments; humor and the sense of it (laughing) would probably stack up pretty well.

By the way, Congrats of your DSM-V committee nomination. Is it possible you could push for a diagnosis and treatment label for those that post more than fifteen comments in one thread?

I would think rationally that multiple 150,000 volt electro convolsive therapy treatments could have a positive outcome on this gravely disabling condition.

Though the old standard of taking a baseball to an already dead horse would prove more cost effective. lol................

Francesca,

I did mean testable but I as I read it again I can see how it doesn't really flow as it did in my head when I thought it...

I guess my point was that theoretical underpinnings of biological psychiatry can be tested and shown to be valid or invalid.

The results so far are inconclusive and contradictory. The miasma permeating the research is why I call it crap.

I said I wasn't going to comment again, but Alan, I do appreciate your sharing that story. I'm glad this poor fellow has you as a friend and he needs more like you. It's true that Breggin's strength is not really "solutions" for people like this and it also may be that meds might help in a crisis situation for a short period of time but what this fellow really needed was something from the people in his life that he didn't get at some long ago point in time. It's something that really needs to be rectified in society, rather than at the drug store. That's my idealistic stance anyway.

And I'll be a prime candidate for that disorder of posting more than umpteen times a day on Philip Dawdy's blog -- furious season compulsive (or comment) disorder (FSCD).

Alan,

I couldn't care less about the psychiatry/anti-psychiatry debate.

I care about how people are treated, that it is humane, freely chosen, and is respectful. The current influence of biological psychiatry has negatively impacted the practice of psychiatry in this regard, imho.

Psychiatry would be better served by judicious use of experimental pharmacological agents and by maintaining a strict divide between itself and industry. Psychiatry should be demanding that science provide it's own independent, objective measures that can identify mental diseases for which its drugs actually treat. That's not what's going on today.

I've also been thinking on your friend a bit.

One of my favorite sayings that I am fond of repeating when faced with a situation that upsets my world view:

He's not mad. He never was. It's just that his sanity went beyond most men's understanding.

Perhaps you'd be happier if you looked at your friend in a different way. Do not look at him as an illness or disease and a waste of potential. Think how negative and polluting this is to you.

He's also not a criminal requiring behaviour modification or incarceration. He's not harming himself. He need not be subjugated to fit your view of him or of the human condition. Is it possible that he's waiting for something? He may a hurt so profound that he cannot express it in terms you recognise as such. I am sorry his manners and behaviours make you unhappy - this is actually your problem, truthfully, not his.

I don't know what, if anything, troubles your friend but he is fortunate to have you nearby. It's not easy to see people we care about not doing or behaving the way we think they should do - it's worse with your kids.

Regards,
Paul

Paul:

You wrote: "He's not mad. He never was. It's
just that his sanity went beyond most men's
understanding."

A very fine-sounding sentiment which surely
reflects some distant truth that has NOTHING
to do with the suffering of the human being
in front of your eyes right this moment.

"That starving child is not really hungry.
He never was. It's just that his cosmic satiety
went beyond most men's understanding".

Uh-huh.

You wrote: "Perhaps you'd be happier if you
looked at your friend in a different way."

I am not looking to be "happy". Happiness is
a derivative of things that come from deep
within; i.e. it is spontaneous, not something
that can be sought and grasped.

You wrote: "He's also not a criminal requiring
behaviour modification or incarceration. He's
not harming himself. He need not be subjugated
to fit your view of him".

I know very well that he is not a criminal, Paul;
I never suggested anything of the kind.

I don't think he requires "behaviour
modification", and certainly not incarceration,
for God's sake! What the fuck do you think I
am? Some kind of authoritarian and punitive
asshole? Well, I'm not. FYI.

What he requires, desperately, is healing, not
"behavior mod" -- though some measure of
behavior mod, a la CBT, MIGHT be some part of
his healing, and I've suggested as much to him.
HE will have to determine that, not me.

He most certainly IS harming himself, every
day.

No, of course he need not be "subjugated to
fit my view of him or of the human condition",
for God's sake! Again: what kind of asshole
do you think I am? And WHY do you think that?

Sorry if I'm coming off as harsh, but it seems
to me that YOU are being quite harsh toward ME,
in your implicit judgments of me.

You wrote: "Is it possible that he's waiting
for something? He may [have] a hurt so profound
that he cannot express it in terms you recognise
as such."

"Waiting for something" sounds very nice and
plausible, provided we ignore the fuzziness and
insubstantiality of it, and its probable
uselessness.

Yes, of course he has profound hurts that can
be articulated only with difficulty, if at all.
Most of us do. He, probably more than most.

You wrote: "I am sorry his manners and
behaviours make you unhappy".

Where did you get that idea, Paul? His
manners and behaviors do not make ME unhappy;
they make HIM unhappy! Or rather they reflect or
recapitulate his unhappiness, his distressed
inner state. I am unhappy with his unhappiness,
the abject misery that keeps him perpetually
on the edge of fucking SUICIDE. "Manners and
behaviors"?! Sheeeit. I don't give a rat's
ass about his "manners and behaviors". I care
about his inner torment. I care about his
"manners and behaviors" only insofar as they
reflect that inner state (as I take
them to do, to a large extent; it is possible
that I am wrong about that).

I apologize again if I am coming off as intolerant
or short-tempered. It was just what I took you
to be saying or suggesting -- that I am some
sort of moralistic or fascistic asshole who
cannot stand diversity of behavior, who must
have others conform to some fixed standard (MY
standard) of "normal", etc., etc. And maybe I
am responsible for that, for not making myself
clear in the previous message. I mentioned his
behaviors with the implicit understanding
(clear enough to me, but maybe not to you) that
those behaviors represented a gruesome inner
state -- NOT that those behaviors were, in and
of themselves, "the problem". They are NOT
the problem. Sorry if I did not make that clear.

If he were a happy and fulfilled person, who
loved his life, but who just happened to live
in a grim slum and be unable to get organized
well enough to get to the soup kitchen on time,
then FINE. That's FINE. There's nothing wrong
with that. He does not need "treatment" for that.

Copische?

Alan

Sara:

You wrote: "what this fellow really needed was
something from the people in his life that he
didn't get at some long ago point in time."

I TOTALLY AGREE. And is it not true of all of
us? That we need "something from the people
in our lives that we didn't get, long ago"?

Also: "It's something that really needs to
be rectified in society, rather than at the
drug store."

I TOTALLY AGREE. But at the same time, I have
to admit that changing society is a very long-
term process -- multi-decade, or multi-
generational. Meanwhile, if someone is (say)
climbing the walls, beside themselves, it is
tough for me to just say: "hey, it'll take
a half-century or so to build a better
society, and in the interim you'll just have
to DEAL WITH IT". No. I can't do that. That
person needs what they need -- whether or
not produced by evil Big Pharma.

you wrote: "I'll be a prime candidate for that
disorder of posting more than umpteen times a
day on Philip Dawdy's blog -- furious season
compulsive (or comment) disorder (FSCD)."

Me, I suffer from Furious Seasons Episodic
Situational Compulsive Posting Disorder, or
FSESCPD. It is a compulsion, but only
expressing itself in episodes, under certain
conditions. A serious condition, to be sure,
but with early diagnosis and aggressive
medical treatment, there's always hope!

:-)

Madman:

You wrote:
"Not only is bringing a sense of joy,
laughter, and an ability for one to laugh
at themselves and some fairly horrific and
tragic conditions important; but it has
an amazing power to bridge a monumental
power/role gap that is artificially created
in the vast majority of institutional
environments."

I believe it, especially the latter part.
Artificial power relations, and all
status-hierarchy/dominance games, (and indeed
all ego-based bullshit in general), are
supremely vulnerable to humor, which exerts
a sort of solvent effect on the whole thing.
The only thing I know of that is more powerful
in this regard is entheogenic drugs.

You wrote: "Though the actual study would
never get funded; I would theorize that
weighed against SSRI's and other definitely
more intrusive treatments; humor and the sense
of it (laughing) would probably stack up
pretty well."

Agreed. Would probably beat the drugs, hands
down, in the short term. My only concern would
be the practical sustainability of it.

Alan, it is horrible to watch someone you care about live like that. So, I understand where you're coming from, and I understand how it's tempting to think that if a person just took meds that their life would be better. The thing is, I've just never seen it happen that way. I have seen people who stop abusing substances clean up and stop living on the streets and get a job and so on. But, not someone who just starts taking antipsychotics.

What I have seen is someone who has had antipsychotics for years. Her brain is now mush. This is someone who taught at a university, briefly. Gifted pianist, beautiful woman, articulate, probably the most intelligent person I've ever known. Now, she smacks her lips and doesn't even know me. She is no longer a gifted pianist, no longer articulate, and she looks like a bag lady. So, while I understand this magical thinking that if people just took their meds they would quit living on the street, get a job, walk their dog, and make dinner every night. It just isn't reality. Reality is she is barely functional. Luckily for her my grandfather created a trust and an attorney makes sure her rent and utilities are paid every month or she would live on the street like your friend. She can't or won't take care of these things EVEN ON meds.

I don't know what the answer is, but meds don't fix it.

It was through the use of humor used by someone else, that I was given the gift of hearing my non-verbal daughter laugh again. I have witnessed, first hand, the laughter from her and other patients in a locked psych hospital. It is a powerful tool.

Alan; don't you find its so danged difficult when your local shaman gives you "a little pick me up" (peyote aka mescaline) elevating your cognitive functions at the workplace (though I'm not saying that juggling suitcase class thermal nuclear war heads during coffee breaks presents any serious risk in this situation for myself in particular).

Now as for the humorous defacto effect and sustainability component; we just need to give each of them a government job with no clear objective and an unlimited budget (Maybe Health Care Czar, FDA regulatory head, or a position in the defense department procurement office as rudimentary examples).

I know personally, there nothing much more funny and long lasting than taking truck loads of other people's freshly printed money, and running it all through a giant shredder. Talk about some high quality party confetti to bring home to the kids in this continued pursuit of ever lasting happiness, belly bliss and "Joy" (and by "Joy", I meant "Joy" the office secretary that wears tight sweaters every day to work).

Alan,

Not to worry - I have thick skin...

I thought you left a rather clear impression that your friend's condition worried you, concerned you - you certainly weren't happy about it. All I suggested is that you might be a bit less unhappy if you changed the way you perceive your friend's condition.

You care a great deal and that's more than many people who suffer have. If I thought you were any of those nasty things, I'd have just said so. I think you're a good friend.

Also, the quotation (from Azimov) is a for me a reminder to be humble in the presence of suffering.

I think you may have misinterpreted what I wrote. Reread what I wrote in that context.

Madman wrote:
"there nothing much more funny and long lasting
than taking truck loads of other people's freshly
printed money, and running it all through a giant
shredder."

Righto. It's a riot. A regular riot.

And speaking of which -- straying further
off topic, but here goes -- Matt Taibbi's
latest will be shocking to anyone still nursing
the naive belief that Obama is somehow "better",
or "more progressive", or a change agent,
etc.:
http://www.rollingstone.com/politics/story/31234647/obamas_big_sellout/print
http://taibbi.rssoundingboard.com/matt-taibbi-on-obamas-economy#

..... don't miss the youtube video at the
second link.

Lisa wrote: "I don't know what the answer is,
but meds don't fix it."

WHICH meds don't fix it? And, which meds
IN COMBINATION WITH which other techniques
(nutrition, CBT, etc., etc.) don't fix it,
or at least ameliorate it.

I don't doubt that your friend's brain was
"turned to mush". Conventional 2nd-gen
anti-psychotics are, as everyone on this
site very well knows, LOUSY drugs. Or worse
than lousy. Same is true of the 1st-gen ones,
for that matter. The whole "anti-psychotic"
category is highly suspect AT BEST. I call them
the "zombie drugs", I think with good reason.
There MIGHT be good reason to give them in SMALL
doses to highly-select subjects. MIGHT. SMALL.
HIGHLY-SELECT. That's about it, and I think I
am being charitable toward them. I might be
totally wrong; they might be inappropriate for
everyone, all the time, everywhere.

But then, there are meds and there are meds.

Lithium at nutritional or modestly super-
nutritional doses is far, far different from
what I just described, and of course lithium
has a long and well-documented favorable track
record in bipolar.

That is just one candidate agent of many.
Omega-3 fatty acids have now been shown to
have beneficial effects in many bipolars.
Valproic acid may be beneficial for some; it
has very nice neuroprotective, glutathione-
boosting and other neurochemical effects, in
addition to a clinical track record that is
encouraging. Taurine is an essential
complement with numerous relevant actions and
some clinical record. And magnesium, same as
taurine (huge theoretical base, plus some
empirical base). Adjustment of thyroid status
with supplemental thyroid hormones is likely
to be essential for some (most?) cases; see
Phelp's excellent writeup:
http://www.psycheducation.org/thyroid/introduction.htm

Also, glutathione precursors (or glutathione
itself, from raw meat and other foods) have
been shown to be beneficial. Which is not
surprising, given how important glutathione
is for the normal function of the brain.

And so on.

Meds and diet are almost certainly a critical
part of a rational, low-stress (low "side
effect") and economical long-term treatment
protocol for bipolar. Too bad that most of
the anti-psychiatry crowd -- from what I've
seen -- cannot seem to understand that.

BETTER SELECTION of meds, and LOWER DOSES of
the problematic ones (along with nutritional
context/support), is critical.

Most psychiatrists are out to lunch. But then
they've been brainwashed in a particular way,
and it is unlikely that they (the currently
living generation) will get un-brainwashed.

http://www.psycheducation.org/thyroid/HighDose.htm
High-Dose Thyroid Hormone As a Mood Stabilizer in Bipolar Disorder
(Written 10/2007)

http://www.psycheducation.org/thyroid/T4BauerReview2003.pdf
Clinical Applications of Levothyroxine in Refractory Mood
Disorders
SNIPPET:
There is growing evidence, from clinical research, that
thyroid hormone levels below or at the lower end of the normal
range (thyroid hypofunction), may be especially relevant to the
pathophysiology of bipolar disorder and may result in a
suboptimal outcome. Frye et al.43 reported that a low level of fT4,
even if within the ‘normal’ range, was associated with more
affective episodes and greater severity of depression during
prophylactic lithium treatment in patients with bipolar disorder.
It appears, therefore, that a higher fT4 level is advantageous for
treatment with lithium. Lower free thyroxine index values and
higher TSH values (but within the normal range) were also
significantly associated with poorer treatment response in
bipolar patients during an acute depressed phase.44 A 4-week
challenge study, with therapeutic doses of lithium (a
prophylactic agent with established ‘antithyroid’ properties),
found significantly higher delta TSH levels after thyroid releasing
hormone stimulation in unmedicated rapid cycling bipolar
patients compared with healthy controls.45 The investigators
postulated that if ‘central’ thyroid hypofunction is induced by
lithium treatment, or any other mechanism, increasing the
availability of thyroid hormone to the brain may be therapeutic,
with consequent modification of the mood state and improved
clinical outcome.45
SNIP

.........................................

also:

http://www.ncbi.nlm.nih.gov/pubmed/11772699
Am J Psychiatry. 2002 Jan;159(1):116-21.
Slower treatment response in bipolar depression predicted by lower pretreatment thyroid function.

http://www.ncbi.nlm.nih.gov/pubmed/15724143
Mol Psychiatry. 2005 May;10(5):456-69.
Supraphysiological doses of levothyroxine alter regional cerebral metabolism and improve mood in bipolar depression.

http://www.ncbi.nlm.nih.gov/pubmed/16865933
Epidemiol Psichiatr Soc. 2006 Apr-Jun;15(2):123-7.
Hypothyroidism in patients with bipolar I disorder treated primarily with lithium.

http://www.ncbi.nlm.nih.gov/pubmed/19183414
Acta Psychiatr Scand. 2009 Jul;120(1):10-3. Epub 2009 Jan 31.
Depressive relapse during lithium treatment associated with increased serum thyroid-stimulating hormone: results from two placebo-controlled bipolar I maintenance studies.

http://www.ncbi.nlm.nih.gov/pubmed/19296014
Singapore Med J. 2009 Feb;50(2):e65-7.
Mania as a presentation of primary hypothyroidism.

http://www.ncbi.nlm.nih.gov/pubmed/19215985
J Affect Disord. 2009 Aug;116(3):222-6.
The use of triiodothyronine as an augmentation agent in treatment-resistant bipolar II and bipolar disorder NOS.

http://www.ncbi.nlm.nih.gov/pubmed/19108898
J Affect Disord. 2009 May;115(1-2):230-3. Epub 2008 Dec 23.
Long term augmentation with T3 in refractory major depression.

http://www.ncbi.nlm.nih.gov/pubmed/17289154
J Affect Disord. 2007 Nov;103(1-3):253-6. Epub 2007 Feb 7.
L-thyroxine augmentation of serotonergic antidepressants in female patients with refractory depression.

That's interesting to a point; but since any Doctor worth their "Salt" would check/test the thyroid first before ever giving any bipolar/psychiatric diagnosis.

In fact an over or under active Hyper/Hypo thyroid would most certainly preclude any psychiatric diagnosis until that condition was properly treated as a physical medical condition.

your thoughts?

Madman,

That might be true except that there are many people that are symptomatic even though TSH, T3/T4 are within lab normal ranges.

My experience is that there are many people who have very narrow ranges and get missed as having "normal" thyroid function. I can't be certain if this related to pituitary/hypothalamus pathway issues or within the gland function itself or some combination. It's suspicious, however.

I don't know what to say- all the back and forth is confusing to a very broken brain. I know this much. I was a moody teen, I thought too much about things other teens didn't think about. When I went to college I was told I was a genius, I was creative, I had a poet's soul, this is why I thought these thoughts. I was told I had a beautiful life- career to look forward in academia, professorship, studying, and writing.

When I was 22 I lost the first boyfriend I ever had, and took it badly, as some do the first time their little hearts are broken. I ended up in the hospital. Diagnosed BP 1. Since then, over 43 different me cocktails and ECT. The ECT ripped holes in my memory, and gave me a drop in AT LEAST 20 IQ points. The drugs have given me side effects, that, if you look at my latest blood work- I have a thyroid that is pooping out and I am a whisper away from developing full blown Leukemia from lithium. Haldol almost killed me, I had to learn to walk all over again, and teach myself how to eat again.

I have been off my anti depressant since the end of Sept, and off all meds(mood stablizer) other than Tylenol for joint pain (from the Leukemia) for slightly over a fortnight. My brain is clearer than it's been in almost a decade. And because of this, my immediate family believes I've just done something as horrible as clubbing a baby seal. I am in the process of being non compos mentis so the state will put me in a group home, make sure I am taking my pills and I can just sit in a room all day and rot. If I get back on meds, it will be stopped. It's a weird Sophie's choice.

My family and my Ex tell me not to read this site, not to listen to anti psychiatry people. But they have not been hospitalized. They haven't seen the things I have, those memories are intact. They don't know what the drugs have done to me, and when I complain- the docs don't listen, cept in the case when I was on Lamictal- and got the rash.

I lost 20 years of my life, my career. I tried another career, was good in that, enjoyed it, not as much as the first, but that was taken away from me too with the memory loss and side effects. I am now living on a fixed income, the only pleasures I have besides my fur baby are my blog and reading other peoples blogs. I;m not living. I;m existing. It's almost too much to bear without the people here who at least understand.

Happy Holidays.

sorry. I should have said "Nursing home' not "Group home"

Susan, my heart goes out to you. My greatest fear was that my parents would, out of fear, have me committed if they knew I had stopped taking the meds. And considering how bad things got during the withdrawal process, had they been aware of what I was doing, they probably would have. Unfortunately, even though I love them, I had to keep them in the dark about it because they were just too afraid. My sister, on the other hand, trusted me to know what was right for me. She was my confidante during that time.

Do they have to know you've stopped the meds? Is there a family member you trust that would in turn trust you to know what you need (and don't need)?

I'm not surprised that anyone critical of psychiatric treatment gets tagged as "anti-psychiatry." If they can just label those critical of psychiatry as a Scientologist or anti-psychiatry or both, then they don't have to take any responsibility for their part in the crappy treatment that has led to the formation of anti-psychiatry groups in the first place. Very convenient.

Alan-

I haven't read the entire thread, but to get your stance straight, you believe that ssri's and the like are simply a bandaid and not a cure correct?

I think it's obvious after years of experimentation with these kinds of drugs that they cure nothing. Changing the chemistry of the brain to make it act in a way that it wasn't meant to isn't curing, it's simply changing. While this can work for a while to cover up what's wrong, it doesn't get to the core issues that could be helped primarily through diet, exercise, relaxation/stress relief, and therapy.

I'm not 100% against use of psychiatric drugs, but they should be used as a last resort ONLY, in order to allow time to get to the core issues.

Maybe it's just me, but it seems to make sense that our bodies already have amazing healing mechanisms in place, we just have to support those systems the best we can.... and psychiatric drugs don't seem to have much of a place.