Monday, December 31, 2007

Weight Loss

Hey all - wondering if anyone has experienced this.

I've been on Lamictal for a few years, and have tried various other things with it. I haven't stayed on any of them, the return was not great enough to justify the costs. After a couple years of trying, the doc finally convinced me to try Lithium. We spent a lot of time discussing potential side effects, and among others I mentioned my concern about weight gain. He said average was about 20 pounds, but if I continued to work out I probably wouldn't experience that much gain.

It's only been 2 months, but this stuff is amazing. It's not as side-effect free as Lamictal, but it has tamed my predominantly manic side perfectly. I'm not tranquilized, I can think, I can work, I can write, I can work out. It's just incredible.

But - the reason for the post. I'm losing weight. 2 pounds in the last week, 5 pounds in the last month. Hooray! Right? Not so fast. I just came through the holidays eating like a horse. I've worked out only 3 times in the last 2 months, so I'm not exercising it off. I'm eating more than I have in a long time. But today I'm equal to the lowest weight I attained last summer after working out every day for 6 months. I'm not understanding this, and it has me a little nervous. I'm physically nervous, nervous tics, constantly shaking legs, hands on the verge of tremors, so forth. But I don't feel that nervousness in my head. I'm like a calm, placid, pond in my head.

Anyone ever experience this?

15 comments:

Dream Writer said...

I have been on Lithium for almost a year and never gained a pound. I seem to be able to lose weight easier.

It is known that medicine can have the opposite effect on some of us. Those who gain, those will lose and so on.

My manic signs were wonderful for a long time until this recent dip into darkness. But that is normal I think as there is NO Miracle drug.

I am staying on lithium as I NEVER had its side effects which is great.

The tremors might be from something else but something to discuss with your doctor.

I don't have tremors but major "Restless Leg Syndrome" lately. I cannot sit still.

Dream Writer said...

I meant my manic episodes were at ease for a long time :)

Just Me said...

First, can I say "told you so"?:)

Second, tremors are a side effect of lithium. A really common one. They can be treated with Inderal, a blood pressure med, if they are cosmetically irritating or mess with function (back when I took a lot of lithium they were for me because my assistants couldn't read my writing and I was constantly breaking dishes. Once I broke 3 pie plates in one blow.) I refused and refused the inderal but when I finally agreed it really helped. I just wrote to my doctor last night to see if I can go back on it.

I believe weight loss can occur (as in is a known side effect) of lithium. As I recall the weight gain stabilized after a few months so maybe loss does too?

I think all meds cause both gain or loss depending who takes them. I know that's happened for me, unfortunately it's nearly always gain. I'm 90 lbs. heavier than at diagnosis. I'm hoping 20 of that which came with hypothyroid this summer will go away, but we'll see.

Dream Writer said...

I guess it depends how many milligrams you are on and what you are takign it with.

I am on 900 milligrams of lithium and 300 milligrams of wellbutrin and I guess the two together are pretty good even though I am going through a moment right now.

This is the first darkness in almost a YEAR of being on lithium so that is not bad at all.

This too shall pass

Just Me said...

DW-

Lithium's side effects are pretty level dependent, not dose dependent. It is possible for your body to change some and your level to change with it. This happened to me a number of times when I was on 1200 and 1500 mg. Watching side effects is a good way to watch for this. As is, obviously. your mood not staying stable.

A year isn't long to be on lithium, your body will continue to adjust for a long time. So if you're not feeling well labs are a good thing. I know back in the beginning couple years there were several times I'd feel bad and all it needed was a bit more lithium.

It is also possible to just be a lithium weirdo. My doctor has several of us. One has kidney damage that means he needs a low dose and another man and I both have had toxicity followed by our bodies not regulating well. All 3 of us tried being off of it and all 3 have chosen to take a low (technically sub-therapeutic) dose because we "just don't feel right".
If I'm on more I have signs of toxicity (nausea, diarrhea, substantial tremors). My level is typically around .4 so I shouldn't be anywhere near toxic, but my body has redefined toxic, I assume as protection after the real thing, which is the sickest I have EVER been by far.

Also, just to throw this at you, have you ever been told about antidepressants triggering mania? I'm just throwing it out there because I know you've had a really hard time lately and I hate when meds are potentially at fault. Having said that, I do take an antidepressant at a very low dose which I can adjust at will. It's not always bad, but often is. See www.psycheducation.org for a psychiatrist's view.

Dream Writer said...

I have a lab prescription as we speak. In my opinion, no matter how long we are on medication the truth may be...there is NO miracle drug..we will always have our moments.

I have been on Depakote, Geodon, Topamax, Invega, Lithium, and god knows whatelse and I have to honestly say that Lithium has been a pretty good friend.

We bipolars CAN be on anti-depressants as long as we are on a mood stabilizer.

We get our triggers and we have our moments, but not all the time is it from our medicine...sometimes it is from us...from how we cope and we chose to deal with our problems.

Just Me said...

I'm sorry, I didn't mean to offend you.

I just know that some doctors don't make a big enough effort to try to avoid antidepressants, and just taking a mood stabilizer doesn't mean that it's enough. Heck, I'm on 3 mood stabiliers, 2 at very high doses and I can't even drink a can of Coke because it makes me manic.

Again, I'm sorry I offended you. My belief is that no matter what is happening in my life that might be influencing my symptoms my meds are supposed to keep up and so if I start feeling bad the psychiatrist will be looking at the meds ASAP. Depression we let go a little bit, mania I contact her after 2 days of no sleep.

I'm sure I come off as very meds oriented. I really place equal value into therapy and therapy helps me tremendously, but without meds therapy would be useless. I've been there, I can't think or talk or participate when I'm off meds and manic. It was scary. Furthermore because I react oddly to meds I have been on 40 some meds in many combinations. I know meds. I know the difference between being off and on for me. And so I know that if my meds are not balanced I will be sick.

mer8 said...

Just the word Lithium makes me nervous and a little anger. I am not happy with the fact we all are blessed with something we will never get rid. In my mind I feel like a lab rat with all of the cocktails these doctors trying to put my new medications. But I do have a question what is with not being on anti-depressants will on mood stabilizers? This is the part of the blog I don't understand and feel like I am being left out of something I should know since it is my health and my Dr. is awesome, that is me being sarcastic.

I so like my cocktail of choice which is Lamictal, Lexapro, and Clananipin (sorry about the spelling) but I do want to try that new drug on the market just for Bipolar patients, I am sorry the name is not coming to me. I also want to try the new antidepressant which supportively doesn't make your body hurt. But I have been stable with my current cocktail and everyone keeps saying it takes years to get to be back to "normal" so maybe I should not try anything new. Does anyone have advise because god only knows my Dr doesn't listen to me.

sara said...

Sure - plenty of people lose weight on lithium. It's just not as common as gaining.

G.J. "Jon" Gregory said...

Thanks all, for your input.

DW - The way I understand it, Lithium seems to control the mania, but doesn't do as much for the depression. Lamictal is more for the lower end. Both are supposed to do a good job stabilizing. That's what I understand, and it matches my experience so far. Like JM said, tremors are supposed to be a common side effect with Lithium, but one I was hoping to avoid. I dread threading and tying a fish hook this summer if my hands aren't steady... Restless leg? Just like you, I have it bad. Constant.

JM - you are allowed to gloat. But not too long...

Mer8,
Welcome. First, as you might know, everyone reacts to medication differently. I'm not sure it's known why one person can take, for example, Depakote, and have one result, while somebody else can have an entirely different result. And Depakote might be the med you are thinking of, I think they're advertising lately. I'm not aware of any "new" medications, although there's been a few releases of extended release versions of existing meds.

It sounds like you're doing this, but it's critical to take an active role in your treatment. Decide exactly what your objectives are, and how to reach them. Too many times a med is given experimentally, then each side effect that arises is handled with a different med. Tell your doc your objectives, seasonal problems you face (if any), and discuss the best way to handle those problems.

Sorry I don't have concrete answers for you, but I'm glad you're here. I visited your blog and will check back from time to time.

Sara - thanks for your input. I hadn't heard of Lithium causing weight loss. I'm glad it does.

Just Me said...

Mer8-

The thing I referred to with antidepressants is that for many of us antidepressants can trigger mania. Not 100% of course and only your doctor can know, but it's a good thing for you to know and maybe ask about trying. Some people believe excess antidepressant use without adequate mood stabilization can lead to increased rapid cycling.

FYI, Lamictal is can sometimes cause people to react more like an antidepressant, increasing manic symptoms.

I'm going to give you a link to my own blog from this last week. It is about doctors, as it sounds like you've got a problem there.

http://masterofirony.blogspot.com/
2007/12/getting-good-treatment.html

Good luck. It can be better. I'm saying this from having been about as bad as it gets just a few months ago. But finally I feel better than I have in 11 years. The good news is that most people get better way faster!

G.J. "Jon" Gregory said...

JM is right about the anti-depressants, that's how I was eventually diagnosed. Every time I'd get depressed the family physician would prescribe an anti-depressant, and after 2 months I was off the grid manic. After a few years of this I asked for a psych referral, and finally was diagnosed.

Just Me said...

To hit the AD thing one more time, just because it matters, I was told at diagnosis that the 11 ADs I had been on (with dose increase after dose increase) probably made my illness substantially worse. ADs increase the frequency of cycling in those susceptible and in my case that meant over several years my cycling became so rapid that I'm nearly constantly in mixed episodes. Without the barrage of ADs I would probably still have a difficult time, but my severity would be lessened to a more normal place.

Also, Jon, I wanted to say see what I mean about lithium just FEELS right? I can tell so clearly that this salt is something my body needs and wants. I do not feel remotely peaceful, ever, without it. What you described is exactly why I won't ever give up my tiny 300 mg/day. My doctor says that all 3 of her tiny dose patients describe it in exactly the same way. I think it's pretty neat.

su1 said...

I am very excited to read about your progress with Lithium as an add-on. What dose are you at? I hope the weight-loss thing can get resolved.

Anonymous said...

I tried Lithium & had GREAT results, but then I had kidney malfunction & had to get off it. Then began the long qwest for the right meds. Tried so many with bad side effects & finally ended up on Abilify, Lamictal, klonopin, Concerta, Provigil & Trazodone. Been on these for about 6 years with some adjustments (had to add on Wellbutrin one winter but got off it in the spring). Periodically, I've had to increase the Abilify or Lamictal for awhile.

BTW, the person asking about the name of the "new" med for bp might be thinking of Abilify. I was using it off-label, but it recently was approved for bp & they have been putting out lots of ads in magazines & even on TV.