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jbmd
jbmd, Board Certified Physician
Category: Medical
Satisfied Customers: 615
Experience:  Board Certified physician in Internal Medicine - 30+ years experience
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I was on Lithium and Setraline for many years and had been

Resolved Question:

I was on Lithium and Setraline for many years and had been informed that this would be for the rest of my life. I was informed by my psychiatrist that if I came off the Lithium the consequences would be dire. Suicidal tendencies would be the least of these consequences.
Last year, however, blood tests indicated that the Lithium was damaging my kidneys. I was therefore weaned off the Lithium.
The main problem now is that I am not as stable as I was. Is there a Lithium substitute that I could think about?
PS The Lithium and Setraline combination provided an absolutely stable mood. My moods are now more varied.
Submitted: 4 years ago.
Category: Medical
Expert:  jbmd replied 4 years ago.

jbmd :

I can give you some suggestions, though I cannot treat or examine you and cannot replace your local medical care. Lithium is a mood stabilizer. There are multiple other mood stabilizers in different classes: anticonvulsants (working to prevent the rapid neurologic/electrical shifting of mood) and atypical antipsychotics (working for mood, not psychosis).

jbmd :

In the first group are (with US trade names and some of the other reasons they might be selected for use for patients Olanzapine (Zyprexa),for people with severe or psychotic depression, which often is accompanied by a break with reality, hallucinations, or delusions7



  • Aripiprazole (Abilify), which can be taken as a pill or as a shot

  • Risperidone (Risperdal)

  • Ziprasidone (Geodon)

  • Clozapine (Clorazil), which is often used for people who do not respond to lithium or anticonvulsants.8

jbmd :

(Please wait for further--I have some good suggestions but just got called away--back in about two hours.)

jbmd :

I'm sorry--the above are the second group, the atypicals, not the anticonvulsants. The side effects of the atypicals can be weight gain and worsening of diabetes.

jbmd :

The best, XXXXX XXXXX of the anticonvulsants (seizure medicines) is Lamictal, which is available in the UK: http://www.nhs.uk/medicine-guides/pages/MedicineOverview.aspx?condition=Epilepsy&medicine=Lamictal

jbmd :

I prefer to consider drugs while trying non-drug therapy like neuro- or bio-feedback, which can be quite effective and retrains your brain without giving you radiation or putting electrical impulses IN, like electroshock therapy, but only takes a recording of your brain activity and gets YOU to straighten it out.

jbmd :

Please ask any questions and again--I apologize for the slightly messy arrangement of facts above. I wanted to finish my thoughts of help for you while not neglecting my tasks here!

jbmd :

Please ask any questions you wish to. There are lots of options to find the best solution for you.

jbmd and other Medical Specialists are ready to help you

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