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Title: Lithium ? Post by hornedone on Dec 2nd, 2007, 1:36am Question for those taking Lithium. I am currently taking a preventive combo of Lithium & Klonopin. Working pretty well so far...well except for one thing. Once the combo starts to wear off (taking it 3 times a day), I start to get very angry/aggressive. Have anybody ever dealt with this? And if so any suggestions? Really need some help here...the wife thinks I'm going to end up hurting someone. But since the Topamax is no longer effective, and since this is working relatively well (70% or so)...I really don't want to be taken off this, which i suppose could happen if i mention it to my doc. btw...this combo is allowing (so far) for some good painfree sleep. |
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Title: Re: Lithium ? Post by nani on Dec 2nd, 2007, 2:10am I wish I could offer some help. :-[ I remember reading about this effect before, but I have no personal experience. I didn't tolerate lithium very well, so I never went beyond 300mgs a day. I suspect you're taking more than that, right? Hopefully someone who can actually help will be along... Glad you're getting some pf sleep, anyway. :) |
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Title: Re: Lithium ? Post by Pinkfloyd on Dec 2nd, 2007, 2:19am on 12/02/07 at 01:36:05, hornedone wrote:
You should discuss this with your doc. How long have you been taking it? Sometimes these types of side effects will stop after you've been on it for awhile. It could be possible to change the change your dosing regimen and take the same amount in 4 doses rather than 3 whilch might stop the ups and downs due to it wearing off. Maybe you could try using melatonin at night to get the same sleep results. Bobw |
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Title: Re: Lithium ? Post by hornedone on Dec 2nd, 2007, 2:28am I'll check and see if I can do 4 doses instead of 3. Thanks for the tip! btw - I am currently on 900mg of Lithium and 3mg of Klonopin. As for the melatonin...for me it really wasn't ever that effective. Well...I take that back, it was in the beginning, but it wore off pretty quickly (couple of weeks). Another bad thing (minor) with this combo is that i am always hungry...and I am not the type that can afford the extra poundage. ;;D |
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Title: Re: Lithium ? Post by Damon on Dec 3rd, 2007, 2:42am I have been taking 900mg of Lithium for about a year and a half now, combined with 480mg of Verap and 1500mgs of Depakote. The only time I ever had anger issues like you describe was when I took Topamax three to four years ago. I hope the Dr. had you slowly step up to the three times a day. Luck be with you |
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Title: Re: Lithium ? Post by Guiseppi on Dec 3rd, 2007, 10:39am I'm 47, male and weigh about 190. I do 1200 mg a day of lithium when on cycle. I've never had those effects either going up, on, or coming off. Prednisone has make me a bit of a prick but that's only when I was on it for a long period of time, about 6 months. (I know, bad bad idea I had lots of friends hording it for me, I will eventually pay a price for that I'm sure!) I put on 5-10 pounds when I'm on a long cycle, over 3 months, as the lithium does seem to make me hungrier all the time and a whisker lethargic. Guiseppi |
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Title: Re: Lithium ? Post by rbmb on Dec 3rd, 2007, 2:40pm I've used lithium for headaches and never noticed any side effects involving mood changes but prednisone definately made me edgy and quick to lose my temper at high doses(80mg I think was the max dosage I took). Rich |
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Title: Re: Lithium ? Post by brewcrew on Dec 3rd, 2007, 4:11pm Lithium = nothing. Prednisone = Just try whining within 20 yards of me...I'll rip off your head and shit down your neck. ;;D |
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Title: Re: Lithium ? Post by hornedone on Dec 4th, 2007, 12:15am Wonder if it's the Klonopin then? :-/ |
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Title: Re: Lithium ? Post by Annette on Dec 4th, 2007, 1:02am My husband was on Lithium 900 mg for a while. It didnt work for his CH so it was stopped but the only side effect he got at 900 mg was hand tremor. It could be Klonopin. Klonopin is clonazepam which is a powerful benzodiazepine similar to Valium, Xanax etc. It used as an anticonvulsant as well as antianxiety medication. Its supposed to reduce anxiety and panic attacks. However, it can cause paradoxical reactions in some people with irritation and even anger and rage. This is a list of its possible side effects: The most frequently occurring side effects of Klonopin are referable to CNS depression. Experience in treatment of seizures has shown that drowsiness has occurred in approximately 50% of patients and ataxia in approximately 30%. In some cases, these may diminish with time; behavior problems have been noted in approximately 25% of patients. Others, listed by system, are: Neurologic: Abnormal eye movements, aphonia, choreiform movements, coma, diplopia, dysarthria, dysdiadochokinesis, “glassy-eyed” appearance, headache, hemiparesis, hypotonia, nystagmus, respiratory depression, slurred speech, tremor, vertigo Psychiatric: Confusion, depression, amnesia, hallucinations, hysteria, increased libido, insomnia, psychosis, suicidal attempt (the behavior effects are more likely to occur in patients with a history of psychiatric disturbances). The following paradoxical reactions have been observed: excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, sleep disturbances, nightmares and vivid dreams Respiratory: Chest congestion, rhinorrhea, shortness of breath, hypersecretion in upper respiratory passages Cardiovascular: Palpitations Dermatologic: Hair loss, hirsutism, skin rash, ankle and facial edema Gastrointestinal: Anorexia, coated tongue, constipation, diarrhea, dry mouth, encopresis, gastritis, increased appetite, nausea, sore gums Genitourinary: Dysuria, enuresis, nocturia, urinary retention Musculoskeletal: Muscle weakness, pains Miscellaneous: Dehydration, general deterioration, fever, lymphadenopathy, weight loss or gain Hematopoietic: Anemia, leukopenia, thrombocytopenia, eosinophilia Hepatic: Hepatomegaly, transient elevations of serum transaminases and alkaline phosphatase For more information read here http://www.rxlist.com/cgi/generic/clonaz_ad.htm You should talk to your doctor about it. He may be able to tweak the dosage/timing of the meds for you or he might decide to change it all together. Dont do anything without first checking with your doctor though. Best wishes and painfree days and nights to you. |
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Title: Re: Lithium ? Post by Annette on Dec 4th, 2007, 1:19am I have to post this separately because the whole thing wouldnt fit into the same post. These are the side effects of Lithium The following reactions have been reported and appear to be related to serum lithium levels, including levels within the therapeutic range: Neuromuscular/Central Nervous System: Tremor, muscle hyperirritability (fasciculations, twitching, clonic movements of whole limbs), hypertonicity, ataxia, choreo-athetotic movements, hyperactive deep tendon reflex, extrapyramidal symptoms including acute dystonia, cogwheel rigidity, blackout spells, epileptiform seizures, slurred speech, dizziness, vertigo, downbeat nystagmus, incontinence of urine or feces, somnolence, psychomotor retardation, restlessness, confusion, stupor, coma, tongue movements, tics, tinnitus, hallucinations, poor memory, slowed intellectual functioning, startled response, worsening of organic brain syndromes, myasthenia gravis (rarely). Cardiovascular: Cardiac arrhythmia, hypotension, peripheral circulatory collapse, bradycardia, sinus node dysfunction with severe bradycardia (which may result in syncope). Gastrointestinal: Anorexia, nausea, vomiting, diarrhea, gastritis, salivary gland swelling, abdominal pain, excessive salivation, flatulence, indigestion. Genitourinary: Glycosuria, decreased creatinine clearance, albuminuria, oliguria, and symptoms of nephrogenic diabetes insipidus including polyuria, thirst and polydipsia. Dermatologic: Drying and thinning of hair, alopecia, anesthesia of skin, acne, chronic folliculitis, xerosis cutis, psoriasis or its exacerbation, generalized pruritus with or without rash, cutaneous ulcers, angioedema. Autonomic: Blurred vision, dry mouth, impotence/sexual dysfunction. Thyroid Abnormalities: Euthyroid goiter and/or hypothyroidism (including myxedema) accompanied by lower T3 and T4. I131 uptake may be elevated. (See PRECAUTIONS.) Paradoxically, rare cases of hyperthyroidism have been reported. EEG Changes: Diffuse slowing, widening of the frequency spectrum, potentiation and disorganization of background rhythm. EKG Changes: Reversible flattening, isoelectricity or inversion of T-waves. Miscellaneous: Fatigue, lethargy, transient scotomata, exophthalmos, dehydration, weight loss, leukocytosis, headache, transient hyperglycemia, hypercalcemia, hyperparathyroidism, excessive weight gain, edematous swelling of ankles or wrists, metallic taste, dysgeusia/taste distortion, salty taste, thirst, swollen lips, tightness in chest, swollen and/or painful joints, fever, polyarthralgia, dental caries. Some reports of nephrogenic diabetes insipidus, hyperparathyroidism, and hypothyroidism which persist after lithium discontinuation have been received. A few reports have been received of the development of painful discoloration of fingers and toes and coldness of the extremities within one day of the starting of treatment with lithium. The mechanism through which these symptoms (resembling Raynaud's syndrome) developed is not known. Recovery followed discontinuance. Cases of pseudotumor cerebri (increased intracranial pressure and papilledema) have been reported with lithium use. If undetected, this condition may result in enlargement of the blind spot, constriction of visual fields, and eventual blindness due to optic atrophy. Lithium should be discontinued, if clinically possible, if this syndrome occurs. For more information read here http://www.rxlist.com/cgi/generic/lithium_ad.htm As you can see, comparing the two, I would say its more likely to be the Klonopin than the Lithium, despite what Nani and Pinkfloyd said. Still, I urge you to talk to your doctor and dont do anything without his approval. Your treating doctor is the one ultimately responsible for your health. |
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Title: Re: Lithium ? Post by LeLimey on Dec 4th, 2007, 6:36am Wow that was interesting about the hyperparathyroidism but since I stopped taking Lithium 2 years before the PTH problems came to light I don't think I can blame it! I have a general question about Lithium though while the subject is up. I have a very close friend who is manic depressive and is on Lithium to stop his mood swings. He is stable now and all is well but he used to go from being so laid back he could fall over to being really quite frighteningly angry. I took lithium for CH but it didn't seem to have any effects for me good or bad so we gave up on that idea but it made me wonder - if Lithium is prescribed for CH (for which it isn't really intended) and it's usually prescribed for mood swings (to simplify what I mean) could it CAUSE them in someone who hadn't previously had them? I ask this because I remember when I was on topiramate that I read if you didn't taper off it properly it could cause the seizures it was designed to prevent! Scary drugs we take! Probably a good time to remind everyone ANYWAY that you should always taper up and down on any drugs under your doctors supervision and if you aren't sure - ASK!! |
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Title: Re: Lithium ? Post by Annette on Dec 4th, 2007, 8:16am Helen, not sure who were you asking but I will give this a go. :) Topiramate when stopped suddenly can lead to seizure due to the withdrawal effects of dropping the dose too quickly, not because it CAUSES you to get epilepsy/seizure. Topiramate reduces the excitability of your nerves, therefore it reduces seizure. Once you have been on it for a while, your nerves reset themselves to this new level of activities. When you stop suddenly, the nerves and the brain dont have enough time to adjust to the new level of excitability therefore they can start firing abnormally, giving you what is called pseudoseizures. However, it doesnt mean that you have suddenly developed epilepsy. Once the level stablelises and your body adjusts itself you will be fine. As to your friend who is manic depressive ie bipolar, I would say his anger is related to his illness rather than the lithium he was taking. Lithium is a very good drug for mania in bipolar but its not by any mean able to control all the symptoms of bipolar. Regarding whether giving a certain medication to someone who doesnt really have the problem, or for what its intended for, whether or not it can cause the person to actually develop those symptoms is an interesting question. Personally I dont think so but I have not studied into this topic. Just from observation though, if we apply your theory to 2 people here who take Lithium on a regular basis, namely Jonny and Guiseppi, then maybe it can be true for Jonny ( that would explain his moods 8) Sorry Jonny, just pulling ya legs ;;D ! ) but what about Guiseppi ? I would fall over in shock if I ever come across an angry/aggressive Guiseppi :) . While we are at it, why dont we go a bit further and have some fun here? So what would happen if you take shrooms or seeds for CH while you dont really have CH ? Would that cause you to then develop headaches similar to CH or Hortons syndromes ? According to Helen's theory you might ! Does that mean if you use shrooms or seeds recreationally for a while when you stop you may develop CH ? I dont have the answers to those questions and I dont think anyone does, as of present. Very interesting thought though Helen, thanks for making me think :-* |
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Title: Re: Lithium ? Post by pattik on Dec 4th, 2007, 8:52am on 12/04/07 at 08:16:42, Annette wrote:
While we are at it, why don't we stay on topic for a change instead of throwing out bait to get people stirred up on a topic to which you are clueless. As to the lithium, when I took it years ago, it just gave me tremors with no noticable help for CH, and no significant mood issues that I can recall. Patti |
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Title: Re: Lithium ? Post by Annette on Dec 4th, 2007, 8:56am on 12/04/07 at 08:52:33, pattik wrote:
Indeed I am clueless about that topic so I am hoping that the experts will come along to help clarifying things so that we can all learn :) Do you, per chance, have the answers to those questions? :) |
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Title: Re: Lithium ? Post by LeLimey on Dec 4th, 2007, 9:54am Thank you for answering Annette, I asked simply because it was something that occured to me just based on reading that topiramate is supposed to stop siezures but could cause them if mis-used - not necessarily permanently, that I have no clue about - it was just something that occured to me. I explained my point badly because I did actually mean it in the way you described so thank you for clarifying that. My friends anger is absolutely caused by his illness, it comes back (as does the other end of the spectrum) if he reduces his dose or doesn't take it or whatever. Basically, he knows now to take it and thats that. Lithium HELPS him, it doesn't cause him any mood problems. The subject was just one I find quite interesting in a very uninfomed sort of a way, for instance I have just finished a course of tablets that according to the leaflet can cause a type of meningitis! I realise that's really rare but it obviously has happend for it to be printed and its why I do read those drug leaflets. We come up with all sorts of things to go off at a tangeant with here when all's said and done! Your theory is like the bipolar version of mine ;) but it's exactly the same question on the other hand too - can misuse of meds cause other conditions? Obviously the answer to that is yes to a degree - think Pred and AVN for instance. I don't think taking them could cause the condition they were being created for if used for something different but I do think it can cause the "symptoms" as in the case of topiramate for a perfect example. Just to throw another thought of mine into the mix. I was on Pred at between 60 and 80mg per day for 13 months and I was switched overnight to a different steroid. Two days later my CH started and I've been chronic ever since. I don't think it caused it for one minute. I now know I had cycles every spring and autumn since Barney was born but wasn't diagnosed (own fault) I think the Pred triggered my "cycle" into coming early but I know it didn't cause me to have CH. I don't think anything could actually cause CH if you aren't pre-conditioned to having it but hasn't it been proved that some drugs can cause mental health issues? I'm not sure which ones (issues) but I'm absolutely certain I read something about that in a newspaper a while ago. I'm sorry if I'm not explaining myself well, I'm very fuzzy at the moment Helen edited for clarity |
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Title: Re: Lithium ? Post by Kevin_M on Dec 4th, 2007, 10:32am on 12/04/07 at 08:16:42, Annette wrote:
It has not seemed so from shrooms or other hallucinogenics with many others encountered from the 70's through 90's. Being just me that I knew of afflicted from among them and after that time. CH appears more a predisposition, or even possibly perhaps otherly acquired if it could be enabled. from a small world :) in fact, changing lifestyles was when I first encountered CH. |
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Title: Re: Lithium ? Post by sandie99 on Dec 4th, 2007, 10:36am This thread reminded of quite interesting discovery from my own ch meds experience: when I was taking prednisone I bought from Finland, I was feeling happy and bit manic. Doc perscribed me some more and I got that in London - that pred made me deeply sad, even slightly depressed. "Same" med, complitely different mood... |
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Title: Re: Lithium ? Post by Pinkfloyd on Dec 4th, 2007, 6:01pm on 12/04/07 at 01:19:53, Annette wrote:
What exactly did I say, that what you posted, refuted? He shouldn't discuss this with his doctor? Changing his dosing regimen might not help? Was that what RxList said? The symptoms may not wear off over time? If I gave some bad advice, please tell me what it was so I can offer better advice in the future. Bobw |
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Title: Re: Lithium ? Post by rolo65 on Dec 4th, 2007, 8:00pm Lithium does even you out. If you were to make a scale say 1-9 then 5 would be the mid point. So now say if you’re Bi-Polar you may swing in mood from 1-9 or 2-8 so it is a big swing. If you are normal (so to say) you may swing only from 4-6. The lithium is going to center you towards 5 and if you don’t naturally swing far from the center you may not notice the centering effect vary much. I do notice that I feel happier if I stop taking it until the K-8 hits come back in about two days. Rolo…. Edit cause I said the same thing twice. :) |
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Title: Re: Lithium ? Post by Annette on Dec 5th, 2007, 5:45am To Pinkfloyd What exactly did I say, that what you posted, refuted? Please see below He shouldn't discuss this with his doctor? No, I agree he should discuss with his doctor, I said so myself, didnt you see it? Changing his dosing regimen might not help? Was that what RxList said? The point here is that its very unlikely that Lithium is causing the anger/aggression, its much more likely to be the Klonopin. Therefore changing the dosing regimen of Lithium is least likely to help. Furthermore if you think changing the dosing regimen helps means that you believe the individual dosage is too high, leading to withdrawal symptoms. This is not the case here. Lithium is a drug that has a therapeutic level, he would have had blood tests to check the level, therefore the 900 mg a day would have been within therapeutic range, since he is stable on this dosage, unless the total dose is changed, the level wont change. He is taking it 3 times a day ie 300 mg each time, then changing it from 3 times to 4 times a day wont change the overall level but will reduce each individual dosage from 300 mg to 225 mg. Do you really think that a drop of 75 mg would make a real difference to the withdrawal level ? No it wont. We dont even know whether he is taking the slow release or the immediate release version of lithium. If he is taking the slow release version then changing it from 3 times a day to 4 times a day wont change anything. If he is taking the immediate release version then how do you suggest he split the tablets to get 225 mg ? The symptoms may not wear off over time? You have got to see how severe the symptoms are here. He is saying that he gets VERY angry/aggressive, to the degree that his wife is concerned that he will end up hurting someone. Now this is not a mild side effect. These are MAJOR side effects that NEED to be addressed NOW with his doctors. What if he waits around hoping that the symptoms may wear off and they dont and he ends up hurting someone? |
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Title: Re: Lithium ? Post by LindaM on Dec 5th, 2007, 9:15am ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ |
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Title: Re: Lithium ? Post by LeLimey on Dec 5th, 2007, 9:42am on 12/05/07 at 09:15:13, LindaM wrote:
Which reminds me of a Lisa Simpson quote. It is better to keep your mouth shut and be THOUGHT an idiot than to open it and remove all doubt. |
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Title: Re: Lithium ? Post by nani on Dec 5th, 2007, 10:49am on 12/04/07 at 01:19:53, Annette wrote:
Are you suggesting that I never read about it? Well, I have. On this board. I just can't remember exactly when. I suppose I could have googled this, found RX list, copied and pasted it here, and tried to sound like an expert... but that's not my thing. Well, wait...not exactly...when your very first post asked about your DH's unusual symptoms, I was concerned enough to google BAM and give you the link. ::) |
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Title: Re: Lithium ? Post by deltadarlin on Dec 5th, 2007, 7:52pm I don't understand, exactly what did nani and pink floyd say that was so contradictory to what you said annette? hurting heads want to know. |
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Title: Re: Lithium ? Post by Annette on Dec 6th, 2007, 12:33am on 12/05/07 at 10:49:00, nani wrote:
You did too Nani and I was so grateful for that ! Thank you :) |
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Title: Re: Lithium ? Post by Pinkfloyd on Dec 6th, 2007, 1:31am on 12/05/07 at 05:45:20, Annette wrote:
I saw below and I'm just not buyin what you're sellin. <sigh> I'm only answering this because it has to do with medications and I want everything clearly understood. Please don't feel the need to respond on my account. To make things easier, I am pasting what I originally posted: on Dec 2nd, 2007, 12:36am, hornedone wrote:Working pretty well so far...well except for one thing. Once the combo starts to wear off (taking it 3 times a day), I start to get very angry/aggressive. . You should discuss this with your doc. How long have you been taking it? Sometimes these types of side effects will stop after you've been on it for awhile. It could be possible to change the change your dosing regimen and take the same amount in 4 doses rather than 3 whilch might stop the ups and downs due to it wearing off. Maybe you could try using melatonin at night to get the same sleep results. Bobw 1. Please note the first line of my original post. It said he should discuss this with his doctor. "This" meaning his problems and the suggestions I made that follow the opening line. 2. Nowhere do I say that the symptoms he is describing are due solely to lithium. Why you thought I needed the encyclopedia version of lithium treatments, I have no idea. 3. I specifically quoted his use of the "combo" of meds and the problems he described when the "combo" began to wear off. 4. No one knows if the symptoms he is describing are due to the lithium, the Klonopin, the combination, or something unrelated to the combination. 5. Sometimes these types of symptoms do disappear over time. Was I supposed to withhold this information? Don't answer that. 6. I did not suggest he change his dosing regimen without consulting his doctor. His doctor might suggest changing it. His doctor might suggest he get off of one or both of the medications. Whatever the case, he should discuss these problems with his doctor. 7. All I gave him were some ideas that he could discuss with his doctor. 8. I fully understand therapeutic levels of lithium. I was on it for 5 years. Bobw |
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Title: Re: Lithium ? Post by Annette on Dec 6th, 2007, 1:43am In that case I read you wrong PinkFloyd, my apology. :) |
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Title: Re: Lithium ? Post by hornedone on Dec 6th, 2007, 8:50pm Hello all! My appt. is next week so hopefully I can hold out until then...that is if I don't run someone off the road first. j/k ;) My KIPs have gone from 5-9 to for the most part 3-6, so I (pain wise) really don't want to come off of this for that reason. Maybe everyone else will just have to get used to me being an ass. ;;D Or...maybe there is something that can be added to "even" me out, even though I thought the Lithium was supposed to do that. Perhaps (of course with the docs supervision), more Lithium could be in order. PFDAN 2 all. |
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Title: Re: Lithium ? Post by LeLimey on Dec 7th, 2007, 8:40am You being aware there is a problem is half the battle won - you can make a conscious effort with it. (which I know is sometimes easier said than done honestly!) Let us know how you get on okay? We're all rooting for you to get the best possible meds combo and have the best possible quality of life to boot. Hang in there and come and have a gripe here any time you need to in the meantime. Your wife is more than welcome to come and post too. We have a good mix of sufferer's and supporters here and there is help, advice and compassion for all. Its no easy task watching us suffer like this and my hat goes off to all those who do. Tell her hello from me please! PFDANS Helen |
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Title: Re: Lithium ? Post by E-Double on Dec 8th, 2007, 10:41pm on 12/03/07 at 16:11:29, brewcrew wrote:
lmao.......i will eat your first born then your car good luck |
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Title: Re: Lithium ? Post by Corinakitty on Dec 20th, 2007, 4:43am I was on Lithium for a few months to treat my bipolar disorder (My DH is the clusterhead in the house). I didn't have any trouble with mood swings but I had to pee about fifty times a day and my husband finally begged me to ask the doc for another drug after I developed a rather strange side-effect: Fish Breath. My breath smelled like fish, and NOTHING from Listerine to eating a dead cat would cover up the fish smell. Lamictal ended up being a better solution for my bipolar. Maybe it would work for your CH? I was just reading another thread on here that suggests it... |
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Title: Re: Lithium ? Post by Guiseppi on Dec 20th, 2007, 11:08am I developed a rather strange side-effect: Fish Breath. My breath smelled like fish, and NOTHING from Listerine to eating a dead cat would cover up the fish smell. And I've been under the impression my wife was avoiding me because I was grumpy in cycle.... :-[....dang... Guiseppi |
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Title: Re: Lithium ? Post by brewcrew on Dec 20th, 2007, 11:45am So, I can stop eating dead cats now? |
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Title: Re: Lithium ? Post by monty on Dec 20th, 2007, 5:52pm on 12/20/07 at 04:43:29, Corinakitty wrote:
Curious - lecithin (an emulsifier from soy) can cause the same fish breath symptom if taken in large doses. Lecithin is phosphatidyl choline. Lithium raises choline levels. And choline levels are quite low in people with CH. Choline is the essential building block of the neurotransmitter acetylcholine. Probably just a coincidence. -------------------------------- O. Pleul1 and B. Müller-Oerlinghausen1 (1) Institut für Klinische Pharmakologie and Psychiatrische Klinik, Freie Universität Berlin, Berlin, Germany Received: 24 February 1986 Accepted: 1 August 1986 Summary In 17 lithium-treated patients with manic-depressive disorders and 11 healthy subjects the concentrations of choline, phosphorylcholine, cytidyldiphosphate choline, lipid bound choline, and glycerophosphorylcholine were measured in plasma and erythrocytes. Plasma levels of high density, low density, and very low density lipoproteins were also estimated as well as the concentrations of 4 free fatty acids. Free choline (more than 10-fold) and phosphorylcholine (2-fold) were significantly increased in erythrocytes of lithium-treated patients as compared to the healthy untreated controls. Differences in the other substrates were not significant. Osmotic resistance of the erythrocytes was not changed during lithium treatment. Inhibition of the choline flux across the erythrocyte membrane in vitro from lithium-treated patients was not abolished by equilibration of the concentration gradient. It is concluded that the accumulation of choline in erythrocytes from patients on lithium therapy may be due to trapping of lipid derived choline because of an alteration in membrane permeability and not to increased breakdown of phosphatidylcholine. --------------------------------------------- Br Med J (Clin Res Ed). 1984 Jan 28;288(6413):268-70 Erythrocyte choline concentrations and cluster headache. de Belleroche J, Cook GE, Das I, Joseph R, Tresidder I, Rouse S, Petty R, Clifford Rose FC. Erythrocyte choline concentrations were measured in patients with cluster headache and age related control subjects. Concentrations were significantly reduced in the patients with headache both during a cluster period and between clusters, being 58% and 55% of the control value, respectively. After two weeks' treatment with lithium, choline concentrations in the patients with cluster headache increased to 78 times the control value (mean 369.2 mumol/l (3840 micrograms/100 ml) compared with 4.7 mumol/l (49 micrograms/100 ml]. The presence of depressed erythrocyte choline concentrations during and between cluster attacks indicates that this may be a predisposing condition which results in a cluster attack only when associated with a trigger factor. |
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