Does anyone know a recommended schedule for tapering off lithium? I've been taking 900mg per day for over three years. Mainly I'm interested in knowing what risks are associated with tapering off too quickly.

Also, I'm coming to you, my brothers and sisters, because I don't fully trust my doctor to give me anything but the "I would be comfortable with..." answer. That really means "My malpractice insurer would be comfortable with..." My doc's comfort level and my pain level are measured on two completely different scales.

I want to know how quickly I can stop without risking too much.

I never took it as long as you've been on it, I think 8 months is the longest. I go from the 1200 mg a day, to 900 for 2 days, 600 for 2 days, 300 for 2 days....and if I haven't been hit at all, down to zero. So I go off of it pretty quick. This was what my original neuro told me to do and it's how I've alwys gone off.

Hoping this means your catching a break brudder.

Joe

Guiseppi wrote on Oct 15^th, 2009 at 12:22pm:

I never took it as long as you've been on it, I think 8 months is the longest. I go from the 1200 mg a day, to 900 for 2 days, 600 for 2 days, 300 for 2 days....and if I haven't been hit at all, down to zero. So I go off of it pretty quick. This was what my original neuro told me to do and it's how I've alwys gone off. Hoping this means your catching a break brudder. Joe

Nope. Means it's not doing shit for me anymore and that I must explore other avenues which require me not to have any lithium in my system.

But thanks for the kind wishes and hopes. They mean a lot to me.

Hi Brew,
      I am currently doing this myself.(I was on 600)My
Neuro who I trust a  great deal,recommended dropping
100mg every 5 days.I'm down to 150mg/day and so
far no problems,although I do seam to be a bit shorter
tempered than normal.Good luck and remember YMMV

wrote on Oct 15^th, 2009 at 2:35pm:

Hi Brew,       I am currently doing this myself.(I was on 600)My Neuro who I trust a  great deal,recommended dropping 100mg every 5 days.I'm down to 150mg/day and so far no problems,although I do seam to be a bit shorter tempered than normal.Good luck and remember YMMV

Can I ask how long you were on it?

The longest I've ever been on Lithium is 10 weeks during the course of an episode. When the episode stops I go cold turkey and have never noticed any side effects at all. Bear in mind though that my maximum dose was 900 mg. per day. What's good for the goose is not necessarily good for the gander. 8 years is a long time.
Jim

jim murphy wrote on Oct 15^th, 2009 at 3:01pm:

The longest I've ever been on Lithium is 10 weeks during the course of an episode. When the episode stops I go cold turkey and have never noticed any side effects at all. Bear in mind though that my maximum dose was 900 mg. per day. What's good for the goose is not necessarily good for the gander. 8 years is a long time. Jim

Thanks for the response, Jim.

Yes, 8 years is a long time. But I've been on it for just over three. Which is still a long time.

"It can be stopped quickly without any apparent physiologic difficulty...."

PSYCHOTROPIC DRUGS: FAST FACTS, 3RD ED, JERROD MAXMEN, m.d.

Bob Johnson wrote on Oct 15^th, 2009 at 3:15pm:

"It can be stopped quickly without any apparent physiologic difficulty...." PSYCHOTROPIC DRUGS: FAST FACTS, 3RD ED, JERROD MAXMEN, m.d.

So might it be safe to assume that doctors who wean their patients off lithium very slowly are probably of the psychological persuasion, and that their patients are most likely bipolar? In other words, let's see what kind of effect it has on their personality disorder rather than on their body?

My guess is you're right. There are a boatload more people prescribed it for psychological then for CH'ers, nice to know it hasn't shown any detox issues though.

Joe

Brew wrote on Oct 15^th, 2009 at 3:27pm:

Bob Johnson wrote on Oct 15th, 2009 at 3:15pm: "It can be stopped quickly without any apparent physiologic difficulty...." PSYCHOTROPIC DRUGS: FAST FACTS, 3RD ED, JERROD MAXMEN, m.d. So might it be safe to assume that doctors who wean their patients off lithium very slowly are probably of the psychological persuasion, and that their patients are most likely bipolar? In other words, let's see what kind of effect it has on their personality disorder rather than on their body?

Well then, In your case I would suggest going slowly........ ;D

Be ready with that stockpile of O2 you have. Lithium may have been helping more than you think.

Best,

Marc

Marc wrote on Oct 15^th, 2009 at 7:40pm:

Be ready with that stockpile of O2 you have. Lithium may have been helping more than you think.

That's what I'm afraid of.

Yeah, I saw your post about the number hits after I made my comment.

Wish you the best, Bro.......

Marc

The experiment is over for now. Back on the preventatives until this bitch has calmed down significantly. Today has been brutal.

Someday soon, but not today. Hercules I am not.

have you thought about upping the dose rather than tapering off?i was on 1200mg a day for about 2 years and recently it was upped to 1500 mg a day,,at 1200mg i was at the low end of the safe range of lithium in my system.doc told me the range is .6 to 1.2,,1200mg had me at .8     hope you find something that works for ya


jason

TarHeel-blues wrote on Oct 16^th, 2009 at 9:24pm:

have you thought about upping the dose rather than tapering off?i was on 1200mg a day for about 2 years and recently it was upped to 1500 mg a day,,at 1200mg i was at the low end of the safe range of lithium in my system.doc told me the range is .6 to 1.2,,1200mg had me at .8     hope you find something that works for ya jason

Nope. I've avoided adding verapamil into the mix for several years now, but I will be doing that.

I didn't want to get in the rat's nest of use for mood disorders, etc. In these situations, rapid stopped is associated with potential for recurrence of the mood problems.

Regardless of one's position, our self-interest requires letting the OUR doc making the call on taper rates...

Update: I reinitiated both lithium (900mg/day) and verapamil (480mg/day) on Friday. Last night (played out with the band) was the best my head's behaved in over two weeks. Also took an Amerge about an hour before playing as insurance. Slept uninterrupted from 3:30 a.m. until minutes before kickoff of the Packers-Lions at noon.

Feeling a little zombified, but this sure beats the alternative. Say what you will, but a complete night's sleep is highly underrated.

YOW BREW....play on.... :D

Bill - I sure hope this means you're about to catch a long overdue break!

Carol

Grandma_Sweet_Boy wrote on Oct 18^th, 2009 at 6:38pm:

Bill - I sure hope this means you're about to catch a long overdue break! Carol

From your lips to God's ears, Carol.  It's not been fun to him these last few weeks.

Bill,

Several years ago I took myself off of Lithium because of the side effects I was getting with it.  I had been on Verap as well, and weaned myself off of it also and went to Kudzu.  Don't try it now during a high cycle, but you might want to look into it when things calm down.  I'm getting a lot better control and don't have the lassitude I had with Lithium and Verap. 

Personally I think I'm doing much better with just the Kudzu and the Testosterone.  Have only had a handful of breakthroughs over a K4 in the last couple of months, and they were when I missed dosages a couple of days running.  After resumption the HA's subsided again.  Not PF, but much much better.

Jerry

You are one brave man Brew. I've been taking Lithium and Verap. for over 18 yrs and have never had the guts to stop.

I have talked to my Doc many times about stopping but always chickened out. I was chronic before I started these meds.

I wish you the best and please say Hi to Pat & Roy for me.

Don

I hope this cycle ends for you soon, Bill.

Thanks for being such a great support, Pat.

Jeannie

Brew wrote on Oct 16^th, 2009 at 9:10pm:

Someday soon, but not today. Hercules I am not.

Good luck when you do.. I hope you catch some PF time Bill...


Lefty..!