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Brew

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Tapering off lithium
Oct 15^th, 2009 at 11:24am

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.

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Guiseppi

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Re: Tapering off lithium
Reply #1 - 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

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Re: Tapering off lithium
Reply #2 - Oct 15^th, 2009 at 12:36pm

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.

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"I have been asked if I have changed in these past 25 years. No, I am the same. Only more so." --Ayn Rand

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just-squiggles Ex Member	Re: Tapering off lithium Reply #3 - 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
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Brew CH.com Sponsor CH.com Alumnus Offline Posts: 14163	Re: Tapering off lithium Reply #4 - Oct 15^th, 2009 at 2:43pm Quote: 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?
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jim murphy CH.com Newbie Offline I Love CH.com! Posts: 23	Re: Tapering off lithium Reply #5 - 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
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Re: Tapering off lithium
Reply #6 - Oct 15^th, 2009 at 3:12pm

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.

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"I have been asked if I have changed in these past 25 years. No, I am the same. Only more so." --Ayn Rand

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Bob Johnson CH.com Alumnus Offline "Only the educated are free." -Epictetus Posts: 5965 Kennett Square, PA (USA) Gender:	Re: Tapering off lithium Reply #7 - 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.
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Brew

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Re: Tapering off lithium
Reply #8 - Oct 15^th, 2009 at 3:27pm

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?

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"I have been asked if I have changed in these past 25 years. No, I am the same. Only more so." --Ayn Rand

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Guiseppi CH.com Moderator CH.com Alumnus Offline San Diego to Florida 05-16-2011 Posts: 12063 SAN DIEGO, CALIFORNIA USA Gender:	Re: Tapering off lithium Reply #9 - Oct 15^th, 2009 at 4:35pm 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
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Re: Tapering off lithium
Reply #10 - Oct 15^th, 2009 at 7:40pm

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

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?

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

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

Best,

Marc

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« Last Edit: Oct 15^th, 2009 at 7:43pm by Marc »

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Brew CH.com Sponsor CH.com Alumnus Offline Posts: 14163	Re: Tapering off lithium Reply #11 - Oct 15^th, 2009 at 8:07pm 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.
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Marc Ex Member Gender:	Re: Tapering off lithium Reply #12 - Oct 16^th, 2009 at 7:08pm Yeah, I saw your post about the number hits after I made my comment. Wish you the best, Bro....... Marc
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Brew CH.com Sponsor CH.com Alumnus Offline Posts: 14163	Re: Tapering off lithium Reply #13 - Oct 16^th, 2009 at 9:10pm 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.
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TarHeel-blues CH.com Veteran Offline I Love CH.com! Posts: 132 matthews nc Gender:	Re: Tapering off lithium Reply #14 - 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
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Brew

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Re: Tapering off lithium
Reply #15 - Oct 16^th, 2009 at 9:35pm

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.

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"I have been asked if I have changed in these past 25 years. No, I am the same. Only more so." --Ayn Rand

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Bob Johnson CH.com Alumnus Offline "Only the educated are free." -Epictetus Posts: 5965 Kennett Square, PA (USA) Gender:	Re: Tapering off lithium Reply #16 - Oct 17^th, 2009 at 8:55am 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...
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Brew

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Re: Tapering off lithium
Reply #17 - Oct 18^th, 2009 at 3:27pm

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.

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"I have been asked if I have changed in these past 25 years. No, I am the same. Only more so." --Ayn Rand

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jon019 CH.com Alumnus Offline "Ya gotta believe!" Posts: 1656 USA Gender:	Re: Tapering off lithium Reply #18 - Oct 18^th, 2009 at 4:28pm YOW BREW....play on....
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Grandma_Sweet_Boy CH.com Alumnus Offline What Goes Around Comes Around! Posts: 4496 Georgetown,Ontario Gender:	Re: Tapering off lithium Reply #19 - Oct 18^th, 2009 at 6:38pm Bill - I sure hope this means you're about to catch a long overdue break! Carol
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Mosaicwench CH.com Sponsor Offline www.mosaicwench.com Posts: 3507 Near Milwaukee WI, USA Gender:	Re: Tapering off lithium Reply #20 - Oct 18^th, 2009 at 6:53pm 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.
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Re: Tapering off lithium
Reply #21 - Oct 19^th, 2009 at 11:23pm

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

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Skyhawk5 CH.com Alumnus Offline I love YaBB 1G - SP1! Posts: 1320 Ypsilanti, Mi. USA Gender:	Re: Tapering off lithium Reply #22 - Oct 20^th, 2009 at 12:59am 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
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Jeannie CH.com Sponsor Offline Live, Laugh, Love.... Posts: 2333 St Louis, Missouri Gender:	Re: Tapering off lithium Reply #23 - Oct 27^th, 2009 at 8:47pm I hope this cycle ends for you soon, Bill. Thanks for being such a great support, Pat. Jeannie
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Lefty CH.com Alumnus Offline Posts: 759 Gender:	Re: Tapering off lithium Reply #24 - Oct 27^th, 2009 at 9:16pm 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..!
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