[Annichka]

Ok, another lithium question. I've been on it for about 10 months now and feeling well enough to start to wonder about what it's doing to me! I really do like it, though, and would rather not stop taking it, so I'm trying to figure out what's "normal" and what is a potential bad omen. All my life I've had arrhythmias and also mild mitral valve prolapse, which between them get me EKG'd a the drop of a hat. I've never had trouble, however, and never been asked to behave differently (cut back on exercise or anything). I got used to the fairly frequent mis-beat or hard THUMP as it makes up for a feeble stroke. Everything's good. It's just that I think since I started taking lithium, it seems to happen much more often. In fact, the kind of weird beating that leaves me feeling breathless for a second or just weird in the whole cardio-pulmonary network seems to happen pretty often. I'm still running, swimming, biking, not passing out, nothing alarming. I've read this can be related to lithium (that arrhythmias may happen on it), and I'm wondering how many of us out there experience it. I should probably bring it up to my doctor, but my doctor (the only one I can see because I'm on a state health plan) isn't very experienced in lithium treatment, so I'm trying to get as educated as I can. And she's a little treatment-alteration-happy, and I don't want to alter treatments since this is working so well, so I don't want to bring it up unless I HAVE to.

So. Common side effect, or something more serious?

[martasi2]

Well, this is really about your heart function and the possible, but as yet unknown, influence of Lithium. The best strategy would be to have your usual cardiac testing routine. Do you have this at any time of the year? The one thing that has to be balanced with Lithium is electrolytes, but if you're eating adequately and drinking enough fluids, maybe taking some extra minerals, your electrolytes should be OK. Disturbed electrolyte balance can affect the heart muscle, but you'd have to see an expert to know if this is happening. It sounds like something you'd want to get checked out anyway if you're noticing more symptoms. Can you get to a cardiac specialist?

[mj1127]

Arrhythmia is listed on the PI sheet, but arrhythmia as you know, can be a relatively harmless thing or not so harmless. I'd have it checked out. Do you know whether you have just mitral prolapse or mitral regurgitation as well? It might be a good idea to have an EKG and an echocardiogram to make sure all is as normal for you.

[VAL]

I understand how you feel about your doc maybe wanting to immediately chuck the lithium when you like it but this isn't really an area to mess around in. I think you don't have a choice but to inform your doc.

[Annichka]

Thanks for the replies - I guess I'll bite the bullet. I can probably get myself referred to a specialist. We'll see. It isn't just a matter of my liking lithium - I've run the gamut on the most reasonably benign end of the drug options, and lithium is the only thing that has even come close to working. It saved my life. I'm really afraid to go off of it. I guess if it is for any reason endangering my life, though, that would defeat the purpose (though it would be a close race, considering the rampant suicidal ideation I used to experience).

[VAL]

I think I understand what you're saying. After taking Abilify, I spent months never thinking about suicide and was stunned when it suddenly occurred to me that I hadn't had even a slightly suicidal thought in so long. I was thirteen the first time I thought about suicide and I'd never stopped since. I loved it...it saved my life and I felt like a pretty normal person for years and then realized that I was gaining weight and it was probably the abilify. I avoided facing that for a very long time. My pdoc knew that my GP ran my blood every three or four months so he never ran it himself. I usually kept him informed but the first time my cholesterol went up by thirty points I didn't mention to the pdoc because I was still in denial about what abilify was doing to me. The GP wanted me to let him fax over the results of my bloodwork to my pdoc and I wouldn't let him. When my cholesterol went up another forty-seven points and my glucose went up 35 points, I finally had to admit that I had no choice but to go off of it. I miss it like hell, but i so regret what I allowed abilify to do to me. I've been off of it now since April and am awaiting the results of my latest bloodwork on Monday. I immediately lost fifteen pounds after going off abilify but haven't made the effort to lose more.

More info than you wanted...just saying that I really feel for you and I hope your doc makes every effort to determine if it's the lithium or just some sort of normal progression of your problem. My pdoc was not thrilled that I withheld that info from him though I can't say he was mad....I haven't been able to determine yet if he is actually human or a robot.

[Annichka]

Thanks, Val, it helps to hear others' experiences. Sometimes it seems like a choice between which unpleasant condition I'd rather deal with: lithium and its weird side effects (and continuing nausea and sometimes impaired cognition), or bipolar disorder. Well, the second one has threatened my life and so far the first one - while sometimes problematic - has not. At least, I'm hoping not. I do not want to go on that destructive withdrawal/drug search/drug ramp up/drug acclimation rollercoaster again, either.