Posted by SLS on January 25, 2023, at 6:57:35
In reply to Re: Lithium biochemistry (low level mechanisms), posted by Lamdage22 on January 25, 2023, at 2:15:42
> Lithium is the new big thing on Psychobabble :)
Actually, that is sad. If I'm right about low-dosage lithium treatment, then thousands and thousands of opportunities have been wasted.30% of people with depression end up being treatment-resistant. That's huge. How many cases could have been successfully treated if low-dosage lithium had been added as an augmenter? I like to think that low-dosage lithium treatment will convert non-responders or inadequate-responders to responders. According to a paper I found, there is a bimodal dosage distribution between low-dosage versus high-dosage lithium. Low dosages of lithium increased the release of glutamate in the hippocampus, while high dosages decreased it. More recently,the hippocampus has been recognized as, not only the structure most associated with memory, but a it is also a contributor to the regulation of mood and emotions.
There isn't very much written about this. However, I remember an investigation performed 20 years ago by Harvard looking into the combination of fluoxetine and lithium wherein the dosage of lithium used was 300-600 mg/day. If I remember correctly, 450 mg/day was much more effective than 600 mg/day. I don't recall the relative effectiveness of 300 mg/day, but it was higher than placebo. For me, lithium 300 mg/day plays an integral role with my other three medications. When I increase the dosage from 300 mg/day to 450 mg/day, I relapse (big time). It only took three days after the discontinuation of lithium for me to deteriorate.
I am but n=1.
I represent only one clinical anecdote. However, considering the bimodal results of one neuroscientific study and the dosages used by Harvard in their clinical study, I am *somewhat* optimistic that a significant percentage of people with TRD will find that low-dosage lithium augmentation converts TRD to remission. That's what it did for me.
It's kind of a no-brainer to use low-dosage lithium. Lithium exerts an incredible number of actions in the brain. I consider low-dosage lithium to be sort of like aspirin for the brain. The danger of having thyroid and kidney damage at these low dosages is very, very small. These two side effects are dosage-dependent. The second argument for this no-brainer is that low dosages of lithium seems to reduce the risk of contracting Alzheimer's Disease. It might have utility in other neurodegerative brain diseases like Parkinson's Disease. That's why I decided to continue taking 300 mg/day of lithium for life. It is integral to the treatment that produced my remission. It was completely unexpected - and fortuitous. If a great number of people who have MDD or BD respond this way, it argues in favor of leaving lithium onboard in the background as one progresses through their drug trials.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.The only thing necessary for the triumph of evil is that good men do nothing.
poster:SLS
thread:1121631
URL: http://www.dr-bob.org/babble/20230117/msgs/1121638.html