Posted by SLS on February 2, 2023, at 9:13:07
In reply to Re: Lithium in suicide prevention -- short review, posted by Lamdage22 on February 2, 2023, at 3:05:42
Hi, Lamdage.
> >
> > > I can say that I felt that 15 mg elemental lithium cut my suicidal thoughts down. I could leave the closed unit once and for all. I never returned.
> > >
> > > It was 15 mg elemental lithium from a larger amount of Lithium Orotate. I think 375mg.> >
> > Interesting. What does elemental 15 mg of lithium convert to in lithium carbonate?
> I believe that is about 80 mg lithium carbonate. There are about 19mg of elemental lithium in 100mg lithium carbonate.
> https://pubmed.ncbi.nlm.nih.gov/18072162/> > > I can say that I felt that 15 mg elemental lithium cut my suicidal thoughts down. I could leave the closed unit once and for all. I never returned.
> > >
> > > It was 15 mg elemental lithium from a larger amount of Lithium Orotate. I think 375mg.> > Interesting. What does elemental 15 mg of lithium convert to in lithium carbonate?
>
> I believe that is about 80 mg lithium carbonate. There are about 19mg of elemental lithium in 100mg lithium carbonate.
> https://pubmed.ncbi.nlm.nih.gov/18072162/> > If you can say that you are in remission, don't rock the boat - ever.
What are your concerns regarding lithium carbonate?
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A Harvard study used lithium carbonate 300-600 mg/day as an add-on to fluoxetine (Prozac):
1. Fluoxetine 20 mg/day - The usual rate of response at this dosage.
2. Fluoxetine 60 mg/day - A much higher rate of response compared to 20 mg/day.
* This would be expected according to what is seen anecdotally today.3. Fluoxetine 20 mg/day + Lithium 300-600.
* Adding lithium 300-600 mg/day to fluoxetine 20 mg/day produced a rate of response somewhat higher than is normally seen with fluoxetine 20 mg/day monotherapy.4. Fluoxetine 60 mg/day + Lithium 300-600mg/day
* The addition of lithium 300-600 mg/day to fluoxetine 60 mg/day produced the highest rate of response, but the increase was not as high as was seen when the dosage of fluoxetine monotherapy was increased from 20 mg/day to 60 mg/day. In addition, the researchers found that adding lithium at 600 mg/day produced the lowest response rate. 450 mg/day of lithium produced the highest rate of response, but 300 mg/day came close.Personally, I thrive at 300 mg/day of lithium, but relapse pretty hard when I raise the dosage to 450 mg/day.
I guess the lessons to be learned here are:- The response rate to fluoxetine monotherapy at 60 mg/day is much higher than that seen at 20 mg/day. Unless side-effects are a consideration, one should not discontinue fluoxetine until a dosage of 60 mg/day is arrived at and allowed 2-4 weeks to produce results. The time period that one must wait for a therapeutic response to occur after a dosage increase of fluoxetine is longer than with other antidepressants. This is because the half-life of the active compounds is over a week. It takes longer to establish an equilibrium. I have never seen a loading-dose used for fluoxetine.
- When used as an adjunct to fluoxetine when treating depression, low-dosages are more effective than high dosages. Please note that if mania or rapid-cyclicity are to be controlled, the traditional dosages of lithium are necessary (900-1500 mg/day) or sometimes higher.
- Scott
Some 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:1121702
URL: http://www.dr-bob.org/babble/20230117/msgs/1121713.html