Lithium + SSRI'S
Was surprised I found no thread re lithium.
Anyone uses it for relapses of major depression (not bipolar)
Before giving up everything and trying TMS my psychiatrist suggested I try add Lithium while remaining on prozac.
I have major depressive disorder (not bipolar) and had never had other docs recommend it.
Even if I stayed on regular meds long term I still relapse so am running out of options.
I started it yesterday but am real tired of experimenting on my skin when I always end up in same place anyway.
Hello! After a horribly failed attempt with a particular SSRI, my doctor's suggested I try Lithium to treat my MDD (also not bipolar). We started low and worked all the way up to 1500mg. My blood levels tolerated it very well! It took a few months to get to that level but by the time I did, I honestly felt like it gave me some distance from my emotions. I didn't feel them any less; they just were far enough away that they didn't control me nearly as much.
Then, a psychiatrist suggested I could benefit from another SSRI (Lexapro). He said he liked how's the two worked together. It was much quicker getting to a theraputic dose! I went a good 6 months not experiencing symptoms I'd experienced my whole life almost! No suicidal ideation. Stressors were so much easier to face. I was actually just happy at times.
Treating MDD with Lithium is still fairly new, but it is starting to become a bit more known. It's usually used for mood disorders. But I think what makes it so effective for mood disorders also makes it effective for the intense and extreme emotions MDD can produce.
I really hope this helped! My experience is anecdotal, butt I am a believer in Lithium for MDD!!!
Please feel free to ask any questions. Thank you for sharing!
@knownotknow thanks so much for sugaring your experience. Much appreciated and it was very helpful reading through it. Sounds like it helped you function better? At moment I have no motivation and not sure I can return to work.
My doc suggested it may potentiate the prozac (not sure I f that was term used) but I pretty much feel anything is useless at this stage.
Glad it worked for you!
Did your doc say its temporary or you need the combination of the two longterm?
* sharing (not sugaring!)
I should clarify that the combination of the two reached full potential over the span of about a year and a half. I started with 600mg of lithium (I think it was). Then added 300mg just about every month and a half to tell months. Blood tests in between each dose increase, because lithium toxicity is dangerous, so they keep a good eye on how your body is using it. It took a good 6-8 months to reach 1500mg.
Then after a few months of being on Lithium, we added the Lexapro. It only took about a month to get to a theraputic dose.
I've been told that lithium can potentiate SSRI's as well. And I had previously been on Zoloft for a while when I attempted suicide in such a way that I should NOT have survived. So I was extremely hesitant of any drug, and adamantly against any SSRI.
But my depression was bad enough that I was either going to end up in a crisis center again, or doing something different. That's when my doctor suggested Lithium, and I thought it couldn't be any worse than what I was living with.
No one has told this is temporary. Until there's a cure, I'm absolutely happy taking these two long term.
One other quick observation from my own experience. November was one of the most stressful months of my adult life. Also, I went off my meds toward the beginning. In December, I ended up in a crisis center for suicidality. I got back on my meds and am now starting to notice that my depression symptoms are becoming manageable again. My stress hasn't decreased very much. But I'm managing it much better.
@knownotknow thank you for sharing this. It must have been a very rough time. Had you stopped meds because you were feeling better or as self sabotage (if I may ask).
I have never yet been to a crisis centre, not sure what it entails but where I live it seems only option is a very dated and crumbling mental hospital which has a terrible stigma and increasing bad reputation for the sorry state it's in. My family dies not think I have anything serious so am feeling quite isolated as I live alone and feel unable to get back to work while I'm in this state and testing out new drug.
For now I started on 200mg evening only. Next wk if I get through I should up to 400 but am already seeing this thing if having to go out and take blood tests as very tiring. The ssri already were making me feel dehydrated and this wknd felt a bit like my brain was being fried in a desert between the loud tinnitus.
Am glad you are managing better and glad you stuck around, I'm grateful for meeting you here 🙏🏽.
I stopped because my family became very suddenly and unexpectedly homeless (3 kids, 3 pets, and my wife and I), the day after my Dad died. We had moved across state, but our planned accommodations fell through. I ran out during the days to follow and the stress of seeing my family suffer, plus the lack of my meds, just broke me.
Also, for me, the side effects from lithium were all mostly physical comfort related. Sleepy, dizzy, etc. But, they were very short lived (a couple weeks). I was on Lithium alone for several months and noticed no real long term side effects except a slight (but noticable) decrease in my libido.
If your current SSRI is causing issues you find intolerable, you might consider trying a different one. I wish there were no side effects. I'm not happy with the side effects Lexapro has given me. But it's better than living with near-constant thoughts of suicide, regardless of how I'm feeling.
Man, it takes some time to get the right med combos figured out. That's been the consistent thing with everyone I've talked to about it. It's tiring and frustrating at times, but once you find what works for you, it's amazing. I think of those videos of color blind people putting on glasses that help them see colors for the first time and I can relate to their reaction. I used to hate the idea of meds and I fought it for so long, but this really has been a gift and I'm so glad I fought through the struggle. I hope your journey is easier. And just know that you can get through it! You will find what works best for you!
@knownotknow my heart goes out to you. You sound like a very inspiring, resilient person.
I'm so sorry for your loss and hope you found a home by now and good support. May you and your family find longlasting serene times.
I cannot imagine what it must have been like. And still you find the energy to also reply to my queries here!
I cannot say I have any justification for my depressive episode. Which usually means I then torture myself more because I don't see why I do not have strength to go on when I'm living relatively in comfort and in safety compared to others in very difficult situations.
I wish you well on your journey
Depression sucks! My family and I aren't together. My wife could not handle my depression, do since I got out of the crisis center, I've been on my own. I've had help! I found resources.
The first time I was in a crisis center, I was in middle management working for Montana's biggest University. I was technically middle class. But depression destroyed me. I tried to end it and damn near succeeded. But after, I seriously began my journey of recovery.
Your justification is that you have an illness and that illness has symptoms. Lifestyle, income, diet... all that type of stuff don't cause your illness. Sure, they can exacerbate symptoms sometimes, but without the illness, they are meaningless. Please, give yourself some grace. This is not your fault. You didn't cause these symptoms, depression did. It doesn't care if you're living in comfort or in your car. It's a monster, but there are tools available to fight it.
This last trip to the crisis center for me was a major victory, because I was able to reach out for help before I made an attempt on my life. That's big for me. I was in an awful place, but I am now proof that this thing is not indestructible. We can beat depression!
WICKED, both you and Lemon had the same treatment regiment as I did (when I was younger and their Guinea Pig). Must be some textbook solution with those meds and a probable, most favorable outcome with dosage levels.
I went through so many different meds I can’t even remember, unless you name them, sparking the memory of mine. But Lexapro, Prozac, Welbutrine, Lithium,….and any other. None of it worked. I got tired of the rollercoaster and hope for a solve all pill. Seemed to me there wasn’t any for me. So it left me to just talk therapy…then silence. Nothing more could I say as nothing changed.
Hope y’all fair better in your pill search.
@TrappedInLife I understand how you feel.
I recently started wellbutrin as well.
The thing is I've realised time and time again that if I do not have medication I precipitate much faster.
This time I'm more exhausted of it because I have been on medication regularly so was hoping I wouldn't sink so easily.
In the other hand am grateful that it seems the lithium calmed my self destruction urges and stopped the crying fits.
I too don't know what else to try except was hoping for eventual introduction of psychedelic therapy after reading a lot about it. I'd be willing to submit myself to experimentation if that chance becomes possible one day.
Ps Have you tried TMS or is not available where you are?
My psychiatrist will not refer me as yet but I also read about good outcomes especially for persistent depression.
Deep inside though I feel there is something I nerd to be doing which is not medicine related. So far I don't know how.
Wishing you well wherever you are at
I never heard of TMS. I’ll have to read up on that one.
I had read about psychedelic treatment when I was younger. Having access myself to obtain it, I experimented and can say one dose can provide a weeks worth of relief. I came to do this almost every weekend after that, not just because it was fun, that was a bonus. But I slept like a champ after a dose, amazing vision during and an enlightenment. It’s hard to describe, but well worth it. I have often thought about starting again, as my issues have risen to an all time high. But I am not sure I can find a dose source.
If you decide going outside of a doctors care to dose, I recommend you read up very well on how to manage your treatment! It’s very important, and FAR FAR beyond what could affect you taking script pharmaceuticals. Scripts have their side effects, plenty of them. But dosing psychedelics requires hours of prep for a “state of mind”, before taking. It can be a most awakening experience when done correctly. And it can be a nightmare when not.
Be safe. Best of luck.
oh…as far as my daily meds, I don’t take any, not for a very long time. I get by, staying as busy as possible. And unfortunately I turn to alcohol mainly for the evening decompress. Weed too on occasion. If I don’t….I can’t sleep.
Oh no I'm so sorry you are not with your family. Apologies I had not understood that.
Your input here has been the warmest thing I've read today so thank you.
Am not sure what happens at a crisis centre (is it hospital emergency) but If some time (it it's not traumatic for you) you'd like to share what helped you regain hope in life I'm listening!
@knownotknow How's it going these, days for you?
I was just looking up the thread on lithium and cannot believe it was two months ago...
I still cannot return to normal life or to work.. but at least the lithium seems to have helped with the darkest thoughts and have now been prescribed yet another new medication on top of everything.
I felt a shift last 2weeks but wonder if I'll be fit to work again as have no mental or physical energy still.
I started having hand tremors and it increased this week. Apparently a lithium side effect.