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PAPERS:
LEONARDO TONDO, ROSS J. BALDESSARINI, and GIANFRANCO FLORIS
Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders
The British Journal of Psychiatry 2001; 178: s184-190s [Abstract] [Full text] [PDF]
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[Read eLetter] Potentially Harmful and Ignored Side Effect of Lithium Therapy
Kate M. Reeh   (25 June 2004)

Potentially Harmful and Ignored Side Effect of Lithium Therapy 25 June 2004
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Kate M. Reeh,
Unemployed
Layperson, researcher, and sufferer of Bipolar II Disorder

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Re: Potentially Harmful and Ignored Side Effect of Lithium Therapy

martykate{at}yahoo.com Kate M. Reeh

I write, not as a physician, but as a sufferer of a bipolar disorder who has noticed one side effect, which I believe could have possibly fatal repercussions, that no physician in any article that I have read does not address: the effect of lithium on emotions.

When I am on a strict lithium regimen, the drug cuts me off from feeling any emotions, expressing any feelings when it would be appropriate and cathartic. That the drug cuts off feelings of sadness and grief; that when I take lithium while taking lithium I lose the ability to cry, feel sadness, just feel what I should appropirately be feeling--even severe emotional pain.

The literature, at best, will say "it enables you to control your emotions". That statement is misleading. Another article states that as a side effect that you may "feel dulled". Neither of these articles mentions the true effect of what lithium is doing: causing complete emotional numbness.

This is not something benign. During my first experience with a strict lithium regimen was unable to cry for two years--I was unable even to grieve the death of my father. I felt literally nothing. Lithium robbed me of feeling grief over somehone whom I watched die a painful death--and loved very very dearly. I was not even able to cry. I heard my mother say to my sister that I "seemed unaffected by it". Is that an appropriate response to loss?

My therapist was worried, I was worried and wondered what had happened to me. Crying has always been cathartic for me (and I would assume for many others). I cry, get my feelings out, and then am able to move past whatever emotional blockage, loss, or painful situation that I face.

Two years, two years of feelings locked inside. Then came an incident that was work related and I literally blew up on the job. I started screaming at a supervisor and co-worker and was unable to stop myself. It was like I had stepped out of my body and was watching another person doing these things. The next day I was fine, but the damage was done. I had lost a good job.

Later, due to money I had available at the time; obtaining a job and insurance and eventually COBRA, I was able to take Lamictal and the emotional numbnessthat lithium had caused disappeared,even when I took a small dose of lithium to aid in fighting depression. When l lost my job andI no longer had access to money and insurance I had to go back on a strict lithium regimen. The symptoms recurred.

While back on the lithium regimen, I fought normal side effects of fatigue, dry mouth, weight gain, and other usual side effects, but I fought an almost debilitating depression that was absent when I was on the Lamictal regimen. It took several months, not days or weeks, for the depression to subside. And yes, the emotional dullness returned.

Emotional numbness is not benign. I cannot express adequately in words to you how it feels. I have spoken to others who have had the same experience--this obviously is not a side effect that is experienced by only a few.

This needs to be studied. Patients need to be warned that this may occur. It is being glossed over, ignored, and I wonder if it is even being studied. If this is the situation, the patients taking lithium-- which is highly praised by doctors as the "most effective drug in dealing with bipolars disorders", are being done a great dis-service and perhaps even deceived as to what this medication may do to them.

As a Bipolar II sufferer who does a great deal of research regarding her disorder I am finding no mention whatsoever of this particular side effect when I read about this drug. Any good psychiatrist will tell you that suppressed emotions are not healthy and can even cause harm. It is one thing to be told that lithium will help you "control your emotions", it is another thing altogether to be told that you cannot feel them when you need to. That you spend your days in an emotional vaccuum because you experience an emotional numbness.

I taking Lamictal at the moment on the free meds program. What am I going to do when I am no longer eligible? I won't be eligible for insurance and won't be working full time because after almost three years of unemployment--and losing three jobs in two years--I will not have access to insurance. I have taken Depakote and never will again, is not an option--not after the side effects I experienced, and a tremor that matched anything I experienced on lithium. I am allergic to Tegretol, it caused a severe rash after three weeks and I never had problems similar to that with Lamictal. What is going to happen to me?

I cannot go without medication but I do not ever want to experience what lithium put me through again. I have gone through it twice, and dread the thought of having to deal with it again. I don't think I could do it--frankly suicide is more appealing.

That this aspect of lithium is not discussed in articles about this medication causes me great concern. I don't know how to start to a forum of professionals, or anyone to take me seriously regarding the potential harm this drug may cause. Not being able to cry, feel sadness, feel grief, not being able to let painful feelings out so that a patient can be released from them I cannot help but feel is a potential danger.

What must I say to convince you that this must be studied, that patients should be advised of this side effect, that any article written about lithium should warn of this side effect. How many people must suffer my experience before someone will take notice?

Respectfully,

Kate M. Reeh Bipolar II sufferer