Don wrote:
Lithium is a tricky medication. Too little and it doesn’t work; too much and toxicity can occur. For my Lithium blood concentration, the therapeutic values are between 0.6-1.2. One of the ingredients to Lithium is salt. It can make the patient very thirsty. Dehydration is the enemy. Story: last summer I went with my family to Walt Disney World. I was there in the Florida summer. Highs were in the 90’s. I walked around everywhere with a cup of water and avoided sodas. I knew about the dehydration issue, and I drank water as much as possible. I also don’t sweat so overheating can be dangerous for me. Evidently, there was an issue with my hydration. I came home from Disney on Sunday night. I went to the VA Clinic on Monday morning for labs where they drew a CBC, CMP, and Lithium level check (blood). I thought all was fine. I felt fine. That night about 9:30p, I got a phone call from the VA hospital telling me to go to the nearest ER and that my blood levels were toxic. My level was 2.2. So I called my private physician where I get my regular care from. They asked about my symptoms and told me to come see them in the morning and they would do a stat lab. So I went to bed and woke up like I always do and began driving to my private doctor (outside VA). On my way there, I got another phone call from VA asking where I was. I told them I was going to see my doctor. They said no. Go to the nearest ER right now. So I drove to the hospital where my psychiatrist works. After doing my intake with triage, I told them what my level was and they immediately took me to the back and drew more blood and started an IV. I was informed that this level may be fatal. I spent 6 hours in the ER with the nurses doing 15 minute checks and hooked to fluids trying to flush the Lithium out of my body. All the while, I felt no adverse effects. It’s a good thing the VA called me the night before. Because I would have taken my medication that evening and gone to bed. Had I not done the labs the day before I never would have known. I would have continued to take my medication and continued poisoning myself at the same time until my body gave out. Eventually, I’m not quite sure how this could have turned out. But I feel extremely lucky and fate was on my side that night.
That is a very scary story. Psychiatric drugs are a double-edged sword for me. I suffer from major depression and while I understand the need for medications, I had trouble taking them for many years because of the fear of side-effects, and other reasons. When I did finally give in (after a particularly scary incident involving suicide) I continue to have mixed feelings about them. I have tried a number of different medications that either did not work or they had side-effects that were either too intrusive or just downright bad for my emotional well-being (i.e. increased thoughts and plans of suicide). I just struggle with the fact that while medical science proves that these drugs can be beneficial, we still don't really have a true understanding of how/why they work in the brain. I have been off of my latest anti-depressant for probably around 2-3 months now. While I know I am struggling, I am finding it really hard to want to try anything else. Logically I know that this way of thinking is partly due to the depression, but it's where I am at. While we don't share the same disorder, I sympathize with you in terms of the day-to-day management of the whole thing. I am very glad that God was looking out for you and that the toxicity was caught in time before it was too late. I hope things continue to improve for you Don, and that you have a great week!
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