Q:  Lithium & Blinking

I'm a bipolar teen. I also am aditced to sex, drugs, and alchoal. Does that have any thing to do with bipolar. because I'm going in to a RTC for this.  I am very worried so is my parents.

Lithiem aka Lithibid I blieve I spelled them right. Is making me blink rapdly since they uped the thing to 600 and 300 to 600 and 600.  What should I do I told my doctor and he said that it probly was not it.

Christa

Hi Christa 
You're right, there's a very strong relationship between bipolar disorder and use of things like alcohol and drugs; and sex, although that's a good bit more complicated, as you know. 

Read up about alternatives to lithium so that you know what your options are.  The "big three" choices are lithium, Depakote, and Tegretol (except that a new version of Tegretol called Trileptal is kind of replacing Tegretol, but it's still basically the same deal).  There are two newer mood stabilizers, lamotrigine and topiramate, but they're a lot trickier to use because they have antidepressants effects as well as mood stabilizing effects.  Lamotrigine is pretty good stuff for a lot of folks, very few side effects, but again, pretty new so worthy of substantial caution.  If there's anybody in your family with thyroid problems, read about thyroid and bipolar too, though that's extremely new by comparison.  Finally there's Zyprexa, which is awesome for severe symptoms but causes weight gain big time, so most of us have learned to avoid it except for like emergency symptoms.

And lithium is often a mainstay, used at doses low enough so it doesn't bother you enough to make you want to stop taking it.  Sometimes it takes quite a combination of things to control mood swings, but if together it really works and you don't have hardly any side effects, most people conclude it's worth the hassle.  Is lithium causing your blink?  not sure, because even though that's not a routine side effect, in any particular person almost any drug can cause almost any side effect.  If your symptoms are really well controlled, you could ask him about lowering the dose to see what happens to the blink.  If they're not, you could add low-dose Depakote, or perhaps Trileptal, then try lowering the lithium a bit after your symptom control has improved.  Good luck. 

Dr. Phelps