I know both lithium and bipolar itself can cause cognitive changes.  When given a simple screen with a new psychiatrist I had some minor problems, but since I know the tests for my profession the results were skewed anyway.  The problems were in abstract thinking, memory, and I think something else.  (see, memory :)

Since my diagnosis it seems like it is very difficult for me to deal with grids.  I have to fill numbers into grids as part of my job, and I just can't do it.  It takes twice as long as it should and I make so many mistakes that I get in trouble.  I had no problems with this until the diagnosis and mood stabilizers entered my life.  I had my eyes checked and got new glasses; that's not the problem.  Is this bipolar stuff or is it a separate issue?  thanks

Dear Anonymous -- 
A friend of mine says "medications are guilty until proven innocent".  Obviously we could wonder whether the "grid problem" seemed to start right after lithium was started, or might have been present, even moderately prior to that.  So I presume that when lithium was being started there had been so much in the way of symptoms of one kind or another, hopefully not present now, that you can't really look back now and try to sort out this "timing" question. 

If that's roughly correct, probably the only way to know for sure if it's lithium or the bipolar disorder itself will be to try a cautious, monitored, your-doc-is-completely-in-the-loop trial of decreasing lithium to see if that helps.  Please let me emphasize that you should not do this on your own, this trial of lowering the lithium.  Your doc' needs to be in a position to be ready to add something else if as you do that, symptoms seem to re-emerge -- or perhaps in advance as "insurance", depending on your history.  

Dr. Phelps
 

Published August, 2003