Q:  Lithium & Negative Thinking

I have been treated for BP2 for almost 30 years (hypomania with very infrequent depression); I am currently taking 450 mg. of lithium and 2.5 mg. of paxil every 3 days for o/c with the occasional need of low dose of klonopin for anxiety. I am stable, except when traveling and changing time zones, or when extremely stressed. I have had years of therapy.

I do have alot of negativity about situations and people, and I posted this question on the bipolar support message board. One of the replies was that the lithium was causing the negative thinking and once the dr. changed from lithium to another mood stabilizer, the negativity went away. I have never heard/read that lithium might cause negativity. Is this so? 
 

Dear Denise -- 
Haven't heard that, either in the bipolar research literature nor from my patients. Could have been true for the person who commented (certainly was true in her/his experience), but as bipolar disorder is a problem of changing mood and energy, even for one of my own patients whom I know well, any change in mood has to be considered as either a product of the recent medication change we made, or perhaps also from the patient's own cycling, which means that for any given event, there is always some question about "causality". Because of that, I'm not sure how to interpret what you heard, nor should you be. Nevertheless, all that does not mean that one person, from whom you heard, might not indeed have experienced lithium in such a way as to produce "negativity". But don't go stopping yours on this basis, right? Ask your doc' for her/his opinion on this, and make a joint plan on how to address your symptoms. Good luck with that. 

Dr. Phelps

Published October, 2006