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Suggest Treatment For Fatigue While Taking Lithium

Posted on Tue, 8 Nov 2016

Question: IDr. XXXXXXX it's just amazing that stopping lithium has made a difference in my fatigue. Is my body not able to handle it or could it be reacting with other meds?

Answered by Dr. Chintan Solanki (24 minutes later)

Brief Answer:
Provide details of other medicines

Detailed Answer:
Hello,

Thanks for writing to us.

Lithium causes muscle weakness. Fatigue as a side effect of lithium is not seen frequently. Many other drugs can cause fatigue as a side effect.

Please provide me details of other medicines you are taking with dose and duration. Also tell me dose of lithium with duration you are taking.

I will be happy to help further after your response.

Regards,
Dr Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (9 hours later)

Thank you, Dr. Solanki, for helping me. My medications are remeron 15mg, ritalin 20mg, seroquel 125mg, humalog with insulin pump, aspirin 81mg, fenofibrate 160 mg, fish oil 1000mg, midodrine 15mg, testosterone therapy, and vitamin D 10000 daily. I was taking 450mg lithium. Would any of thewe cause a problem? XXXXXXX

Answered by Dr. Chintan Solanki (4 hours later)

Brief Answer:
many of the drugs you are taking can cause fatigue

Detailed Answer:
Hi XXXXXXX

Thanks for information.

Seroquel, Ritalin and testosterone can cause fatigue as a side effect in descending order. You are likely getting fatigue with one or more of them. 450 mg lithium in my opinion is not likely responsible for your fatigue.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (38 hours later)

Dr. Solanki, I stopped seroquel for 2 weeks and my fatigue was still there. I started ritalin and testosterone AFTER I had the fatigue. All due respect to your opinion, stopping lithium has changed my life. Chances are you wouldn't have thought to stop lithium with a patient but it worked. And I wasn't even on the minimum dose! Lithium in my body doesn't work or it was interfering with another med and the result was fatigue, and not simple fatigue! I would have to lay across my bed for hours at a time and always felt as bad when I got up. If I hadn't thought of doing this myself, my doctor would have kept adding more pills or suggested ECT, etc. Medicine is not an exact science and there's always exceptions to the rule. XXXXXXX

Answered by Dr. Chintan Solanki (8 hours later)

Brief Answer:
lithium can be culprit

Detailed Answer:
Hi,

Thanks for clarification. There is no significant interaction between lithium and other drugs you are taking.

There are many case reports suggesting lithium can cause fatigue. In your case dose of lithium is low and other drugs were there. In first instance it looks that lithium is not responsible. However when other causes of fatigue are ruled out and it is confirmed that after stopping lithium you have improved, lithium is likely culprit.

You are a good patient and your observation is useful. You can ask your doctor to report this side effect of lithium.

Take care XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (16 hours later)

Thank you so much for the information, especially the case reports of lithium causing fatigue. There was a small percentage of a chance that I'd become a diabetic as a juvenile, male, and no family history---but it happened. So if I hadn't stopped the lithium, I doubt the doctor would have done it. Would you have thought to do that with one of your patients who was taking 450 mg?? And my mood has not plummeted. All in all I'm not perfect and wonder if I should try decreasing the seroquel again. What do you think? XXXXXXX

Answered by Dr. Chintan Solanki (4 hours later)

Brief Answer:
you can try to decrease seroquel again

Detailed Answer:
Hi,

Thanks for giving me nice experience about lithium. I will check in my patients if any one complains about fatigue who are on lithium.

If I were your treating doctor I would have recommended first to stop/decrease seroquel or ritalin rather than lithium. However in any instance I would not like to use lithium on 450mg dose as it is subtherapeutic dose.

If I were your treating doctor I would allow reducing seroquel gradually with 25 mg reduction in dose every 10 days. Please ask your doctor and move ahead as he/she is aware about your all history.

If still any query there, I will be happy to answer. If not, you can close the discussion and give your feedback and rating so I can improve my service.

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http://bit.ly/drchintansolanki

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Wish you good health.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar