What Causes Severe Mood Swings After Discontinuing Lithium And Citalopram?

Posted on Thu, 1 Oct 2015

Question: I was on lithium and citalopram for almost 4 years. I was taken off them in may 2014 as my psychiatrist thought I was better and didn't need it anymore. Since being off them my mood has deteriorated rapidly. If I was to go on lithium again (500mg a day) would I get loads of side effects? When I was last on lithium I had barely any side effects, just excessive thirst. Im worried if I go on it again I will gain weight and my acne will worsen. I feel like I shouldnt try any other mood stabilisers because lithium worked so well for me before...the question is, will it work just as well for me now? I was prescribed seroquel the other day and im reluctant to take it because I feel lithium is the one for me.

Answered by Dr. Shubham Mehta (1 hour later)

Brief Answer:
should restart lithium.

Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.

Almost all mood stabiliser drugs are associated with weight gain.

If you were doing well on Lithium earlier, I think you will be to tolerate it again now.

This is expected that person will respond well if he is started on the same drug on which he was doing good earlier.

If there were minimal side effects earlier, there should not be more than that now. 500mg is not a very high dose to cause loads of side effects.

Some dietary modifications and physical exercises will prevent weight gain.

Keep in touch with your dermatologist if you develop acne.

Kindly discuss this with your treating doctor.

I wish you well.

Feel free to ask if you have more queries.
Thanks.

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

Follow up: Dr. Shubham Mehta (21 hours later)

Thanks for your message. I spoke to my psychitrist today but they dont want to put me on lithium again as they feel that long term its too bad for me. Do you know of any mood stabilisers other than serequel which dont make you gain weight so much? I really wish i could go back on lithium.

Thanks again for your help

Answered by Dr. Shubham Mehta (5 hours later)

Brief Answer:
oxcarbazepine or carbamazepine.

Detailed Answer:
Dear XXXXXXX
You are most welcome.

If Lithium is out scene, then I would recommend oxcarbazepine or carbamazepine.

As I mentioned earlier that all mood stabilisers cause weight gain, the drug which cause least weight gain among all should be choosen.

Thats why I recommend the above drug.

Another mood stabiliser which cause weight loss is topiramate. But it is a third line mood stabiliser and not used as the primary drug.

Kindly discuss this with your doctor.

I wish you well.
Thanks.

Note: For further guidance on mental health, Click here.

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