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Lithium Weight Gain - FAST

I've always taken SSRI's because I've been diagnosed with generalized depression/anxiety. My NEW doctor says I have a non-specified mood disorder (not depression/anxiety) on the depressive side and wants me to try Mood stabilizers because SSRI's seem to cause me to have even more anxiety. I am a bit nervous about Lithium because it sounds harmful for your kidneys and thyroid. Also, a significant factor in my life that causes me A LOT of frustration is weight. I am 5' 2" so a little bit of weight is alot on my small frame. I was hoping I wouldn't gain weight on Lithium, but within a week after taking the Lithium... my stomach is HUGE. It feels bloated (not gassy). I'm assuming it's water weight. But you have to drink alot of water on Lithium so it doesn't damage your kidneys. So what in the world do I do? I'm in a bad mood all the time because it's so uncomfortable. I look 3 months pregnant and my stomach just hangs out over my pants when I'm sitting at my desk at work all day. This doctor says Lithium is the best of the best.
18 Responses
Avatar universal
Call up your doctor.  I'm not sure if diuretics would be appropriate for the extra water, but they might be.  Hopefully it will go away soon.  Kidney and thyroid issues don't appear overnight, so regular blood work should allow you to monitor that.  If lithium is really sucking for you though, ask about lamotrigine.  It has its risks, but it's weight neutral and is a great mood stabilizer if depression is your main issue.  Buspirone would also be a good thing to look into for anxiety.  It plays well with mood disorders, unlike SSRIs, and tends to have a very low side effect profile (after some initial constipation, I have zero discernible side effects from it).  It doesn't work for some people, but it's definitely worth a try.  I'm on a lamotrigine/buspirone combo for BP II.

Is your doctor a bit old?  Lithium is the "gold standard", but there are a number of people who respond better to other things, and besides, it's the gold standard for BP I, which you don't have.  Finally, make sure you're following the correct water drinking regimen and not over drinking.  I don't really know what the right amount is, but you should check since it's an easy fix if that is the issue.
Avatar universal
I have been on Lithium for about 10 days. Getting on new meds suck! It makes me feel awful! I think I'm hypersensitive to all of these drugs. All this trying new meds just causes me to feel bad for a few weeks. When can I feel decent? Grrr! Thank you for your input.
Avatar universal
My doctor seems to be in his 60's. But he is always going to seminars once a week. He seems to care about continuing learning about all the latest info.
Avatar universal
I absolutely hate it! My stomach is pushed out so far, all within one week of being on Lithium. I'm uncomfortable sitting at my desk all day and even laying down watching TV. It's pissing me off, which is the opposite of what I'm trying to get treated for.
Avatar universal
Call your doctor and let him know what you are going through with your stomach. I was on lithium for years and it did help me, but I always reported side effects. If the med is hindering you rather than helping you, and that goes for side effects, than call your doctor. You don't ignore side effects, and neither will your doctor. I didn't go through weight gain or increase stomach bloating or girth in 10 days.

If your doctor is other than a psychiatrist, he should check you out for other possible reasons why you are experiencing that kind of bloating. The lithium could be coincidental.
Avatar universal
Thank you for your input. I have an appointment already in 2 days, so I will let him know and see if there's anything that can be done. I just did my first blood test so I can get the results of that back as well.
Avatar universal
Update: I went to my Doc appointment yesterday. My first blood test on 600mg came back as .5 level. He listened to me explain how awful I felt regarding my hugely bloated stomach. He said to switch back to 300 instead of 600. And if I feel OK on that dose then stay there. And if my mood isn't that good then up the dose to 450. I am also on 100 mg Lamictal. I'm not sure how 300mg will do much because the therapeutic dose is 600 plus. It's all I can tolerate right now. I feel awful because adjusting meds makes me feel like I got hit by a train.
Avatar universal
I don't know where you are  getting your information on therapeutic dose, but lithium dosing doesn't really depend on an optimum dose range but more at how good of an beneficial effect it has on the person taking it, and the therapeutic bood level to guide that you aren't being under medicated or toxic. Lithium has a narrow therapeutic range, and depending on your physical condition, like hydration and blood chemistry levels among other things, the levels can change as you take it, which is why lithium lebels are monitored as long as you take it. Therapeutic range for lithium is:  0.8 to 1.2 mEq/L.

For each person, therapeutic effect is different. Just to give you an idea of what I mean, my lithium dose ranged between 900 to 1200 mg for years. I can easily get toxic when I don't eat or I am not well hydrated. It didn't require constant or vigilant monitoring. I got my lithium level checked every 6 months for maintenance.  Only when my physical condition slipped or change and I either show toxicity symptoms or my bipolar disorder was kicking in, caused my doctor to check my level. Then, he adjusted. The blood therapeutic level result that I thrived in was actually 0.7, and for most part, on the same dose, my level would flucuate between 0.7 to 0.9.Lithium wasn't the only drug I was on, btw. Like I said, whether or not it is therapeutic for you depends on how well you are mentally, the side effects, and the therapeutic range.

When I started, I showed improvement and didn't cycle so deeply for most of the time on 150 mg, then it slowly got raised up. My doctor checked on me pretty frequently during the titration period. Besides phone calls when I had side effects, I was scheduled to see him twice weekly during the titration period and my lithium levels were drawn as needed. Unfortunately, most of the  psych drugs can either have no effect on me or go to the other extreme and cause me a lot of problems. That is why he kept a close check on me.

He also had to drill it in my head to alert him him immediately when a side effect happens and not wait or ride it and tell him about it when it gets really bad or when I mention it like it was a footnote, if I ever mentioned it at all. So, he didn't mind phone calls when I forgot to mention something like locking myself out of the house 3 times a week or that I've been popping antacids several times during the day. There were times I just handed or mailed him a short list of things I was going through in the beginning after he told me I didn't report enough or timely. I wasn't being sarcastic, and he knew that. He jknew I was just as busy as he was and that I did that to get it out of the way, and to be compliant. It made him happy, and he always acknowledged when he got the information besides telling me whether he wants me to adjust, stop, clarify something, do a lab test, see my primary doctor or drop in for a sooner appointment.

I chose him because he was reasonable, flexible , thinking, dependable. and we can work together. If I had any questions or I challenged his prescription or planned prescription to me, he wasn't intimidated by my concerns or questions and responded without judgment but gave me an answer that rang true or if I still had qualms about it, we discussed it for the amount of time that was reasonable at the moment, or we would dig deeper to see if it was a good plan. If it was a gamble, then that would be said.

So, if you feel that you cannot tolerate, go through, have an uneasiness about continuing or question the treatment, call him up and sound it out. If he's been practing a long time in psychiatry and he doesn't take things personally, then he can give you answers to,your questions. If you still question him or you are uneasy about it...pay attention to that and either question some more and ask for the rationale, why he is doing it that way, seek a second opinion, drop him, etc. The bottom line is that you decide whether you will follow his lead or be willing to take up the plan or the med and what and who is comfortable for you.

There were times with many different doctors I did not go for the treatment or the drug and I even went for second opinions. I also stop seeing doctors, and there were times when I felt a doctor or a health professional was not practicing safely and made reports and complaints to the appropriate authorities, whether it is the hospital, the Board or State and Federal agencies or all. It depends on the situation and what the response to get an investigation and review started. So, if you don't feel like you are getting decent medical care or feel you ate going through needless suffering, you have avenues to go through and more than one option. That includes medications and treatments...unless the back is really up the wall.

I can put up with some conditions and even people I have to work with when I know that It will end well or I can work with all sorts of people, including people who others can't stand to work with, as long as the job gets done successfully. For people I will depend on that requires some type of relationship and is long on the tooth with trust and on issues close to my heart like my own mind and body, then the trust goes a lot further and requires more "earning" and ease,

Did you just get started on Lamictal at 100 mg right at start of the med? Usually, it gets started lower than that to prevent adverse effects like the rash. For myself, it was started at. 25 mg.

The doctor should tell you what to watch out for. When they don't tell me and I am not familiar with a drug or treatment, I ask and I also read up on it before I take it. I rarely take anything blind. The only times I took something blind was when I was unconscious, whacked out, overwhelmed physically or when someone slipped me a drug without my knowledge...unfortunately, that last bit has happened a couple of times, and I wasn't very forgiving at the end of that.

202665 tn?1248806733
Great answer!  You have to take control of your own health.  Read, research and make sure you have the right doctor to meet your needs.
Avatar universal
I do understand the level of the Lithium in my blood is what counts. My level is .5 at 600mg, so since I lowered to 300mg, my level won't be in the therapeutic range. I was already on Lamictal to begin with. I am just substituting Celexa for Lithium because this doctor thinks I was taking the wrong class of medicine.

My stomach is still huge since day 3 or 4. It's very uncomfortable and I don't want to move around, sit at my desk at work, be in public, meet for dinner, etc. It feels like a big water balloon is in my stomach. If I press on it it's not fat. It's something like water weight gain, but a lot! I really do look pregnant (not an exaggeration)! I'm giving it some time to see if it goes away. I hope so because this will hinder me more than help me. It will consume me and cause me more anxiety and depression.

I like the point you made that I do have other options and routes, and to have him explain further on why he is doing this or that. Part of me feels trapped like this is the only option. This is my first time taking something like this and it's just new and scary. I really appreciate the support being that I’m so unfamiliar with this class of drugs.
Avatar universal
Hi, aCakes. I hear what you are saying.

First off, it is unusual to have stomach bloating that significant. If ai was you, I would be calling my primary PHYSICAL doctor about it. Like I said, stomach bloating could be caused by other things. One thing is that unexplained bloating is one of 3 early signs of ovarian cancer. I emphasize the point that it stomach bloating is caused by other things, because I know you are treated for anxiety.

Secondly, I want to clarify that blood level AND a good response or improvement in mood happens with effectiveness with lithium.

I understand the feeling that you have your back against the wall and that it feels like it is your only option. However, if the doctor is the only option, I would think it would be a good idea to question him. Partly, because it is obvious that you are in distress this week and last. The hesotance that you feel is not unusual, but sometimes, you have to push ypurself to be your own best friend. How much of a trial are you willing to put yourself through before you speak up for yourself?

Quiz him and ask the psychiatrist if he thinks the stomach bloating is from the lithium. Look over what you have been eating and how much fluids, beaides coffee (coffee and teas have diuretic properties), is going on. When I have an enourmous weight gain from psych med, I know it is because I have been eating alot. Also, your psychiatrist should have had q baseline blood chemistry and thyroid levels prior to the first lithium dose you took.

The other thing is that you said it is hindering you. If you go down or stop taking the lithium, the logic is that if the lithium is causing the bloating effect and since you said you are worse in mood, and obviously anxious, for wear for weeks now, I would think that would be a good thing.

as I said, if I was going through a bad reaction that I personally couldn't take or if it was distressing me that much, I would call the doctor up, and besides that, I would say that I am not taking any more of it. People have the right not to take a medication or a treatment. I personally refused ECT and MAO inhibitor. It is up to the doctor if he feels so strongly about a medication to give good solid reasons why he wants you to take it, and you should have the opportunity to think about it and be further informed.

I think you already know that there are times when a drug will work for one person and not another. I think it is great that lithium works for me and The only daide effects I had was dry skin that broke out  on rate occasions and dry mouth requiring vigilant dental checkups and mouth hygiene and bad hand tremors that eventually disappeared and just became fine tremors only when i was stressed out or very upset. You are the first person I heard that went through problematic stomach bloating, and I know a lot of people on lithium.

You are not at the end of the line in the drug arsenal. Lithium isn't the only drug in the bipolar medicine cabinet.

Avatar universal
I'm so uncomfortable right now that I can hardly absorb your response to my post. I can't go anywhere, sit here, don't even want to breath. My doctor, who seems to be on top of the latest research and very thorough, and recommended by my wonderful counselor, said that it is not uncommon to have GI issues or water retention on Lithium (whichever it is that I have). On Thursday (4 days ago) he said the side effects can go away. And he also lowered it to 300mg for now. I am pretty sure it's from the Lithium. I can't concentrate on anything because it's consuming me. His office is closed today. I feel bad because I want to give it longer because maybe it will go away. I refuse to take anything that causes alot of weight gain, that cannot be controlled even if eating right or exercising. And this is just overnight and nothing I can do to stop it. I was hoping someone had a similar issue and could report if the initial side effects went away.
I to am on lithium for bipolar. I have been on lithium for about 5 yrs. It has kept me well. But there is the side effects. I have put in alot of weight and it is mostly around the stomach. I get very dry in the mouth and get very thirsty. Makes me urinate alot. And I had a tremor before know it's like dds.I'm in my mid 30s. And want to have children. So at the moment slowly lowering the dose but it means subtuting for another medication which has a weight gainer to. Hopefully one day they,L find either cure or medication that doesn't have all these nasty side effects.#peace#
Avatar universal
I am taking your advice about going to the Doctor. If anything they may be able to tell me if it's water retention or GI issues. I will report back in a couple hours. Thank you for helping me feel supported.
Avatar universal
The Doctor said there is no obstructions or blockages. How long do I suffer and wait to see "if" this side effect does in fact go away?!
Avatar universal
I went ahead and finally left a message. He called in a different medicine, Latuda. He was very encouraging to call him anytime I need to.
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Thanks for the update, aCakes. I hope you are doing better, and hope things work out.  Very glad you called the doctors,  got a response and encouragements from him to call him anytime.
Avatar universal
You were a big help. Thank you! I have been on Latuda for 3 days and no side effects so far.
Avatar universal
I got off Lithium. I was on it for about 3 weeks and just could not tolerate it. I am now taking Latuda, which is awesome! But my stomach still does the swelling after I eat. I even took out dairy and carbs (gluten/grain). It all started when I started Lithium, which it's not as swollen as it was on Lithium, but it is still a lot.
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