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Suggest Treatment For Withdrawal Symptoms Of Lithium Carbonate

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Posted on Wed, 13 Jan 2016
Question: Lithium carbonate with dosages up to 900mg taken for 6 months. Cessation of lithium occurred 12 months ago. At the time of cessation, lithium tremors were quite troublesome that even eating soup was difficult. This was very upsetting. Fortunately, most of the bad tremors have healed. Tremors are no longer noticable or detectable unless I am doing a fine task like high speed typing or if i am under a high degree of stress. In these situations a very mild finger tremor appears. I did not have this issue prior to taking lithium. Will these finger tremors completely heal? They are a nuisance but otherwise not too troublesome.

Thank you for your answer. You mentioned you recommend alternative medications. What alternatives to lithium do you recommend for BP disorder?
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Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Consultation required

Detailed Answer:
Hello, and thanks very much for your question.

Typically tremor related to lithium use is worst when the level is too high, but indeed can happen at therapeutic levels. Discontinuation of lithium and initiation of a replacement medication is generally the best idea. In my experience, lithium tremors can take as long as a few months to subside. Tremor occurring after one year is highly unlikely to be related to lithium, though I can certainly see where you draw that connection. To investigate this more closely, I would visit a neurologist to examine you. I suspect this is simply underlying essential tremor which, as you say, only occurs in certain high-stress situations and is generally not bothersome.

Once you are satisfied, kindly remember to rate 5 stars and close this answer thread.

In the future, for continuity of care, I encourage you to contact me at my private link below after asking a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX

Brief Answer:
Followup

Detailed Answer:
You're very welcome!

There are two medications that can replace lithium very well. The best is Lamictal, as it has the fewest side effects, but it can be slow to uptitrate to an adequate dose because of risk of serious rash. The second and equally effective is Depakote, which can be started quickly. Other mood stabilizers include atypical neuroleptics, but I would look closely at these two first.

Once you are satisfied, kindly remember to rate 5 stars and close this answer thread.

Dr. Sheppe

XXXX
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Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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Suggest Treatment For Withdrawal Symptoms Of Lithium Carbonate

Brief Answer: Consultation required Detailed Answer: Hello, and thanks very much for your question. Typically tremor related to lithium use is worst when the level is too high, but indeed can happen at therapeutic levels. Discontinuation of lithium and initiation of a replacement medication is generally the best idea. In my experience, lithium tremors can take as long as a few months to subside. Tremor occurring after one year is highly unlikely to be related to lithium, though I can certainly see where you draw that connection. To investigate this more closely, I would visit a neurologist to examine you. I suspect this is simply underlying essential tremor which, as you say, only occurs in certain high-stress situations and is generally not bothersome. Once you are satisfied, kindly remember to rate 5 stars and close this answer thread. In the future, for continuity of care, I encourage you to contact me at my private link below after asking a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX Brief Answer: Followup Detailed Answer: You're very welcome! There are two medications that can replace lithium very well. The best is Lamictal, as it has the fewest side effects, but it can be slow to uptitrate to an adequate dose because of risk of serious rash. The second and equally effective is Depakote, which can be started quickly. Other mood stabilizers include atypical neuroleptics, but I would look closely at these two first. Once you are satisfied, kindly remember to rate 5 stars and close this answer thread. Dr. Sheppe XXXX