QUESTION:
Dear Dr. Heller,
I am currently under doctor's care but am needing a second opinion.
My doctor is strongly urging me to take Depakote instead of lithium. I am doing quite well - flourishing really- and do not want to change. Although I have a level at .7, my doctor says that lithium is too risky.
I am wondering if the fear of toxicity is real, as real as it sounds. Do you feel that my doctors's concerns are necessary? I really appreciate your website.
Thanks.
ANSWER:
They both have risks. Both lithium and Depakote can cause weight gain and tremors. Both
require blood testing on a regular basis.
Lithium can mess up the thyroid and has lots of drug interactions. It has been linked to
long term kidney damage.
Depakote has been associated with severe bouts of pancreatitis.
The doctor's concerns are valid, although Depakote is certainly not a
"clean" drug - meaning it has risks and side effects as well.
The choice is yours. Staying on the lithium since you're flourishing seems a
reasonable course of action - unless the physician has spotted a potential problem that is
directly related to the lithium. It's something you should speak to him about.
