Aids HIV FAQ

Lithium and drink/dope

Question:

>I’ve been taking lithium for many years and have never heard of alcohol >consumption being so directly related to kidney disease. >Can you back that up with source(s) Barry?

        Ask your own shrink, If you don’t want him to know try putting the question to Dr. Ivan Goldberg. Not sure what his email is, but he usually pops in on support groups like this one, maybe someone else knows, or if not, email me and I’ll see if I can find it. Both booz and Lithium act as dyuretics.         Sodium balance and Lithium toxicity MUST be monitored and when anyone takes other diuretics, or changes their sodium intake in a big way, it WILL affect the readings of your Lithium levels. It did for me….big time.         My own experience (I’m bipolar) is that self medication has screwed up my own stabilisation. Don’t think for a minute that you can introduce booz, dope or even high levels of caffeine or nicotine and not have a MAJOR influence on your highs and lows.         As long as you keep your social drug intake to yourself, and not fill your shrink in on the exact level of your use, you will NOT find any proper, scientific or professional solution. In fact in my case booz and dope (grass, hash, peyote, majic mushrooms) and diet aids (Fastine) were my way of masking my highs and lows in my self medicating fashion. The problem was I also like the buzz and was prone to excessive intake.         I’ve been totally clean (also used cocaine) for 8 years now and have only now seen some semblance of sanity, although not cure or total relief. I still think a lot about toking, but not booz or coke. I also know that for me, if I allow myself to get back any one of the substances that there is a significant chance I’ll get back to using most of the others too. Thats my own solution and may not be the one for everyone, but I have yet to meet anyone on psychopharm meds that is effectively combining it with use of social drugs. "iki pasyrasimo"

Response:

>>Is it OK to drink whilst taking lithium? >No.  Lithium + ethanol = kidney damage.

I’ve been taking lithium for many years and have never heard of alcohol consumption being so directly related to kidney disease. Can you back that up with source(s) Barry?

Response:

>>>Is it OK to drink whilst taking lithium? >No.  Lithium + ethanol = kidney damage. >I’ve been taking lithium for many years and have never heard of alcohol >consumption being so directly related to kidney disease. >Can you back that up with source(s) Barry?

Glad to.  By the way, you snipped the part of my post in which I said that a modest intake of alcohol, such as a glass of wine with meals, was probably quite safe… unless one has a drinking problem, I hasten to add. I should have made clearer in my response that I was talking about fairly serious intake of alcohol, and not the occasional beer or glass of wine… and to be perfectly precise, I said kidney "damage," not "disease" – conceptually different, I think, but I’m not a doctor. The best, simplest, and most easily accessible authoritative reference for most people might well be Dr. Mogens Schou’s little book, "Lithium Treatment of Manic-Depressive Illness: A Practical Guide" (4th Edition, 1989, Karger Press, ISBN 3-8055-4841-9). (Mogens Schou, for those of you who don’t know, is the Danish medical doctor who essentially pioneered lithium therapy for bipolar disorder.) Pertinent points with respect to alcohol, lithium, and the kidneys include (and I’m paraphrasing here): — As many lithium patients know, one very common side-effect    of lithium therapy is polyuria–the production of large    quantities of diluted urine, because lithium can impair    the abilities of the kidneys to concentrate waste products.    As long as water intake remains adequate, this side effect,    while logistically troublesome, is usually quite manageable.    (In other words, we need to drink lots of fluids, because    we pee a lot.) — Unused lithium is excreted almost exclusively through the    kidneys.  It is very important that the body be in    balance with respect to water and sodium ion (Na+) levels    (balance = intake matching excretion) in order to flush    unabsorbed lithium out of the system, to prevent toxic    levels from building up.  If the body gets out of balance,    then either dehydration or edema will result. — Lithium is a potent drug.  The difference between an effective    dose and a toxicity-producing dose is often narrow, although    recently updated prescribing guidelines seem to indicate    that lower serum blood levels than previously thought provide    effective control for most people. — Lithium toxicity attacks the brain and the kidneys, primarily.    The preferred treatment for acute lithium toxicity is    hemodialysis. — Activities which can sharply change lithium levels and produce    toxic responses include, but are not limited to:      - physical illness with fever (discontinue lithium therapy         until the fever has broken)      - Dehydration through vomiting, diarrhea, or through other         means      - Treatment with diuretics      - Switching to a low-sodium or radical weight-loss diet      - Drinking large quantities of alcohol-containing beverages — Even modest dehydration or salt deficiencies can lead to    less-efficient excretion of lithium from the body.  Lithium    poisoning, with its attendant ill effects on brain and kidney    tissue, can easily result. — If you drink enough to get sick from it, you’ve got a double    whammy… dehydration through both ethanol and vomiting.   I guess the message here is that if you’re going to drink more than a very modest amount of alcohol, then for God’s sake know the risks and chase it with plenty of water.  LOTS of water. — Barry Campbell             | "Any content-based regulation of the http://www.cris.com/~Btc/  |  purpose, could burn the global village                               to roast the pig." — Judge Dalzell

Response:

Is it OK to drink whilst taking lithium? What about marijuana? What effect does marijuana have on bi-polars?

Response:

>Is it OK to drink whilst taking lithium?

No.  Lithium + ethanol = kidney damage. A *very modest* intake, such as a glass of wine or beer with dinner, may not cause bad problems for you.  Talk it over with your docs. >What about marijuana? >What effect does marijuana have on bi-polars?

Depends entirely on the person, and on the mood stabilizers and other meds that you’re on.  Interactions between marijuana and most medications are not well-studied, but the "underground" scuttlebutt is that marijuana is a safer intoxicant for people with bipolar disorder who take lithium than alcohol, certainly. — Barry Campbell             | "Any content-based regulation of the http://www.cris.com/~Btc/  |  purpose, could burn the global village                               to roast the pig." — Judge Dalzell

Response:

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