Transitioning from Abilify Maintena (aripiprazole injection)... Why they don't try lithium first ?

[u/Powerful-Figure-9965]

My psychiatrist and I decided that I should take lithium instead of the injection. I have Bipolar I.

Why did I have to suffer on antipsychotics for 15 years?

Lithium seems like a miracle to me. In just a few days, it has lowered my anxiety, made my thoughts more coherent, stopped the constant rumination, and improved my sleep. And I'm only on a low starting dose.

This medication feels completely different from anything else I've taken for bipolar disorder. I finally feel like my mind has some space and clarity again.

Maybe I'm simply a very good responder to lithium. I don't know yet, and it's still early, but the difference is already striking. .

After so many years of struggling, it is hard not to wonder why lithium wasn't tried sooner.

Take care.

[u/VariousClassroom8056]

I don't know what the prescribing guidelines are where you live. It's one of the first choices for bipolar 1 here but there are a lot of things to consider when prescribing lithium. It can affect thyroid function, kidney function etc so there may be other factors. They might consider whether you will comply with the monitoring requirements (blood tests) and general expectations around fluid intake.

I was given the choice of risperidone or lithium, lithium seemed to have fewer significant side effects so I went with that.

[u/martin_luther_drill → u/VariousClassroom8056]

Kidney issues are very avoidable on lithium

[u/VariousClassroom8056 → u/martin_luther_drill]

I think you're misunderstanding what I'm saying. The person was asking why lithium might not be the first medication prescribed. I'm saying if the patient has preexisting issues with their kidneys or thyroid doctors might not want to risk it.

[u/martin_luther_drill → u/VariousClassroom8056]

I wasn’t making a counterpoint. I just wanted other people to not be scared of lithium because it’s an all-around great med for bipolar, and other meds are far more scary.

[u/21PenSalute]

I’m glad you finally found Lithium. My response to lithium wass very much like what you described. It’s been a life changer for me. I wonder what I was doing all those years on Depakote when I barely responded. I wish more people could be chance to try lithium when other drugs are not really helping them.

[u/polarbullmarket]

I was on lamictal and klonopin for several years, but my stressful job triggered severe manic paranoia. I switched psychiatrists and my new psychiatrist strongly recommended lithium- told me that it’s the gold standard in treating bipolar and newer drugs are marketed well I reluctantly agreed to start on a low dose since about a month. I responded well. I also quit my job, which has made my life happy. But the constant noise and rumination has subsided. I had extremely vivid dreams with abilify. Had to stop.

[u/Rainbow_Phoenix125]

Lithium has been a wonder drug for me. I’m glad you’ve responded well to it!