I am willing to confess to being addicted to caffeine, I gave it up for lent five years ago and got hellish withdrawal, sweats, nausea and tremor – lovely. I am much more sensible about it now. Still can’t bring myself to completely ditch it or alcohol but I am not a big drinker

I found relief started for me within 2 weeks. It wasn’t perfect, and we’re now on dose adjustment 2, but after years of swimming through murk, anything clear was awesome.

Either I’ve gained weight, or there’s a shit load of bloating I can’t drink off. I have found my desire for caffeine has limited. I try to avoid diet drinks since aspartame and it’s friends worry me. (not a HUGE sample, but it worries me all the same http://www.mcmanweb.com/article-110.htm) and I hate the taste.

I really wish they would have insisted on lithium out of the gate 2 years ago instead of trying new fangled anticonvulsants. I gain weight regardless, so no point trying to avoid it. Breathe after eating a poptart near me, and I’ll gain a pound.

Sometimes it’s just better to say “none” instead of listing the host of “possibles”. Caffeine is a diuretic, albeit not as bad as the anti-caffeine lobby would have us believe. Taken in a liquid — sports drink, coffee — it’s not too bad. But, personally, I think the point of trying to get better is to avoid the stuff which has the potential to make us feel like shit.

I actually drink a lot of Diet Pepsi, which is loaded with caffeine. It’s something I’ve tried to stop doing, but when I do stop I start feeling like shit… so I’ve completely given up tea, coffee and a few other things.

Definitely stay away from the Red Bull-type of drinks… especially if you’re downing it in Litre form.

Alcohol is something I didn’t mention in this piece, but I should have. Alcohol is definitely diuretic and should never be taken with Lithium… or anti-depressants.

With the starting dose of any medication the idea should be to start low and work higher in a gentle manner, but when someone is presenting with full-blown manic depression I’d think the Lithium would be given higher and worked lower.

The effects of any medication used to treat manic depression takes months for the effects to become clear to the person taking the pills… they start to have an effect right away, hence all the nasty side effects, but the person taking them will start to notice the behavioural changes later on in most cases.

It takes just five days for lithium to hit its max concentration given a steady dose -even starting from zero, patients are known to use that to their advantage being non-compliant then the five days before a blood test starting taking it again.

As for it taking months to see an effect. Us what take it aren’t looking for an effect are we – we are waiting on nothing happening so we it can start working after a couple of weeks but take months before we can conclusively say.

Both of those are minor argumentative points. This isn’t. I disagree on the little to no caffeine thing – provided you aren’t pissing about with the caffeine levels you are fine. If you keep the levels roughly similar then the lithium is affected by a systematic error (affected the same way each time) so you can compensate. If you are going days without then have a triple shot latte for breakfast and chug two litres of pepsi then sure.

Final piece of advice – start low and work up – it is chronic treatment, those two weeks you skipped to get to the higher dose quicker will bite you in the ass