Lithium is not mentioned throughout and that is because I have never taken it. I know it is a common drug in the treatment of bipolar with a certain (unwarranted from what I have researched) stigma, but it was never prescribed to me, so I am not in a position to talk about it in detail. However, I was interested to know why it had never been prescribed to me and this is pretty much the statement my Psychiatrist made below.
‘’Lithium is still the golden standard of care for bipolar disorder that is if we are talking about the most classical presentation: bipolar type one with clear euphoric mania and no comorbidity with alcohol or anxiety. In cases of rapid cycling with comorbid substance abuse and dysphoric mania the trend is to consider anti-epileptics or atypical antipsychotics.
About your case: you did a huge part of the treatment yourself by stopping drinking!
If depression is the burden of disease then the choice goes to Lambipol or Seroquel or Lithium.
Lithium might be well tolerated but it is a treatment which needs close monitoring. It can be very toxic and might cause renal damage in a subgroup of patients when taking it for years.’’
You will see my many horrific side effects in the book and I don’t think I can face starting another medication regime… although lithium is always at the back of my mind as a possible golden bullet…