Expert: Libby Bonner - 10/11/2006

Question
Hi,

I have had a significant psychotic crisis that lead me to hospitalization where psychiatrists diagnosed me as Bipolar 1. Since then I take 800 mg of Lithium daily. In a Natural Living department of an organic store, I checked the computer for Bipolar and they would recommend Fish Oils. Would it be an alternative to my meds? Could I take it on top of my meds? I fear the side effects of Lithium on my kidneys and my general health and would feel more comfortable with an herbal, natural remedy. What are your advices? Many thanks. Julie

Answer
Very sorry to hear of your illness, but sounds as though it was treated appropriately and that you are doing well.

To answer you fully, I would need to know your age how long you have been on lithium, and how often your lithium levels are being checked.  [Blood tests]  If you know your lithium blood level at last test, pls include that.

All of the serious and persistent mental illnesses should be treated by psychiatrists prescribing mainstream prescription meds.  IF you have been on Li for a few weeks or months and are doing well, and if it was the first and only med tried, you are very fortunate.  Some patients have so much trouble finding the right med/s and the right dose/s.  [And, at some future point, you might find the doctor needing to tinker a little w/ what meds you take, in order to keep you stable.]

There are other treatments, for some patients and some diagnoses, that are appropriate add-ons to prescription meds.  Cognitive therapy is helpful to some.  Many bipolar docs are [or, were?] very interested in supplementing regular pharmaceuticals w/ over-the-counter meds.  My daughter's doc tried Omega-3 fish oil w/ her for awhile, but they decided she was getting no added benefit from it.  [I'm not sure if this has turned out to be the case for most patients, and it is no longer being tried w/ new bipolars, or not.  Sorry.] I think he also had her on some natural estrogen for awhile, along w/ her regular meds.

Here are my thoughts for you.  You MUST be on lithium or some similar med.  [In many parts of the US, new patients are started on either lithium or Lamictal....used to be that lithium was the only med tried, alone, first.]  You must be on a mood stabilizer...so I suggest you take your Qs to your doctor.  Ask about kidney and thyroid problems; ask how often they will do blood tests to make sure all is well.  

IF using health food products as an addition to other meds is very attractive to you, see if your doc/s can refer you to another psychiatrist who has a strong interest in these, as my daughter's doc has.  Then you will have the best of both worlds: lithium or some other pharmaceutical will give you a good strong defense against bipolar episodes, and you may receive some added benefit and a greater sense of well-being if some other agents, w/ proven benefit [and little risk of harm] are tried when they are appropriate.

IF you go off the lithium, regardless of what you may be taking from the organic store, you have another full-blown bipolar episode immediately ahead of you, complete w/ hospitalization....   AND the possibiliity - depending on who your doc is, where you live - of being discharged, for awhile, perhaps to residential care until they can count on you taking your meds.  Sorry, but that's the truth about what if you go off lithium.....

I do wish you good luck.  If you wish to give me more info, there might be more that I could add, but my basic notion about medication will not be different.