Lithium and rage/ irritability

Hi Everyone

I was just wondering if anyone has experienced this. I have over the last few days been increasing more irritable than usual and at some points in an absolute rage I can feel it build up in side me very quickly from no where and it is the most terrible feeling ever but at the time enjoyable to a certain extent in a strange way if that makes sense. I am now currently taking 400mg lithium on a morning and 600mg at night due to levels being low could lithium be causing this.

Also at present I am unable stay within an environment where there is a lot of talking or stimulation and especially raised voices or shouting it drives me wild.

Hi,

Sounds as if you've been suffering quite a bit and I really feel for you. I haven't been on Lithium as yet so can't comment personally on irritability/rage as a side-effect. However, a quick search online doesn't seem to be showing it as a known one. What you describe with the rage bubbling up seemingly from nowhere reminds me of my highs or mixed episodes, as I get that symptom all the time when unstable. It's highly unpleasant for me and others around me.

If you're still struggling with it and your mood isn't right, I'd check in with your pdoc and let them know how you're feeling. It may be that the Lithium needs more time to work or to be increased, but there are also faster acting and more potent meds which could potentially be added to bring down the high and irritability (usually an antipsychotic for me). Hope this helps and that someone with experience of Lithium will chime in x

Hi Claire,

I'm not sure if you're asking whether there is a link between lithium and irritability. There isn't as far as I know.

Rather, and from my experience only, irritability and restlessness lasting longer than a couple of days is a sign that my mood is going upwards and I should take evasive manoeuvres.

If you've experienced these symptoms for more than a couple of days and it's out-of-character for you then I would start monitoring your sleeping pattern closely and contact a psych nurse. It is easy to let these things slide (I did) and before long you're higher than you realised...which means a crash is on its way.

Get some advice. Get it nipped in the bud if necessary, and quickly.

Hi Clairekyty I've personally found Lithium to be very calming, rather than something which evokes rage or anger in and of itself. If you don't mind me asking, what is it that you are feeling anger or rage about? I'm asking because it might be a real situation which you need to deal with, and which you need this emotion to mobilise you into action.

Actually, lithium does cause irritability. It does for me, depending on dosage and on other medications I'm taking... plus my diet.


It appears lithium can cause spikes in norepinephrine. While for some people this can be good, for others it can cause irritability.

I always noticed lithium instant release, if taken 900mg or 600mg at once, would give me literally a RAGE. I'm talking ab out head butting walls kind of rage (never done it, I can control it hehe).
When I switched to extended release formulation, the rage became more like irritability. Even more unpleasant. But this only lasted from 40 minutes to 2 hours after I took the pill(s), and it was brief, somewhat. However, sometimes it lasted a long time, if I mixed with the wrong stuff.

I noticed the norepinephrine relation when I read a study about 600mg of lithium being more "activating" than the lower and higher dosages, due to a presumed spike in norpepinephrine. The study didn't explain why, though, so I disregarded it at the time. But then I noticed any drugs that cause norepinephrine increase, while I was taking lithium, made this very specific irritability from the lithium worse. Way worse. Any tricyclic or tricycilic related drug causes me to go on a very-very-very irritable day. Not mania or anything, just feel wired, angry, in a I'll-choke-you-if-you-talk-to-me-I-swear-to-God kind of mood. Very nasty. Caffeine also makes me very irritable on lithium. amongst other things.

Also, my girlfriend has an issue with norepineprhine (very sensitive to any drug that increases it), plus she takes Vyvanse. On 300mg lithium she was so wired she couldn't sleep for days. But on 75mg she was very calm.

I take 900mg+ (450 Extended release) and feel good on it, I find the ER version more calming for not having the "rage spike". However, when I need an instant "antimanic" (actually, i dont know if I have mania, I have bad anxiety that might be hypomania in some form), I take 150mg instant release.

But answering your question, yes, lithium does cause irritability and anger, specially in the middle range of blood levels/dosage. Aka: get it at a 0.3 or 0.9 blood level, 0.6 is more activating on norepinephrine.



My advice? Either take lowerish doses (ths

Clairekyty,

Rather, and from my experience only, irritability and restlessness lasting longer than a couple of days is a sign that my mood is going upwards and I should take evasive manoeuvres.

I agree that even while taking lithium it could mean you might be getting manic.

quietgirl2538 wrote:Clairekyty,

Rather, and from my experience only, irritability and restlessness lasting longer than a couple of days is a sign that my mood is going upwards and I should take evasive manoeuvres.

I agree that even while taking lithium it could mean you might be getting manic.

True. However, lithium does cause irritability on it's own. Not on everyone, but the potential is there.

This side effect has been ameliorated since I started taking Trileptal.

Hi claire! I know a lot of people say that Lithium isn't linked to an increase in rage/irritability, but I think it can cause some, but not by it's self.

I guess my first question for you is:

A. Do you have any trauma or sexual assault in your background?
B. Do you have any unresolved issues of an emotional nature?

I know a lot of people like to take medicine to treat their problems, but I found that a lot of my problems in angst and irritability increased once I started taking lithium, but only because I wasn't going to therapy/counseling (also, I couldn't take Lithium by it's self; I find it irritating because I feel like I can't express myself at all; I call it being emotionally constipated, but on it for too long and I get angry). I am a rape survivor, a survivor of molestation and I have had my fair share of scary encounters where I was almost taken away by dangerous men. I am diagnosed bipolar mixed with ADD, but my new counselor thinks I might have some leftover remnants of PTSD in my background, simply from all my bad encounters with men/boys. None the less, it might not just be the medicine that's causing all the angst, but it could be opening the door to something you have long been ignoring.

Just my 2 cents... otherwise, I have no clue.

I have never tried lithium but Abilify maintena and Lamictal really helped me with rage/irritability issues. They also wiped out an alcoholic type drinking pattern. I only wish that I had these drug 20 years earlier.