Question about changing from Trileptal to Lithium

I have a relative who was diagnosed with some form of bipolar after being hospitalized. He was given Depakote in the hospital to stabilize him, but he had some strong adverse effects. After release his psychiatrist recommended Lithium but my relative rejected it (I think because of some emotional response to the drug). He accepted a prescription of Trileptal. This drug seemed to work for a while but eventually he was having anxiety and focus issues with his treatment. He went to his doctor who prescribed Lithium again - and it was accepted with reluctance. My relative made the switch from Trileptal to Lithium in the past day or so, but he seems to have regressed in his mood, and is in a dark place again. I'm trying to find out if the transition from Trileptal to Lithium might normally cause this, and what we might expect from his behavior. I don't want to see him go into the hospital again since it was such a bad experience (for everybody), but I don't have any experience with what to expect or how to deal with it. Any insights that others might have would be appreciated.

Sometimes switching to a different medication can cause withdrawal effects until the new medication's levels can even out and the body adjusts. I have found that the first month or two are the most difficult when switching medications. I think that the most helpful thing that others can do for me when I'm struggling is to just be there and to be a good friend. Offer me support, and try to take me out for a coffee or something, help me with cleaning my house or cooking dinner, listen to me share some of my thoughts/feelings without judgement etc.

Cheze2 wrote:Sometimes switching to a different medication can cause withdrawal effects until the new medication's levels can even out and the body adjusts. I have found that the first month or two are the most difficult when switching medications. I think that the most helpful thing that others can do for me when I'm struggling is to just be there and to be a good friend. Offer me support, and try to take me out for a coffee or something, help me with cleaning my house or cooking dinner, listen to me share some of my thoughts/feelings without judgement etc.

Thanks very much. Should we expect the dramatic reversal in mood to get better in a short time and then gradually improve after that? When he started on Trileptal I could notice some noticeable improvements in a couple days. I'm hoping the same will be true with the switch to Lithium, but I'm not sure.

Every person is different in how they respond to medications. Some people may respond within a few days, and others may take a few weeks. That is of course, if the medication works for them. it's difficult because medication is a trial and error type thing and there is no concrete answers to how it will work unfortunately.

I changed from lithium to trileptal, so my experience is a bit different, but I can tell you that, even apart from any possible discontinuation effects, quitting a medication will lead to a return of symptoms. That's what it sounds like your relative is experiencing. It's going to take a while for lithium to kick in properly, and that's after the target dose is reached; it could take a month or more to get there. What they're experiencing is likely not some specific chemical reaction between the remnants of trileptal and the new presence of lithium, but a return of symptoms and a waiting period before lithium starts really working.

I'm definitely not an expert, but in my case , and from what I've read to be majorly attributed to the drug, is that lithium prevents mania... It can be used to fight depression, but I don't think that's it's primary use. When I went to the dark place I wasn't upped in dosage of lithium but rather an antidepressant was added.