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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2241
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Mental Health

I am taking 900 mg of lithium plus 4 mg of ativan and 2.5 mg

of abilify. I... Show More
of abilify. I am having memory problems, but the worst is I take the lithium 3 times per day. The first dose is goood, I take all of them with a 1 mg ativan. The second dose after about an hour I start to feel tired and want to lay down. I finally take the third dose and it makes me very agitated resless and I cry alot in the evenings..Do you think it is the abilify? do you have any suggestions?
Submitted: 5 years ago.
Category: Mental Health
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replied 5 years ago.

Hello Madam,

What is the reason behind taking Lithium with 1 mg of Ativan?

Are you also feeling depressed with symptoms such as low mood, crying spells, low energy, lack of motivation etc?


Customer reply replied 5 years ago.
I don't seem to have that in the mornings but I do by mid afternoon and it is getting worse. I did have high anxiety and still do from time to time I guess that is why he left me on the ativan. I am very sensitive to meds and maybe going off of it would be to much. Not sure? I have tried to skip an ativan to see how I would do and I become very irritable.
Dr. Vikas, Psychiatrist replied 5 years ago.
Thanks for your reply.

You are on very low dose of Abilify and I don't think your symptoms are because of Abilify.

Memory impairment is a reported side effect of Lithium therapy and so is dysphoric mood, irritability etc.

Both Lithium and Ativan are very sedating in nature therefore if taken together can cause lethargy, sleepiness, poor concentration, tiredness etc.

But in a patient who is on Lithium therapy, symptoms such as dysphoric mood, crying spells, impaired memory, tiredness may also be because of a current depressive episode or hypothyroidism and both of them should be ruled out by your doctor.

Therefore a logical first step in your case would be to ask your doctor to rule out a current depressive episode and hypothyroidism.

The Lithium dosing could be changed from thrice a day to twice a day if possible and this should help in reducing the tiredness and feeling of lethargy. In my personal view, the dose of Ativan should also be reduced and it can be gradually taper down.

In case, if you are not able to tolerate the anxiety symptoms you can discuss with your doctor about adding Pristiq (Desvenlafaxine) to the current treatment regime.

Assuming that your current symptoms could be because of a depressive episode along with comorbid anxiety, Pristiq can be very useful in controlling anxiety symptoms as well as the other depressive symptoms and you will be able to taper down Ativan which is a habit forming drug and can lead to dependence.

Best wishes,


Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated

Customer reply replied 5 years ago.
I can't take any antidepressants. All of the ones I have tried have made me very depressed. We did blood work about a month ago and everything was fine so I don't think it is the hypothroidism. I only have the crying spells after taking the third dose of lithium. I get very tired after the second dose. I don't go back to see my dr until late next week would I be okay to cut off the 12:30 dose of lithium until then? I agree I need to taper off the ativan but I don't know how that will happen.
Dr. Vikas, Psychiatrist replied 5 years ago.

Antidepressants treat depression, they can't make anyone depressed!

If hypothyroidism has been ruled out, I still think that adding an antidepressant could be very useful in your case in controlling the anxiety symptoms. This will also help in tapering down Ativan because once your anxiety symptoms are under control you won't be needing it any more.

There are several antidepressants available in the market and you should give them a try.

I don't think, cutting the dose of Lithium would be a good idea because you are already on a comparatively low dose of Lithium.

You can also take the help of relaxation technique to control your anxiety symptoms in the mean while.

Relaxation techniques

Best wishes,


Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated
Customer reply replied 5 years ago.
Well I have went throught this for 3 years and I know antidepressants can make you depressed and suicidal. All you have to do is watch tv to know that. I have also had several dr agree so I don't appreciate your comment. You have no idea what I have been through. I am also not pleased with the time to answer my question. Best regards.
Dr. Vikas, Psychiatrist replied 5 years ago.
Thanks for your honest feedback and I do appreciate it a lot.

Also, I would like to say that you are partially correct here because antidepressants can make a person suicidal but does not aggravate depression further. A popular theory regarding how antidepressant make a person suicidal is that a severely depressed person lack energy and motivation to do anything but once he or she start coming out of depression because of antidepressant, he may start thinking about ending his life.

Since I was not able to help you, I am opting out from this question, you need not to accept the answer. As soon as I opt out, it will become an open question.

Best wishes,


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