Flashback to London 2012 – just before the Olympics

I was interviewed about some of our research work… This was on the top floor of a building overlooking the Thames. With the start of the Olympic Games just days away, every few minutes another helicopter would go over, hence a lot of editing.

Anyway, I felt it worth saying about this interview again now while I am getting some help tidying my place – skip to 4m 16s to hear what I was saying about surroundings.

Then at 10m 40s I share my views on medication. These have not changed, “the same drug everyday is not likely to be ideal”, “people need choice” (for those in USA paracetamol = acetaminophen).

The video takes a few moments to load…

Ups and Downs – Video – Alice Hicks and Roger Smith #bipolar

Lithium #BipolarDisorder #KidneyFailure #madinamerica

Long-term Use of Lithium Can Cause Kidney Failure

Lithium damaging the kidneys is not new news. I just feel I need to share this link because the article is up to date and gives this important fact in plain English.


If you are taking lithium carbonate please check that your doctor understands it is not ideal to stay on the same dose year-after-year. Be sure to have a plan to be on a lower dose. Lower doses are much safer for your kidneys, heart and other organs than the standard doses.

Next: Ask your doctor how they believe the lithium may be benefiting you and if it is being used to counteract some mineral imbalance. See what your doctor knows about mineral imbalances then search the internet to find out a lot more about digesting good levels of all the minerals that are closely related to lithium, such as sodium, potassium, calcium and magnesium.

One further thought: You need plenty of stomach acid to be able to absorb calcium from food or supplements, so if your doctor is giving you lithium then it will be worth you knowing more about stomach acid.



Spending on Mental Health Research in the UK / McPin Foundatioin

I just read, “For every £1.00 that the Government spend on cancer research, the general public invest £2.75; for heart and circulatory problems it is £1.35. For mental health research, the figure is 0.003p”. Lord Bradley

With so little money available I am  lucky to be employed by a mental health research organisation at  http://mcpin.org/ and even luckier to be involved in some research projects NOT funded by drug manufacturers.

Lithium and Age: Talk to your doctor. He/she needs to know.

Older people cannot tolerate as much lithium. This is a fact that some doctors and psychiatrists seem to have forgotten. Lithium is killing people.

Lithium continues to be prescribed as sedative and many people continue to take lithium for decades. This is bad because lithium gradually damages every part of our bodies and the more we consume the more damage is done.

If you are taking lithium then you need a plan for taking less as you get older. Even if you feel you benefit from taking lithium you need to be aware that it does cause damage and there is no such thing as a safe level.

Recently I accompanied a friend to see a doctor who went on at length about how my friend’s kidneys were fine and how he was thinking about reducing the lithium dose anyway. After a bit more questioning, it became clear that my friend, who is over 60, should have had his lithium dose reduced much sooner in the light of deteriorating kidney function.

We left with an agreement that his dose could be reduced from 800 to 600mg/day, something which I had agreed, for me, with my doctor when I was just 42. There is a mistaken belief that high doses of lithium are more effective than low doses. The research does not bear this out. It takes very little lithium to have a sedating effect.

Having established that less lithium was needed and my friend would most likely live longer with a less toxic level in his blood, the psychiatrist initially said my friend would feel ‘no difference at all’. It seems he had not thought through the logic of this. For 10 years my friend had been on a high level of lithium with blood tests showing that damage was being done all because the high dose was supposed to make him feel better in some way. Now he was being told that in taking less he would feel no different!

The reality is that an instant 25% reduction will cause feelings and energy levels to change. If you imagine 800mg/day as being like having a foot pushed down on a car brake pedal then 600mg/day is going to be like easing off that pressure and so with the accelerator still in the same place (the accelerator being having a busy life and simply just the energy from eating) then the car is going to speed up somewhat. The psychiatrist’s response was, “If you are going to look for problems then you will have problems.” Was he now agreeing my friend’s troubles were not of a physical/genetic origin and his energy levels were more to do with life events and lifestyle?

This psychiatrist, most likely, has no personal experience of what it feels like to be coming off a sedative drug after a decade or more of taking it every day. If you have not been through this kind of withdrawal, maybe think about someone smoking 40 cigarettes a day and then being told, “From now on you can only have 30 cigarettes a day”. It would be amazing if there were no changes in mood at all, and if there were no changes at all then why was that person feeling the need for those extra 10 toxic cigarettes?

The psychiatrist suggested waiting until my friend had used all his existing tablets before making any reduction.

What I recommended was changing from 800 to 700mg/day by cutting one 400mg tablet in half and then a half into quarters. Then 1¾ tablets = 700mg. This is a 12.5% reduction. Slightly more than the 10% recommended by most experts in this field but at least not the drastic 25% from going straight from 800 to 600. The next step 700 to 600 can now be when the new prescription comes through, giving about two weeks to adjust after the first small step and going down to 600 no later than the psychiatrist suggested.

WARNING: Before moving on to why my friend so urgently needs less lithium, I need to stress that coming off lithium altogether after taking it for years is a dangerous process. Lithium is like having brakes on and stopping it suddenly will cause a huge change in speed/mood for anyone regardless of any troubles they had before first taking it.

How lithium came back into fashion

Lithium carbonate is a naturally occurring mineral that was used for all sorts of illnesses until it was proved to be too toxic. Lithium is toxic to all parts of the body. The toxic effects have been proved to be cumulative, that is, the dose level times the number of doses determines the risk of damage.

There was a period when lithium was not used at all and the stocks of lithium in pharmacies around the world just stayed where they were. It was considered too dangerous to use. Then it was proposed as a way of slowing people down, which of course almost any toxin would do. Perhaps not surprisingly there were deaths from toxicity very early on (ref 1+2). It was however accepted that some people had too much energy for their own good and the risks were worth it. Certainly relatives found it easier than living with people who did not sleep or could not stop talking.

Why less lithium is needed as we age

The research into this has focused on deterioration of kidney function which theoretically will happen quicker in anyone taking lithium supplements. A lot of research has been carried out and it has all found the same thing. Yes, those people on lithium are losing kidney function, while damaged kidneys become less able to remove all toxins and that includes lithium.

As we get older our kidneys increasingly struggle to eliminate lithium and blood concentrations become more toxic.

In this example, greater attention to annual monitoring could have allowed this man’s lithium dosage to be reduced a year earlier as his lithium in blood result went above 0.8mmol/l and his kidney function as estimated by GFR dropped below 70.

My opinion

A diet/lifestyle that causes someone to seem ‘manic’, and have to see doctors about not sleeping, etc, requires help other than lithium tablets.

Most people will experience a lot of sedation from just 400mg/day lithium and I know people who are very satisfied taking just 100mg/day. This is said to be below the ‘therapeutic limit’, but they find it therapeutic, while avoiding the risks of complete withdrawal.

If you are supporting someone prescribed lithium, please help them with thinking about how and when they will be able to reduce the dosage. Even if they like the idea of taking lithium a sensible target could be to be on half the dose within a decade.

Summing up

Talking about lithium tends to cause controversy as so many people believe lithium helps. In some ways it does, but overall I am sure the world would be a better place if ‘lithium therapy’ could once again be banned.

Those who read this blog regularly will know there is plenty of evidence that people who have extremes of mood need more help other than tablets, especially help with getting their diet right, to cope with stress. Effective help/support is far better than labelling and drugging.

For those on psychiatric drugs regular reviews and help with reduce drug dependence are essential to avoid lives being shortened by drug effects.

Roger Smith – www.rethinkingbipolar.com – article updated 15th August 2014


  1. Robert Whitaker, 2011, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Broadway Books

Page 183, “…in 1949, the FDA banned it [lithium] after it was found to cause cardiovascular problems.”, “John Cade fed it [lithium] to guinea pigs and found it made them docile.”,

  1. Dr Joanna Moncrieff, 2009, The Myth of the Chemical Cure: A Critique of Psychiatric Drug Treatment

Page 181 “However after looking at Cade’s [1949] clinical notes on this experiment, Johnson suggests that the results were more ambiguous. Toxic effects and ‘side-effects’ were more frequent and severe than the impression conveyed in the published paper. The notes record that one patient  died, two others had to discontinue lithium because of severe toxicity and one patient refused to take it, none of which was reported in the published article.”


Year A few research papers I feel are relevant
1977 Age as a factor affecting lithium therapy

D S HewickP NewburyS HopwoodG Naylor, and J Moody

Br J Clin Pharmacol. Apr 1977; 4(2): 201–205.


1993 Kidney damage in long-term lithium patients: A cross-sectional study of patients with 15 years or more on lithium

Bendz, M. Aurell, J. Balldin, A. A. Mathé, I. Sjödin

Author Affiliations

1Department of Psychiatry, University of Lund Lund

2Nephrology, University of Göteborg Göteborg

3Psychiatry and Neurochemistry, University of Göteborg Göteborg

4Department of Psychiatry, Karolinska Institute Stockholm

5Department of Psychiatry, University of Linköping Linköping, Sweden

Correspondence and offprint requests to:Dr M. Aurell, Njurkliniken Göteborg liniversitet, Sahlgrenska Sjukhuset, 41345 Goteborg, Sweden


2000 Differential pharmacokinetics of lithium in elderly patients

Drugs Aging. 2000 Mar;16(3):165-77.

Sproule BA1Hardy BGShulman KI.

2003 Risk factors for the development of lithium-induced polyuria

Br. J. Psychiatry (2003) 182 (4): 319-323

2008 Lithium-induced Nephrogenic Diabetes Insipidus: Renal Effects of Amiloride

Jennifer J. Bedford, Susan Weggery, Gaye Ellis, Fiona J. McDonald, Peter R. Joyce, John P. LeaderRobert J. Walker

Author Affiliations

Departments of *Medical and Surgical Sciences and Physiology, University of Otago, Dunedin, New Zealand; and Department of Psychological Medicine, University of Otago, Christchurch, New Zealand


Robert J. Walker, Department of Medical & Surgical Sciences, University of Otago, PO Box 913, Dunedin, New Zealand. Phone: (643) 474 0999, 8045; Fax: (643) 474 7641; E-mail: rob.walker@stonebow.otago.ac.nz


2008 Monitoring of glomerular filtration rate in lithium-treated outpatients–an ambulatory laboratory database surveillance

Nephrol Dial Transplant (2008) 23 (2): 562-565


2012 The Effects of Lithium on Renal Function in Older Adults–A Systematic Review

J Geriatr Psychiatry Neurol (2012) 25 (1): 51-61



Boer Walther, Goldschmeding Roel, Rookmaaker Maarten1

http://ndt.oxfordjournals.org/content/27/suppl_2/ii66.abstract  (scroll down to find article SUO018)

2013 Management of the renal adverse effects of lithium

Adv. Psychiatr. Treat. (2013) 19 (6): 457-466


2014 Increased risk of solid renal tumors in lithium-treated patients – Clinical Investigation

Kidney International (2014) 86, 184–190; doi:10.1038/ki.2014.2; published online 22 January 2014

Mohamad Zaidan1,2,3, Fabien Stucker4, Bénédicte Stengel5,6, Viorel Vasiliu7, Aurélie Hummel1,2, Paul Landais, Jean-Jacques Boffa4,9, Pierre Ronco4,9, Jean-Pierre Grünfeld1,2 and Aude Servais1,2

1Department of Nephrology-Transplantation, Necker Hospital, APHP, Paris Descartes University, Paris, France

2Paris Descartes University, Sorbonne Paris Cité, Paris, France

3INSERM U845, Centre de Recherche “Croissance et Signalisation”, Paris, France

4Department of Nephrology, Tenon Hospital, APHP, Paris, France

5INSERM U1018, Centre for Epidemiology and Population Health, Villejuif, France

6UMRS 1018, Univ Paris-Sud, Villejuif, France

7Department of Pathology, Necker Hospital, APHP, Paris Descartes University, Paris, France

8Department of Biostatistics, Necker Hospital, Paris, France

9UPMC Univ Paris 6, Paris, France

Correspondence: Aude Servais, Department of Nephrology-Transplantation, Necker Hospital, APHP, Paris Descartes University, 149 rue de Sèvres, Paris 75015, France. E-mail:aude.servais@nck.aphp.fr

Received 1 September 2013; Revised 14 November 2013; Accepted 12 December 2013
Advance online publication 22 January 2014



Vitamins and Minerals Help Fight Off Diseases of The Mind and The Body

Vitamins and Minerals Help Fight Off Diseases of The Mind and The Body

All of the following has simply been pasted here from: Life Extension Magazine because I feel it is worthy of reproducing here and in the hope that more people will appreciate how much illness can be treated and often even cured through improved nutrition. This article was recommended by a reader of my blog who was diagnosed as bipolar and now says, “I am one of those who has rejected the bi-polar label and am totally off drugs for more than two years. I was on lithium and respirdal for just six months. It took me three months to get off the drugs (with the help of Truehope supplements). I am feeling 85% recovered.

I am not necessarily recommending any particular vitamins or minerals as a lot of research is needed to get the right supplements, whereas I have found that getting help with changing to a healthier diet to be the quickest lowest cost option for rapid improvements in health and well-being.

From: Life Extension Magazine

 Interview with Abram Hoffer, M.D., Ph.D.

Hoffer: We ran it for two years, and then we did a blind follow-up. We had a follow-up team that would call the patients in every three months to see how they were doing, and at the end of the two years, we wanted to see what had happened. We found that for the patients on placebo, there was a 35% recovery rate, which is what you would expect from acute schizophrenic patients. The other two groups had about an 80% recovery rate. These results were very encouraging, so we ran another study, and another. Eventually, I did about six double-blind, controlled experiments in Saskatchewan between 1953 and 1960, and they were all confirmatory.1-3 Also, by this time, I was developing a good deal of clinical experience because I was also treating other patients who didn’t fit into our study.

By 1960, a large number of American psychiatrists had joined us, and by 1970, I think we had a collective experience of over 100,000 schizophrenic patients treated. The results were really good. They weren’t perfect-we’ve never claimed that-but they were certainly an awfully lot better than what you get today by simply taking drugs.

LEF: Have you been able to apply this to bipolar patients or other types of psychiatric problems?

Hoffer: Yes, we have. This was, later on, called Orthomolecular Psychiatry by Linus Pauling [American chemist and researcher], who published his very important paper in Science in 1968.4 For a long time, I didn’t believe that depression would really respond, but I began to see a large number of people who were bipolar or depressed.

LEF: I understand as your research continued, you also made some discoveries by accident in regard to this approach to treating certain cancers.

Hoffer: It wasn’t our discovery. We just confirmed what Linus Pauling had reported. The first observation happened in 1960. A retired professor who was psychotic was admitted to our ward, and I discovered he had cancer of the lung. He was terribly psychotic, and he was declared to be terminal. At that time, we were examining the urine for a chemical factor that has since been discovered to be crypto pyrole. I was looking for psychotic people, and normal people [for a planned trial]. When he came in, and was psychotic and had cancer, we ran [several tests on] him, and we thought we had a huge quantity of this product in his urine. So, I wanted to start him on niacin because I wanted to treat his psychosis, and I didn’t think it would do anything to his cancer.

So, I started him on niacin-1 gram taken three times per day with vitamin C-on Friday. The following Monday, he was mentally normal. It wasn’t really schizophrenia he had. He was in a delirium, and he recovered very quickly. Then, I said to him, “I want you to stay on these two vitamins as long as you can,” not expecting it would do very much for [his cancer]. He was supposed to have died within a month or two, but he remained well for another 30 months. When he died, we couldn’t get an autopsy because he died at a different hospital. But as far as I can tell, the tumor was completely gone 12 months after he started on this approach. On an x-ray, they couldn’t see the tumor anymore. This was one observation.

I had another observation in 1986; a woman who had a terminal cancer of the head of the pancreas, and she, too, made a complete recovery, and lived for 20 years.

LEF: Were there other treatments used as well, or was this the primary treatment?

Hoffer: By this time, it was a fairly comprehensive treatment because we had concluded by then that one or two vitamins wouldn’t be adequate; that this was a major nutritional problem that required a more comprehensive approach. By this time, Linus Pauling had published his very important book on cancer and vitamin C5-13 [additional citations noted]. So, having read what he and [Ewan] Cameron had written, and in my own few observations, I decided that I would do the same. Because I was well known as an expert in the field of nutrition, cancer patients who were told by their doctors that there was nothing more they could do, would demand that they come and see me.

So, I began to see more and more patients. And after seeing five that first year-and some of them did remarkably well-it gradually began to increase. Eventually, I was seeing up to 150 cancer cases a year. It’s not a cure. Every one of my patients also had the usual treatment, which consisted of either surgery, chemotherapy, radiation or some combination. But when the vitamin program was grafted onto that, they certainly felt much better, and, according to my data, they also lived a lot longer.

LEF: Should these vitamins be taken in combination, or do they have their own unique value when they’re taken individually?

Hoffer: Each vitamin has its own unique value. It depends a lot on the patient; it depends on their condition, it depends how old they are.

LEF: Do you find that they need a multivitamin, so that they get all the basic nutrients to work together with the megadosages of the other vitamins that they’re using for treatment?

Hoffer: I think one should do that. One should use a good, comprehensive approach, using the essential vitamins and minerals. Not all, because a lot of the vitamins we get from our food. But the B vitamins are the most important, I think [as well as] vitamin E, vitamin C, and maybe some of the others depending on what condition you’re treating. For example, I’ve treated a few cases of Huntington’s disease. I think that’s a double dependency of vitamin E and niacin. And when I put the patients on 4000 [international] units of vitamin E and 3 grams a day of niacin, they were the ones whom I saw got well. And this is a disease from which there is apparently no treatment.

LEF: When you say “vitamin E,” it has a whole new meaning to us these days because there are a few different components we’ve discovered now besides alpha-tocopherol. Which kind were you using?

Hoffer: The alpha-tocopherol. Four grams a day. I worked up to it. I started out with 800 units, and gradually worked it up.

LEF: Can you explain the risks related to the toxicity that exists in our environment, and how vitamin regimens can help ward off that risk?

Hoffer: I think that we are overwhelmed today with a large number of chemicals, which are present in our air, soil, water and in our food. I found that since we can no longer live in a pure world, the best thing we can do is to improve the immune system of the body so that it can deal with these toxic compounds more adequately than it has been doing, and vitamins and minerals are very helpful with that.

LEF: What is your opinion in terms of conventional medicine? Where does it fall short? For instance, why don’t government RDAs work, in your opinion, when it comes to nutrition?

Continue reading at: Life Extension Magazine

Ups and Downs – Research Report Published #bipolar #bipolardisorder

‘Listen, empower us and take action now!’: reflexive-collaborative exploration of support needs in bipolar disorder when ‘going up’ and ‘going down’. Billsborough J, Mailey P, Hicks A, Sayers R, Smith R, Clewett N, Griffiths CA, Larsen J.

This is an article published in J Ment Health. 2014 Feb;23(1):9-14. doi: 10.3109/09638237.2013.815331.  US National Library of Medicine National Institutes of Health


This was a project I was involved with and that I will say more about soon. 

I was fortunate enough to present this work at Nottingham University in 2012, where I concluded with one thing I learned from the study. Influenced by a sister of someone with a bipolar diagnosis who I interviewed during the study this thing I learned was that a (maybe ‘the‘) key factor in recovery and long-lasting wellness is love or if not love then it is something very like love that a lot of us need.

I have to admit that perhaps only one of all the people we interviewed actually said ‘love’, it is just that with everyone interviewed telling us how much difference it made when they were ‘really’ listened to… it is seemed clear to me that something very like love from the people closest to us makes all the difference.

As I say, I will write more about this research later.


Lithium treatment damages more than just the thyroid ( #hyperparathyroidism )

Everyday I wake up thinking I will add to this blog. Almost every day I feel too anxious, weak, confused and a lot of other unpleasant stuff such that I write nothing. Day after day disappears and… well, my life is disappearing, while more and more people are being labelled as bipolar.

I am not a great advert for what happens when in recovery, but at least I am still here, which I am sure I would not be, had I taken all the drugs prescribed.

People who are new to bipolar are still being given lithium as a treatment without the potential consequences being explained.

It is a subject I have thought about for ages. I have had lots of blood tests… I hope one day to have more energy, get to the bottom of this and explain more about how much lithium treatment has affected me. Today, I have just enough energy to post the following which is from:


Note: Dr Pomeranz is not associated with this site… we just feel strongly that what he says needs to be seen, especially by doctors who come into contact with those being treated with lithium.

Hyperparathyroidism Resulting From Lithium Treatment Remains Underrecognized

By Jay M. Pomerantz, MD | March 26, 2010

Dr Pomerantz practices psychiatry in Longmeadow, Mass, and is assistant clinical professor of psychiatry at Harvard Medical School in Boston.

Until recently, I never paid much attention to the possibility that abnormalities of the parathyroid glands could be relevant to patients in my practice. But I decided to learn more about this issue when one of my patients with bipolar disorder who had been treated with lithium(Drug information on lithium) told me that she had been given a diagnosis of a parathyroid adenoma after her primary care physician noted hypercalcemia on routine testing. Since undergoing successful surgery to remove the adenoma, she is feeling much sharper mentally and more energetic.

Lithium continues to be the gold standard for the treatment of bipolar disorder. It is also helpful for related diagnoses, such as schizoaffective disorder and cyclic major depression. In addition to watching out for the well-known complications of lithium treatment—hypothyroidism and decreased renal function—health care providers should be aware of hyperparathyroidism.

Development of Hyperparathyroidism 
The parathyroid glands are 4 small structures located on the posterior surface of the thyroid gland, which monitor calcium levels in the blood and release parathyroid hormone (PTH).

PTH is a peptide that acts to increase the concentration of calcium in the blood by enhancing the release of calcium from bones. In addition, PTH acts on the kidneys to increase active reabsorption of calcium from distal tubules as well as to increase the excretion of phosphate, also leading to more free calcium in circulation. Finally, PTH raises calcium levels by increasing the production of activated vitamin D, which enhances absorption of calcium by the intestine.

Primary hyperparathyroidism usually results from an adenoma in a single gland, although other causes may be double adenoma or hyperplasia in multiple glands. Previous exposure to radiation in the facial or neck area and certain medications, including thiazide diuretics, may cause primary hyperparathyroidism. In some families, the disease may be inherited. Parathyroid cancer is an extremely rare cause of primary hyperparathyroidism.

Secondary hyperparathyroidism results from any medical condition that causes low calcium levels. This is most often due to kidney failure and the consequent rise in phosphate levels. Vitamin D deficiency is another possible cause.

The lithium connection. It turns out that lithium, a mainstay in the treatment of bipolar disorder, is associated with an increased incidence of hyperparathyroidism. Approximately 15% to 20% of patients receiving long-term lithium treatment show elevated calcium levels, although only a few of these patients also have significant elevations of PTH levels and clinical symptoms of hyperparathyroidism. Interestingly, lithium-associated clinical hyperparathyroidism is almost always caused by a single parathyroid adenoma rather than 4-gland hyperplasia.1

The first case of lithium-associated hyperparathyroidism (LAH) was reported in 1973,2 and many additional reports followed. It appears that longer duration of treatment is associated with an increased incidence of LAH.3Curiously, about 75% of patients receiving lithium in whom LAH develops are women, which is consistent with the overall higher prevalence of hyperparathyroidism in women and unlike the gender-neutral ratio typical of bipolar disorder and lithium use.4

Rather than considering the cessation of lithium treatment when LAH is discovered, which may or may not reverse the calcium and other abnormalities, the usual procedure is to surgically intervene and remove the offending parathyroid glands.

Effects of Hyperparathyroidism
When a parathyroid gland enlarges and produces too much PTH, the blood calcium level becomes high, bones may lose calcium, and kidneys may excrete too much calcium. These changes may give rise to symptoms and signs such as polyuria, thirst, fractures, and kidney stones.

Neuropsychiatric symptoms associated with primary hyperparathyroidism include anxiety as well as cognitive and psychotic presentations. However, the most common presentation is depression with associated apathy.5 In a prospective study of 34 patients with hyperparathyroidism, Velasco and colleagues6 found that approximately one-third of participants had no psychiatric symptoms, one-third had affective symptoms (with or without paranoia), and one-third had cognitive impairment. Affective symptoms were most common in patients with modest elevations in electrolyte levels, while cognitive deficits were more often related to higher calcium concentrations.

Hypercalcemia. The severity of psychiatric symptoms in patients with hyperparathyroidism often correlates with the increase in serum calcium levels. Calcium performs a crucial role in nerve conduction. Consequently, it is no surprise to find out that some common symptoms of parathyroid hyperactivity and high calcium levels are related to the nervous system.

Other symptoms have to do with the muscular system, which uses changes in intracellular calcium concentration to initiate and transmit the command to contract muscle fibers. Improper regulation of calcium levels may result in muscle cramps and weakness. The heart is a muscle, and therefore its conduction system is also vulnerable, with possible shortening of the QT interval, rhythm disturbances, and even cardiac death.

The skeletal system not only functions as the reservoir of calcium for the body, but calcium phosphate(Drug information on calcium phosphate) is an essential ingredient of bone tissue. Consequently, a hyperactive parathyroid system contributes to osteoporosis and vulnerability to bone fractures.

When hypercalcemia is present, it is important not only to screen for hyperparathyroidism but also to rule out other possible underlying conditions, such as malignancy and drug-induced elevations in calcium levels.

Case Note
Already, early in the process of screening for elevated calcium levels in my many patients who are receivinglithium(Drug information on lithium), I have identified a patient with hypercalcemia and a markedly elevated PTH level, which may indicate hyperparathyroidism. She is a 50-year-old woman with schizoaffective disorder who has been receiving long-standing lithium therapy and is undergoing further evaluation by an endocrinologist. All of us are hopeful that her recent cognitive decline and mental apathy will prove to be reversible.

– – – –

Schizophrenia Commission Report – Published on 14 November 2012

There is so much similarity between Schizophrenia and bipolar disorder that I feel publication of The Schizophrenia Commission Report yesterday may be an important factor in helping with the understanding of the true costs and need for change regarding bipolar disorder. Link to the report and executive summary…  Schizophrenia Commission

This is what Paul Jenkins, Rethink chief executive of Rethink Mental illness has written about this important report…

Imagine being diagnosed with an illness for which there is no cure. The best drugs available were developed in the 1960s and haven’t vastly improved since then. Your medication makes you rapidly gain weight and doubles your chances of getting heart disease. You have about a 10% chance of getting all the treatments NICE believes you should have access to. If you have to go into hospital, you may be unlucky enough to be treated in units where you don’t feel safe and where staff are burnt out and demoralized. On top of all this, you are shunned by society and treated with suspicion and fear by many.

If the illness we were talking about here was cancer or Alzheimer’s, there would be a national outcry. Because the illness is schizophrenia, there simply isn’t   People with schizophrenia and their families have quietly had to endure substandard care and treatment for too long. None of us should accept this.

It doesn’t have to be this way. For the last year, I have been part of The Schizophrenia Commission , an inquiry into the state of care for people with schizophrenia and what needs to change. Our report, ‘The abandoned illness’ published today, sets out what could be done to transform the lives of everyone affected.

The cost of schizophrenia to society is £11.8 billion a year and there is no doubt that would be significantly less if did more to support more people to recover.  What we currently spend on services is not always spent in the right place.  For instance, nearly 20% of the whole NHS mental health budget is spent on secure care, driven by an obsession with risk, when some of those resources could be better spent on improving community support.

While it may take years for better medication to be developed, the drugs we do have could be used more effectively if they were prescribed properly. If health professionals knew more about how mental illness puts your physical health at risk and carried out extra basic monitoring, such as blood pressure checks, they could cut the number of people with schizophrenia dying from preventable physical illness. There are services across the country showing the way on what can be done, but they need to become the norm in every part of the country.

Part of the problem is that it’s easy to think; this doesn’t affect me. Mental illness and schizophrenia in particular is something we often think happens to other people. To different people, not people like us. That’s how one of the members of my charity, Rethink Mental Illness , told me recently she had always felt about schizophrenia. With no history of mental illness in the family and a bright, popular son at university, she had no reason to think schizophrenia would ever play a part in her life or that the poor standards of care would ever impact on her family. That was until Christmas 1996, when her son woke up one morning, convinced she was dead. He was suffering from an acute psychotic episode and has needed support and care ever since.

Schizophrenia and psychosis can affect anyone, from any background at any age. Over 220,000 people in England have a diagnosis of schizophrenia and many more thousands care for someone who does. Schizophrenia is everybody’s business and we all have a duty to stand up and say – this isn’t good enough.

Link to the report and executive summary…  Schizophrenia Commission



Some benefits to having extremes of mood #bipolar #bipolarhope

Thoughts on work at  Lancaster’s (Bipolar) Spectrum Centre, UK

Bipolar ‘disorder’ has to be one of the most fascinating disorders ever described. It is difficult to think of any other disorder where such a high proportion of those diagnosed are so keen to keep the label. This perhaps is less surprising when we consider that to stop being seen as bipolar we may need to:

  • be a lot less energetic,
  • work less,
  • sleep more,
  • be less creative
  • and most likely put on extra weight

– none of these things especially appeal to me.

When active we can all tend to over-estimate just how productive and creative we can be. To understand the true picture some rigorous level-headed research is needed. Yesterday the spectrum centre shared news of such a study. Here is an extract:

“It is really important that we learn more about the positives of bipolar as focusing only on negative aspects paints a very biased picture that perpetuates the view of bipolar as a wholly negative experience. If we fail to explore the positives of bipolar we also fail to understand the ambivalence of some people towards treatment.”

It is just 730 words so well worth a read… http://www.sciencedaily.com/releases/2012/05/120503115927.htm

Ups and Downs – Rethink Survey

This post was about the survey I helped to design for ‘ Rethinking Mental Illness’ that was live all through January 2012. Our aim is to understand and report on the treatment and support people have when they are feeling ‘up/high’ and ‘down/low’. This is for people with personal experience of using mental health services, AND FOR PEOPLE IN SUPPORTING ROLES.

I will be putting some results from this survey here soon.

Schizophrenia Commission – survey

The Schizophrenia Commission are conducting  a comprehensive review of schizophrenia and want to know what it means to you today.

This survey is available at http://www.schizophreniacommission.org.uk or by simply clicking on http://www.surveymonkey.com/s/szcomm

If just ticking the boxes it takes 10 minutes. I found the questions fascinating and spent longer on it answering in the optional text boxes. I think you will find completing this survey well worthwhile – it certainly got me thinking.

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