Side affects of Haldol and Lithium

[Klenn]

I am the only care taker for my sister who is Bio-Polar and has been on Lithium and Haldol for 42 years.  She is 60 years of age - back in the 70's she underwent approximately 120 electric shock threatments because this was apparently deemed right at that time.   She suffers almost all of the side affects from the above medications and I would like to know what is the safest way for her to transcend to a newer medication with less side affects.  She is under the care of the University Health System here in San Antonio and they are really good at pushing patients out the door with little or no genuine care.  She was born with cerebral palsy and also crippled at birth.  She has diabitis incepitis, scolesis of the spine with one leg being 3/4 shorter than the other.  
Any advice on changing medication and what to expect so that she doesn't end up in another psychiatric ward.

[lindahand]

If you want to talk to a doctor (psychiatrist) go to the doctor forum which is the other side of the lists, and go down to mood disorder. There you can post a question and a doctor will answer. There are limits to how many questions he will answer so it may take a few days to get a spot, but unlike many of the other doctors he doesn't charge anything.

Switching to a new antipsychotic drug could prove difficult because all of the atypical antipsychotics, the newer drugs, have risks of diabetes complications and since she already has it - could make it worse.

Lithium is usually very effective for bipolar disorder but you have to be getting the appropriate blood tests as going toxic can cause damage to the kidneys. Lamotrigine has fewer side effects and is generally a good drug for bipolar depression. It isn't as good as lithium in controlling the manias and hypomanias. It also doesn't reduce the suicide risk at the same level as Lithium. There is also depakote but I don't know much about it except it is a mood stabilizer, can cause weight gain and it can make your hair fall out. It doesn't seem to be used as much as Lithium or Lamotrigine.

I hope you can get a more complete answer from the psychiatrist. This may help a bit though. It is good you are being an advocate for her. She is lucky to have you in her life.

[Anneinside]

Is she doing poorly on these meds? Do you have a reason you want to change the medications? If the answers are no, then leave them alone. If not, then you need to get with a pdoc who is willing to change her. Be aware that if she is currently stable you won't be doing her any favors by putting her on the search for a new stabilizing drug.

[Klenn]

Thank you - are you a physician?  I am not at all familiar with this site and not too good at navigating -
The trouble is finding someone who truly cares in this health system that she is in.  

[ILADVOCATE]

   Lithium is a first line mood stabilizer and many people find it quite helpful but each person responds differently to each medication. If a person is given the blood tests for lithium level and other concerns on a regular basis as is required then they should be safe taking it long term if they haven't experienced any concerns. Haldol is a typical (older antipsychotic that is from Thorazine to Haldol) and has twice the potential of causing short term and long term movement disorders than the atypical antipsychotics (from Risperdal to Abilify, Fanapt and Saphris) but has less of a potential to create diabetes. Some people, especially people with a condition that has psychosis as part of it require an antipsychotic but you could discuss that concern with her psychiatrist. The full information on any medication can be found on the medication website and the PDR (Physician's Desk Reference) that you could discuss with a psychiatrist as well.
   If you are concerned about her treatment you could seek a second opinion. It would depend on how the medications are helping her as contrasted to any side effects she is experiencing or the potential of long term side effects and that is best discussed with a psychiatrist. This is some information on mood stabilizers and mood disorders that you could discuss with her psychiatrist:
http://www.medhelp.org/tags/health_page/34/Mental-Health/Useful-Bipolar--Depression-Webisites?hp_id=523