chemotherapy effects on lithium level

[gin1965]

My 62 yr old mother has had her second chemo treatment for stage iv colon cancer.  She suffers from bipolar disorder as well as rheumatoid arthritis.  She has taken lithium for 30 years, plus prozac with great results and no problems with mood swings.  We began noticing mania symptoms about 3 days after beginning first treatment ( Folfuri 46 hours on take home infusion pump).  That was almost 3 wks ago.  Had her 2nd tx 4 days ago.  I mentioned mania to her oncologist who said steroids were probably to blame but due to RA she has had lots of steroids over last 9 yrs with no problems. And it's my understanding that she gets 20mg pred before tx and that's all, she takes 10mg daily anyway.  After the last tx she skipped next day prednisone dose.  I am trying to get her to have her lithium levels checked but she thinks she is fine (part of the disease), she is not sleeping well and not resting, physically pushing herself which makes swelling and pain from RA worse (had to stop Enbrel, Arava and Methotrexate to begin chemo). Still using patch and morphine tabs for pain, ambien for sleep and there are more meds.  She acts exactly the same as she did when several years ago she tried to stop the meds for bipolar but realized she couldn't.  She is not having vomiting or diarrhea, could chemo effect lithium absorbtion.  Cancer has spread outside colon wall and to liver, breast and lymph node.  On the positive side her cea level is down from 34 to 10.7.  But is the chemo causing the mild mania?

ThankYou

[molyba]

I just noticed the date of which you posted your situation.  My guess is that your has now passed or the chemo has calmed her down a lot and the doctors don't give her much time.  My father just past June 27, 2008 of Colon Cancer.  When he was diagnosed he was already at stage 4.  I researched it on WebMD.com and found that even with Chemotherapy, a patient with stage 4  only has a 1yr to 1 1/2yr to live.  My father's cancer spread to his liver and stomach, and that was after a year of chemotherapy.  It started out in his colon and a little on his liver.  I was there the last 3 weeks of his life.   He ended up starving to death because the cancer caused a blockage in his intestines and nothing could get through.  All we could do was make him comfortable.  I'm so sorry about your mother.  I only hope she does or did not suffer too much.                Sincerely,   Molyba

[Pills404]

I wish I could help you but I think you need to seek a couple of good doctors.
Good luck to you and your mother.