Li-zyme lithium and other alternative approaches

Q: I read in a recent BP book by George Lynn that some nutritionist use "li-zyme", a natural lithium product to help some of their clients with bipolar disorder. My son is on 5mg of Zyprexa and 2 grams Omega3s (not enough Omega I know, but I am afraid that too many pills will make him non-comliant) and a Vit. B complex, but can't go on lithium or depokote because he refuses blood draws. He has had a phobia since he was a child, and is not willing to try any fear reduction methods as of yet. I was thinking about adding li-zyme, and I was hoping you might have had some experience and thoughts with this product. I know that the amounts of lithium in the product are tiny. Any other suggestion would be great. Also I just recently added 500mg of L-Tyrosine. Any comments on amino acids and li-zyme or li-zyme forte would be much appreciated.

Dear Jayne --
You're making a valiant effort to work around the blood-draw problem.  Let's think about your alternatives.

We all got pretty excited about Omega-3 fatty acids but so far there is only one small study to support their use and several significant reports of inducing hypomania with this agent.  I haven't had any luck with it at all in my difficult patients.  I wouldn't rely much upon it, at least not yet. 

What's on the list of medications with known mood stabilizing properties?  Zyprexa is one.  Most doc's like to get a blood test before Depakote but many don't test again after that, especially if doses are low, which one must routinely consider to avoid weight gain (especially if used with Zyprexa!). 

Lithium in unknown doses presents a risk -- period.  Some people can develop a high blood level on a relatively low dose, and unless you know exactly how much is being given, you won't really know what risk you're facing.

Carbamazepine definitely requires a lot of blood testing, so it's out.  But it's new close cousin, in use in Europe for more than 10 years and just introduced here, called Trileptal (oxcarbazepine) does not require blood testing (it does cause blood sodium to decrease in about 2-3 per 100 people, looks like -- but people will get a flu-like sick feeling then; although figuring out that this is the problem also requires a blood test!). 

That brings us to the edge of what's known, at least for use in kids. 

From there, it's educated guessing.  Not much "education" to guess by when it comes to B and tyrosine -- so if you're already worried about "too many pills" I'd encourage you, at the risk of sounding like an old fuddy-duddy, to lean even farther in the direction of known effective medications, even if it takes a blood draw or two (or I guess you could get somebody to treat that phobia with standard exposure treatment, which is highly effective, to open up some new options -- try your local behavioral therapist!). 

Good luck with it all.

Dr. Phelps

Published January, 2001