Switch from lithium to Bach Flower?

Q: I am a counsellor wondering if a psychological counsellor has worked with a patient wanting to come off the meds (lithium) and using BACH FLOWER Formula "Rescue REmedy" to help her with the transition. Thanks, Diana

Dear Diana --
You may have seen me "go off" about "evidence" elsewhere on this site, e.g. in other replies.  So I'll forego that rant, save to say that lithium has great evidence for effectiveness and to my knowledge no herb does (omega-3 fatty acids such as in fish oil comes close).

So the question is, why does your patient want to "come off the meds"?  If there are side effect problems, our current common solution is to lower the dose of lithium and use a low dose of another (evidence-based) mood stabilizer.  This is my routine response to such a situation and works out quite well often, although for folks with years of symptoms sometimes it takes several low-dose (i.e. no side effects) mood stabilizers.

Or perhaps she does not believe her diagnosis is correct?  She could be right.   Surety about the diagnosis is pretty crucial to wanting to stay on the medications. Help her get that straight first.

And finally, does she believe that without effective protection against subsequent episodes, she's at some sort of risk?  If not, then why shouldn't she want to "come off the medications"?  In this case she'd need to learn more about bipolar disorder generally (if she has bipolar II, one such basic source is www.psycheducation.org).

Can you send me some information about this Bach Flower stuff?  (psycheducation@yahoo.com)  Thanks.

Dr. Phelps

Published February, 2001