We rely on patients to tell us how their meds are working, but sometimes patient report is a poor guide.

Today, we step into that difficult terrain with maintenance mood stabilizers, rapid cycling, and sleep meds.

Welcome to the Carlythe Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlott Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

We are launching a new series on PsychoFarm Secrets. Unlike our usual series, these episodes won't be back to back. We'll release them as the secrets come, and we invite you to share your own secrets with us. Write to C. Aiken, A-I-K-E-N, at the Carlatte Report.com. We hope to bring you uncommon tips that you won't find elsewhere,

and today's episode focuses on stuff that you won't even learn by asking your patients.

Psychopharmacology would be easy if you could just try a bunch of meds and ask patients which

one they liked best.

But if that was all there was to it, we'd be out of a job.

Patients are very good at telling us what feels better after a few hours or a few days.

It's the long-term effects they are less clear on.

And that brings us to our first secret.

Patients may not tell you that lithium has helped when it has.

Lithium does have acute effects, benefits in mania and depression, but most of its benefits build up over the long term. Patients function better, they have fewer hospitalizations, less violent, suicide, and legal

problems when they take lithium long term, as well as fewer episodes of mania and depression

and bipolar.

Compared to other mood stabilizers, people live longer on lithium.

And not just because of its anti-suicide effects, they have lower rates of Compared to other mood stabilizers, people live longer on lithium.

And not just because of its anti-suicide effects.

They have lower rates of cancer, neurologic, cardiac, and viral illnesses.

This is true for lithium in both bipolar and unipolar.

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