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Hi Gordon: I approach this topic from being a mental health worker

and an acupuncturist. One thing about bi-polar illness: a classic

feature is that folks want to discontinue their medications. We can

think what we want re: " the poisons of western medication " (my term)

but they do have their place. I would ask several questions:

Do you have a good history on your patient's previous treatment

history? Are they in mental health treatment? Have you spoken to

their therapist or the prescriber to coordinate care? (you must have a

release). Have they tried in the past to d/c lithium? If so, what

was their experience and the outcome? Why do they want to d/c now?

(Often folks with bi-polar illness seek and rather enjoy the " edge "

that hypo mania brings them).

I have seen on too many occassions where an acupuncturist will

encourage a patient to discontinue their medication (not in our scope

of practice--in Washington anyway); the patient seems fine for awhile

and then the acupuncturist doesn't see them again. The end of the

story often can be a manic or depressive episode that leads the

patient to a hospitalization because thier bi-polar illness has become

unstable due to the discontinuation of their medications. AND, the

acupuncturist has no idea of this occurence; the mental health system

and the patient are left trying to restabelize the individual, which

again, often requires a medications such as lithium (there are other

alternatives). Bottem line, both you and your patient should be

talking to the prescriber. That's my 2 cents.

Cordially, Rachel Diaz

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