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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by deak on March 30, 2003, at 20:06:36
2 weeks on Lithium dose now 750mg) and still no response. I'm taking this with an AD. Should I stop it?
Posted by Janelle on March 30, 2003, at 20:17:22
In reply to Should I give up on Lithium?, posted by deak on March 30, 2003, at 20:06:36
Oh have I got things to share with you about Lithium! I've been on it for almost a year I'd say, and the key to Lithium is DOSE, DOSE, DOSE (did I say DOSE? lol!) -- you've been on it *long* enough for a blood draw to see what the level is. Lithium has a very NARROW level of toxicity, meaning there's only a few points so to speak between the minimum therapeutic dose and the maximum.
So, my initial recommendation to you is to get a Lithium blood level done - you may very well need a higher dose.
In fact, most people I know who are on Lithium and have blood levels within the therapeutic range and are feeling benefits from this med start at 900 mg/day and titrate up into the thousands!
I tried that and could not tolerate 900, both side effects-wise and my blood level was above the max. It was toxic. EEEEEEK. I was lowered to 600 mg where I stayed a long time and basically at that level, the Lithium (and I was also on an a-d plus other meds) apparently did nothing.
HOWEVER, when I got a new pdoc he eventually switched me from regular Lithium Carbonate to one of the slow release forms, and again, I could only tolerate half the starting dose! During this time I also switched a-d's because the one I was on was inducing frequent and intense mood swings that the Lithium dose was too low for.
Enter Depakote, also at a very low level. I was leery, let me tell you. I did not want to be on two meds that have to be monitored with blood tests, one for kidneys, one for liver, but I am at LOW doses, and am not even in the minimal therapeutic ranges. HOWEVER, my pdoc told me and I read on the Net that low doses of Lithium and Depakote can prove effective.
So far, so good (and I knock on wood) -- no mood swings since the intro of Depakote and I've been doing okay. Not great, but not terrible.
I've probably told you more than you ever wanted to know, but the bottom line is GET A LITHIUM BLOOD LEVEL done and take it from there before you give up on Lithium. Hang in there, and do not give up on it yet!
Good luck 2 U.
Posted by deak on March 30, 2003, at 21:29:39
In reply to Re: Should I give up on Lithium?NOT YET! ?deak, posted by Janelle on March 30, 2003, at 20:17:22
> Oh have I got things to share with you about Lithium! I've been on it for almost a year I'd say, and the key to Lithium is DOSE, DOSE, DOSE (did I say DOSE? lol!) -- you've been on it *long* enough for a blood draw to see what the level is. Lithium has a very NARROW level of toxicity, meaning there's only a few points so to speak between the minimum therapeutic dose and the maximum.
>
> So, my initial recommendation to you is to get a Lithium blood level done - you may very well need a higher dose.
>
> In fact, most people I know who are on Lithium and have blood levels within the therapeutic range and are feeling benefits from this med start at 900 mg/day and titrate up into the thousands!
>
> I tried that and could not tolerate 900, both side effects-wise and my blood level was above the max. It was toxic. EEEEEEK. I was lowered to 600 mg where I stayed a long time and basically at that level, the Lithium (and I was also on an a-d plus other meds) apparently did nothing.
>
> HOWEVER, when I got a new pdoc he eventually switched me from regular Lithium Carbonate to one of the slow release forms, and again, I could only tolerate half the starting dose! During this time I also switched a-d's because the one I was on was inducing frequent and intense mood swings that the Lithium dose was too low for.
>
> Enter Depakote, also at a very low level. I was leery, let me tell you. I did not want to be on two meds that have to be monitored with blood tests, one for kidneys, one for liver, but I am at LOW doses, and am not even in the minimal therapeutic ranges. HOWEVER, my pdoc told me and I read on the Net that low doses of Lithium and Depakote can prove effective.
>
> So far, so good (and I knock on wood) -- no mood swings since the intro of Depakote and I've been doing okay. Not great, but not terrible.
>
> I've probably told you more than you ever wanted to know, but the bottom line is GET A LITHIUM BLOOD LEVEL done and take it from there before you give up on Lithium. Hang in there, and do not give up on it yet!
>
> Good luck 2 U.thanku for reply. i have recieved 2 blood tests. my experience is close to another poster. i scored .2 and then at a higher dose for 5 days i scored the same!!! what explains that? can't understand?
do u have to get .5 b4 result comes. But i use antidepresant too with it.
Thankyo, happy day.
Posted by Janelle on March 31, 2003, at 18:12:50
In reply to Re: Should I give up on Lithium?NOT YET! » Janelle, posted by deak on March 30, 2003, at 21:29:39
Gee, I have no explanation for why you scored .2 lithium blood level at two different doses, except that maybe you should have waited a few days longer after you raised the dose? How about having another one done - by now surely the Lithium has reached a steady state in your blood and whatever score you get (even if it's only .2) that is IT.
In my humble opinion, and based on what I've heard from pdocs, etc. yes, .5 is the lowest level for any benefits to be felt, and if I'm not mistaken, .5 is still BELOW the minimal therapeutic level for Lithium. I'm at .5, but I take low dose of Lithium in combo with low dose of Depakote (interestingly, I placed into the low end of the range for Depakote, but the range is MUCH WIDER for that one than for Lithium).
Good luck.
This is the end of the thread.
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