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Re: Should I increase my lithium?

Posted by Geezer on March 27, 2002, at 14:36:02

In reply to Re: Should I increase my lithium? Geezer, posted by Ritch on March 27, 2002, at 13:57:27

> > > > Hello,
> > > >
> > > > I am currently taking 60mg of prozac (which doestn't seem to be doing anything) and 600mg of lithium which doestn't seem to be doing anything either, although I am no longer agitated I feel flat, tired, depressed, sick and morose. I was wondering if maybe increasing the lithium would help, I'm not sure what to do, whether to increase it or ditch it. I've been taking the lithium for about 3 weeks now.
> > > >
> > > > I was wondering if anyone out there had had little response on a small amount of lithium only to up the dose and then find it suddenly worked.
> > > >
> > > >
> > > > Alternatively should I up the Prozac.
> > > >
> > > > Note, I am aware that you have to be careful with lithium and have blood levels checked so won't be doing anything stupid.
> > > >
> > > > Denise
> > >
> > > NO!! It doesnt work that way. With lithium, you must have blood drawn and get a "lithium level" to see where the levels are. With lithium, the range must be in a very exact spot for it to have a theraputic effect. Too little lithium and you will probably feel like you describe...depressed as dirt, flat, etc. But too high lithium levels and it becomes toxic and can harm you physically. The only way is to have blood drawn, sent to a lab and have your psychiatrist determine whether you need to go to 900 mg or even higher.
> > >
> > > Old School
> >
> > Old School is CORRECT as usual.
> > I am currently at 900mg. Lithium with a Lith. blood level of .55 this blood level is sub-theraputic. I THINK the theraputic range would be .7 to 1.0. I will be increasing Lith. dose to 1200mg. tomorrow (have delayed this a few days to get Lithobid perscription instead of regular Lith. Carbonate prescription from pdoc). I am also taking 1000mg. Depakote - hope to discontinue that gradually if Lith. does the job. May add Lamictal.
> >
> > Geezer
> Hi,
> I thought you were going to play around with Zonegran, what happened? :-) From what I have read over the years about lithium levels .5-1.5 mEQ is used for "short-term acute control" with .6-1.2 mEQ used for "maintenance". There have been some studies showing that maintenance blood levels all the way down to .3 mEQ are effective for some folks. Usually a min. of .45 is a target. FWIW, I found the "subtherapeutic" blood levels to be "therapeutic" for BPII symptoms.
> Mitch

Hi Mitch,

The Zonegran trial is gone for now. Its very involved but it came down to what had the best chance of doing the job. I have a "treating" pdoc and the "research" pdoc - they are finally talking to each other - now we try the Lithium trial, I have given up thinking about what might come next......if anything. The research pdoc mentioned .6-1.2 mEQ level, can't offer any opinion on the other readings. I can proclaim with certainty that .55 mEQ has done nothing for my Bipolar II Depression. With my history I tend to get "Maxed Out" on all drug trials - to be expected I suppose with so few options left. I have told the pdocs I will try Parnate if the depression doesn't break.....would love to add some Dex. but that's out due to previous abuse.





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