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Re: Starting Lithium--should I ask for ER version? JohnX2

Posted by Ritch on May 14, 2002, at 9:16:42

In reply to Re: Starting Lithium--should I ask for ER version? lizbeth, posted by JohnX2 on May 13, 2002, at 22:49:53

> > Hi,
> >
> > I'm on Depakote Sprinkle 625 mg. and Prozac 30 mg. My pdoc suggested trying Lithium 300 mg. to start and moving up to 600 mg. if it really works (lowering the Dep. to 500 mg. and lower if I stay on it).
> >
> > From past posts, it sounds like I should push for an Extended Release version. I asked him about it and he said he's seen no huge difference, but I think he was thinking in terms of efficacy and not side effects. I've got a script for the regular Lithium. Should I call and ask for ER? Will it make that much of a difference. Part of me just wants to try the regular Lithium tonight to give it a try (I'll have to wait until tomorrow to try ER).
> >
> > Thanks,
> > Elizabeth
> Hi Elizabeth,
> Today I popped my 1st lithobid (extended release lithium).
> My pdoc seemed to indicate that the extended release may have
> "smoother" action and less overbearing side effects as the
> medicine does not spike up in your body.
> I haven't heard much anecdotal information from other patients
> who have tried the ER vs regular version.
> Some people recommended "Eskalith", but I don't recall off the top
> of my head what is different from that and lithobid? (There were
> some long threads on this for me..)
> Good Luck,
> John

Hi John (and Elizabeth),

There is Eskalith CR (coated release), and it is a scored 450mg tab only (unless they have changed things since I last took it in 1992). Lithobid (from what I remember) just came in 300mg doses and it was a light beigy-pink satin-finished shellaqued tablet and CIBA-GEIGY pharmaceuticals was making it. It is supposed to release more gradually, but I think just for the first hour or so to avoid the blood-level rush you mentioned. It also is supposed to have some sodium in the tabs to help the lithium not be as "competitive" (ionwise). That was the stuff I was on the longest (1980-1988 I think). I liked it the best. They started me on "Lithane" which were nasty green tablets that often would start dissolving before you swallowed them and I sometimes ended up spitting one out and hurling down a different one. They stopped making the Lithobid for some time in the early 90's, and I couldn't get it. Evidently they must have started making it again. The last lithium I was on (in the mid-late 90's) were the pink Eskalith 300mg IR capsules. Price-wise, any of it was never very expensive, similar to generic tricyclic antidepressants $2-3 can get you a full bottle!




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