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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by colin wallace on June 12, 2003, at 15:32:34
Hi guys,
I've tentatively added a small dose of lithium-200mg- to my combo.(Lamictal/Prozac), and have been told that this dose is too small to be concerned about blood tests.
I'd like to try a few weeks at 300mg, and would like to know at which point blood tests become necessary or advisable.
I'm aware that fluoxetine can both increase or reduce lith. blood levels, but to what extent I'm not sure.
I'm aiming to keep the dose low enough to avoid blood tests for the time being(my psych's. moved on, and I can't get to see another for ages).
I've had a clean bill of health on the electrolyte tests etc., so do you reckon 300mg is low enough to be safe?Col.
Posted by Taylor123 on June 13, 2003, at 9:27:08
In reply to Lithium Novice, posted by colin wallace on June 12, 2003, at 15:32:34
> HI!
I'VE JUST QUIT MY LITHIUM AGAINST MY DOCTOR'S ADVICE, SO I WON'T GIVE YOU MY OPINION ON LITHIUM AND HOW IT MAKES YOU FEEL, BUT I'LL GIVE YOU THE FACTS:
dOSE IS DEPENDANT ON WHAT YOU ARE TREATING. IF YOU ARE USING IT FOR MANIA TREATMENT OR HYPOMANIA, YOU'LL NEED A DOSE GREATER THAN 1000MG PROBABLY.
MY GUESS IS THAT YOU'RE USING IT AS AUGMENTATION WITH YOUR ANTIDEPRESSANT. IN WHICH CASE YOU WILL ONLY NEED A SMALL DOSE; FOR EXAMPLE 400MG.BUT: THE WHOLE THING WITH LITHIUM IS IT IS DEPENDANT ON YOUR BLOOD LEVELS, NOT HOW MANY MG YOU TAKE.
THE THERAPUTIC RANGE IS 0.5-1.2 mmol/L
the 200mg u are taking now, will give a blood well below that range, so effectivly it won't be doing much anyway.there is no absolute in regards to when to get blood tests done. some people will have a high blood lithium level after taking 400mg, and others will have less than 0.5 (and hence be out of theraputic range.)
I reckon that you should get your blood tests done, untill you establish a consistent blood level of around 0.5-0.6 mmol/L (probably taking about 400mg.)
Lithium is a toxic drug, and you shouldn't really take it without seeing how your body metabolises it.
I HOPE THIS HELPS YOU OUT A BIT...
HAVE TO RUN, GOT A MILIION THINGS TO DO...
HAPPY VIBES TO YOU; HOPE ALL IS WELL
TAY
P.S - YOU SHOULD ALSO GET TFTs (THYROID TESTS) DONE.
Posted by Ritch on June 13, 2003, at 10:43:52
In reply to Lithium Novice, posted by colin wallace on June 12, 2003, at 15:32:34
> Hi guys,
>
> I've tentatively added a small dose of lithium-200mg- to my combo.(Lamictal/Prozac), and have been told that this dose is too small to be concerned about blood tests.
> I'd like to try a few weeks at 300mg, and would like to know at which point blood tests become necessary or advisable.
> I'm aware that fluoxetine can both increase or reduce lith. blood levels, but to what extent I'm not sure.
> I'm aiming to keep the dose low enough to avoid blood tests for the time being(my psych's. moved on, and I can't get to see another for ages).
> I've had a clean bill of health on the electrolyte tests etc., so do you reckon 300mg is low enough to be safe?
>
> Col.
Colin, I went for two or three years at a time between blood tests when I was on 300-450mg/day. However, when I was on 600mg-1500mg, I was more frequently tested (every 3-6 months).
Posted by colin wallace on June 14, 2003, at 10:14:39
In reply to Re: Lithium Novice » colin wallace, posted by Ritch on June 13, 2003, at 10:43:52
Thanks for the tips guys.
As it happens,I managed four days at 200mg, and yesterday I felt the results.
A definite return of the anxiety I'd brought under control a year ago, and a very unpleasant dazed and fuzzy headed feeling, as though I'd been malleted on the head.
This happened to me just as quickly on lith. monotherapy a while back, although I was hoping things would be different on Lamictal/Prozac.
Still seeking that magic final ingredient....Col.
Posted by Ritch on June 14, 2003, at 15:02:16
In reply to Re: Lithium Novice--Tay,Ritch, posted by colin wallace on June 14, 2003, at 10:14:39
> Thanks for the tips guys.
>
> As it happens,I managed four days at 200mg, and yesterday I felt the results.
> A definite return of the anxiety I'd brought under control a year ago, and a very unpleasant dazed and fuzzy headed feeling, as though I'd been malleted on the head.
> This happened to me just as quickly on lith. monotherapy a while back, although I was hoping things would be different on Lamictal/Prozac.
> Still seeking that magic final ingredient....
>
> Col.Hey, that's too bad about the lithium. I definitely have found it very tough to tolerate. It does cause that "dazed" or "zoned" feeling that can be pretty icky. Interestingly, it does seem to also cause a buzzy activating feeling as well. You might consider popping in just a smidge of Neurontin with your Lamictal/Prozac, and see what happens. It won't torque with your Lamictal blood levels and I've always found it great for anxiety.
Posted by Ron Hill on June 15, 2003, at 2:21:34
In reply to Re: Lithium Novice--Tay,Ritch, posted by colin wallace on June 14, 2003, at 10:14:39
Hey Colin Buddy,
> A definite return of the anxiety I'd brought under control a year ago, and a very unpleasant dazed and fuzzy headed feeling, as though I'd been malleted on the head.
"Malleted on the head"??? Ummm, must be British terminology.
> Still seeking that magic final ingredient....
Colin, I thought the Lamictal/Prozac combination was working for you. What symptoms are causing you problems? Talk to me friend.
-- Ron
Posted by colin wallace on June 15, 2003, at 3:23:34
In reply to Re: Lithium Novice » colin wallace, posted by Ron Hill on June 15, 2003, at 2:21:34
Ron ol' chum,
> "Malleted on the head"??? Ummm, must be British terminology.
>Yeah, you know..mallet...as in those big wooden hammers you use to knock tent pegs into the ground...?
> > Still seeking that magic final ingredient....
>
> Colin, I thought the Lamictal/Prozac combination was working for you. What symptoms are causing you problems? Talk to me friend.
>
> -- RonWell, I do have my symptoms pretty much 'held in check'-as in I'm not depressed or anxious right now.But I still have bad days,and (longstanding)problems with muscle-stiffness, poor coordination,attention difficulties,and- now to a much lesser extent- fatigue.
The Lamictal is prone to fading as I've mentioned, and Prozac alone won't cut it, as/when/if the Lam. does finally poop-out.
I need to keep the ball rolling,and instinct tells me that *something* is missing.
It may be a very small amount of another mood stabilizer, possible a noradrenergic med., a dopamine enhancer- hence my dabbling with NADH.
We'll see.
Will keep ya posted!Col.
Posted by fluffy on June 15, 2003, at 17:50:24
In reply to Re: Lithium Novice » Ron Hill, posted by colin wallace on June 15, 2003, at 3:23:34
Hi Collin-
I've been yammering away on the other thread about Lamictal--hoping you'd join. I've wanted to know what your experience has been with it so far. I'm on Lamictal *only* right now, and I have the same concerns as you--wanting to keep the ball rolling. I feel myself slipping, (unless I increase my dose). I've been able to retain an anti-depressant effect so far on Lamictal only, but I still feel myself cycling. I've also wondered about adding an SSRI or Lithium--but scared about being unstable again.
Lately, I also feel like I've been "malleted"--walloped over the head--esp. in the afternoon through early evening. VERY sedated. It's been 3 weeks since my last Lamictal increase, (I'm at 200mg now) and I wonder if this sleepyness is at all related to timing/amount of dose.
Did your sleepyness coincide with your starting Lithium? Or did you feel it before?
I hope your side effects fade and it ends up working for you. I'd like to know what happens with you and your combo, as it sounds we have a similar predicament.
Katy
Posted by fluffy on June 15, 2003, at 17:59:15
In reply to Re: Lithium Novice, posted by fluffy on June 15, 2003, at 17:50:24
Either thread is fine. Maybe our conversation should go under the 'Lamictal' thread??
Posted by JackD on June 30, 2003, at 1:19:41
In reply to Lithium Novice, posted by colin wallace on June 12, 2003, at 15:32:34
THat's quite a low dose. *Assuming* you're healthy you shouldn't really have to worry TOO much. I was taking 1800mg of Lithium at which point my level was about .80 . Anyway, I've drank at that level a few times and I must've gotten dehydrated and reached a near toxic level; let me tell you, your body will let you know! I can't begin to describe it. It's not like suddenly at 300mg you'll get brain hemmorhaging or something, if you feel strange or have headaches stop taking it or get a test.
Things to keep in mind: Kidney function, Thyroid function, (de)hydration.
This is the end of the thread.
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