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lithium levels Rate Topic: -----

#1 User is offline   Beetzart 

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Posted 21 November 2009 - 08:20 AM

I got my lithium levels a couple of weeks ago and the doc said they are too low; I take 600mg. The pdoc said this shouldn't be the case as 600mg should give a thearaputic level and he said I can't be taking my med properly!

I am taking it correctly; every night at around 10pm. I always assumed 600mg was quite low for lithium, is this the case?

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Dx: Depression and anxiety

Meds: Lithium Carbonate 600mg, Olanzapine 10mg, Citalopram 60mg, Buspar 30mg.

Previous meds: Lofepramine, Seroxat, Diazepam, Fluoxetine, Zispin, Largactil, Imipramine, Zoloft, Venlafaxine, Propanolol, Tamazepam, Xanax, Zopiclone, Zolpidem.

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#2 User is offline   sorrel 

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Posted 21 November 2009 - 08:57 AM

That is a strange statement from him -- first of all the relationship between levels and dose varies somewhat for each person, and furthermore 600mg IS a low dose. Most often people take 900-1200mg.
Dx: bipolar I
Rx: lithium 1800mg, propanolol 40mg (for tremors)



#3 User is offline   blackbird 

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Posted 21 November 2009 - 10:07 AM

600mg is low, I am only beginning to get therapeutic levels at a dose of 1000mg

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DX: Schizoaffective (bipolar type - ultra rapid cycling with major paranoid refractory psychosis), Borderline Personality Disorder, OCD, Anorexia Nervosa, Alcohol Dependence (in recovery 26/12/09)

RX: 50mg Risperdal Consta Injection x once per fortnight (equivalent to 6mg a day), 600mg Lithium, 60mgs Prozac, 5mgs Diazepam x 3 a day, 7.5mg Zopiclone

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#4 User is offline   witchywoman 

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Posted 21 November 2009 - 11:02 AM

I find that odd too. At 600mg my level was .6. He moved me up to 900mg because of some depression and now my level is .8. I've seen people here taking more lithium with the same level as me. It does vary person to person.
Dx:Bipolar 1 mixed type, OCD, anxiety

Rx:Seroquel XR 600mg, Trileptal 1200 mg, Lithium Carb ER 600 mg, Synthroid 75 mcg, Nexium 40 mg

#5 User is offline   steves 

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Posted 23 November 2009 - 05:47 PM

i take 900-1200. I am at 900 now haven't had a level in a while but last time it took to 1200 to get right.
rx. halperdol 15mgs /seroquel 200mg/ prozac/ ativan 3 times a day/ depekote 2000mg /cogintin

old rx's risperdal,seroquel,abilify,invega,zyprexa,lamictal,perfenzine, all the newer ssri's effexor/cymbalta damnit lets just say alot..i have a bad habit of switching meds..lithium 9000 geodon

oh and dx is bipolar.......

#6 User is offline   DarkendHour 

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Posted 24 November 2009 - 09:49 AM

my level is low at 1200mg a day.... started on 1350 a day.. but had to go back for insurance reasons... so I don't know what my level is at 1350 yet.

Different people need different amounts.. even the same person can need different amounts throughout their life.

Edit = hit the wrong number button lol

This post has been edited by DarkendHour: 24 November 2009 - 09:50 AM

Current: Schizoaffective Bipolar type, PTSD
Past history: SI, ED, Schizotypal PD, Major Depression
Meds: lithium 1200mg, Geodon 160mg 200mg 160mg, Saphris 10mg, Benztropine Mesylate (Cogentin) 2mg, Prazosin (Minipress) 2mg, Aplenzin (bupropion hydrobromide) 522mg

#7 User is offline   karuna 

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Posted 24 November 2009 - 10:24 AM

A therapeutic blood level is between 0.5 and 0.8. Above 0.8 and it's toxicity levels.

It's worth checking what mg you're prescribed, and what mg your tablets are. I take 800mgs but it's two 400mg tablets. Could you be taking too few tablets by mistake?

It's worth checking that you are eating enough, drinking enough and you're not under the weather with any infections etc that might be messing with your levels.

This post has been edited by karuna: 24 November 2009 - 10:25 AM

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#8 User is offline   Stacia 

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Posted 24 November 2009 - 11:26 AM

To my knowledge, toxicity starts over 1.2 serum level. My regular level is between .8 - 1.1, depending on dosing and the phase of the moon or whatever. My doc gets nervous and reduces my dose when it goes over 1.0, but I've yet to have any real toxicity symptoms.
Dx: Bipolar I, ADD
Rx: Carbatrol 400mg, Lamictal 250mg, Risperidone 1.5mg, Adderall XR 25mg, five freaking blood pressure meds and still not normal readings, Klonopin these days! and other stuff PRN.
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#9 User is offline   sorrel 

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Posted 24 November 2009 - 12:18 PM

In the US the official "therapeutic range" is 0.6 to 1.2.

I have had a level of 1.2 and was totally fine, FWIW.
Dx: bipolar I
Rx: lithium 1800mg, propanolol 40mg (for tremors)



#10 User is offline   crazynotstupid 

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Posted 24 November 2009 - 09:13 PM

And I've had symptoms of toxicity while at 900 mg and was very likely in the therapeutic range as none of my levels had ever shown me going near a toxic range. Just goes to show. The diabetes likely doesn't help though.

#1 I think your doc is a dip and #2 you might try splitting your dose if that is possible.
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#11 User is offline   leadinglady 

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Posted 01 December 2009 - 09:47 PM

I was told today by the psych nurse that normal lith levels are 0.5 to 1.5 and I'm at 0.9. I also have nystagmus. Am I toxic and they are ignoring it or what?
Psych Diagnoses: Bipolar 1 - mixed type, generalized anxiety disorder, borderline personality disorder with histrionic features, alcohol abuse - in remission.
Meds: Depakote 500 mg at bedtime, Zyprexa 5 mg at bedtime, Lexapro 20 mg a day, Wellbutrin XL 300 mg a day, Synthroid 88 mcg a day, Klonopin 0.5 mg three times a day, multivitamin 2 x a day, Calcium citrate and D 2000 mg a day, B12 shot monthly, protein 60 gm a day, and Mirena IUD. Feeling better, about to add in Topamax and quit Depakote.


#12 User is offline   whoamihere 

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Posted 28 January 2010 - 03:36 PM

I take 1350 mg of Eskalith CR per day and my levels are around 0.8 I would definitely get a second opinion if I were you, what your doc is telling you just doesn't make sense based on what you've said in your post.
Dx: Bipolar 2, MDD
Rx: Lithium, Effexor, Topamax, Klonopin
Past Rx: Abilify, Stelazine, Tegretol, Ativan, Zoloft, Zyprexa, Prozac, Wellbutrin........

#13 User is online   crtclms 

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Posted 28 January 2010 - 09:16 PM

There used to be a belief that lithium levels had to be over 1.0 to be effective, but that has been debunked. The psychiatric nurse is not current on the literature. Levels as low as .4 have (rarely) been effective. My dad really prefers his patients not to go over .9. But there are always outliers, who can handle higher levels, or who are treatable with very low levels. I think your p-doc is jumping the gun.
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Dx: Bipolar NOS, with refractory Migraine
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FAIL: Amerge; Anaprox; Buspar; Di-Hydro-ergotamine, inhaled and injected; Inderal; Klonopin; Lithium; Neurontin; Propanalol; Prozac; Relpax; Sansert; Tegretol; Topamax; Trazadone; Verapamil; Zoloft
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#14 User is offline   papertrees 

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Posted 31 January 2010 - 06:03 PM

I took 900mg two years ago and my serum level was 0.9. Now, I'm taking the same amount, and my level is 0.5. So what gives? I do not understand why this is so... Nothing changed. My weight, diet and physical activity have remained the same. Anybody have a clue?
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Diagnosis: Bipolar 1
Meds: 10mg Abilify, 200mg Lamictal, 2mg Biperiden, 900mg Lithium, 40mg Propranolol, 15mg Dormicum, 10mg Sibutramine



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