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Lithium causing problems again


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I’ve taken lithium for four years and have started having some problems. My psychiatrist says that I have a narrower therapeutic index than the standard. On 1500 and 1200 I’m toxic. On 900 I’d previously started having symptoms. I know it’s about blood levels and not dosage, but there’s no in-between dosage for me. 
 

On top of that, I have recent kidney damage from the toxicity. So all my providers agree, the lithium’s got to go. We’re going down on the lithium slowly, and then starting to optimize my other mood stabilizer (Lamictal). I’m scared af about this. I just started 900mg a day right now.  Unlike the last time I was at this dosage, I have the Lamictal on board. I’m hoping for the best but yeah. Really scared. Anyone been through this or have some reassurance?

 

Edit: Should add that I also have 100mg Latuda on board as part of my core treatment and then also gabapentin (anxiety), benztropine (for akathisia), clonidine (sleep), hydroxyzine (prn anxiety), melatonin, and additionally allergy meds, thyroid meds, and GERD meds

Edited by NerdyUnicorn
Adding additional pertinent info
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1 hour ago, NerdyUnicorn said:

I’ve taken lithium for four years and have started having some problems. My psychiatrist says that I have a narrower therapeutic index than the standard. On 1500 and 1200 I’m toxic. On 900 I’d previously started having symptoms. I know it’s about blood levels and not dosage, but there’s no in-between dosage for me. 
 

On top of that, I have recent kidney damage from the toxicity. So all my providers agree, the lithium’s got to go. We’re going down on the lithium slowly, and then starting to optimize my other mood stabilizer (Lamictal). I’m scared af about this. I just started 900mg a day right now.  Unlike the last time I was at this dosage, I have the Lamictal on board. I’m hoping for the best but yeah. Really scared. Anyone been through this or have some reassurance?

 

Edit: Should add that I also have 100mg Latuda on board as part of my core treatment and then also gabapentin (anxiety), benztropine (for akathisia), clonidine (sleep), hydroxyzine (prn anxiety), melatonin, and additionally allergy meds, thyroid meds, and GERD meds

What’s your Lamictal dose 

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