Jump to content

Recommended Posts


My pdoc just prescribed lithium for me. I am nervous about taking it. He wants me to take 300mg 3 times a day. Is this a normal starting dose?

He also never mentioned blood tests or anything beyond the full work up I had a month ago. He also says that I "may be Bipolar". At the least it is cyclic depression?

Anyway I would like to know other's experiences with pdocs and the lithuim start up. It may help me to not be so anxious to start taking it. Also I have some business appointments the next few days and was wondering if I should wait to take it until next week.

Thanks alot,


Link to comment
Share on other sites

Thanks Silver.

I read the info from the link above. It answers a lot of questions but not all.

Is it normal for a pdoc to not mention blood work or serum levels when they prescribe this drug?

Is there such a thing as "cyclic depression"?

What is a typical low dosage and what is a typical high dosage?

Thank you,


Link to comment
Share on other sites

You'd had blood work done within the past month or two, if I recall correctly (which I may not.) Generally that wouldn't be repeated if you're in good health overall.

Usually there is a discussion of blood work, serum levels, etc., yes.

Dosages vary a lot from person to person, as the dosing is to clinical effect / serum level. Look at the different sig lines and you'll get an idea of the range. 900 mg is a fair place to start.

When do you see him next? Within the next 4 weeks, I assume? At that point, you should definitely be getting some lab work, if you've been taking the medication regularly.

As to the cyclic depression as separate from bipolar disorder... that's a big, big topic, DW.

Opinion: But I consider much "cyclic depression" to be a form of manic depressive illness. As do Goodwin and Jamison: note the subtitle on the textbook.

Why not ask your psychiatrist about this directly at the next visit? "Help me understand: do you think right now that we are treating depression, bipolar disorder, or something else?"

I have no doubt there is a wide array of differing opinions on this subject on this very board.

Link to comment
Share on other sites

Hi Silver,

I do see him again on the 28th of Nov. It just seems as if he does not really pay any attention to what I have to say beyond the first three sentences.

What part of the board do I find info on "cyclic depression as separate from bipolar disorder... "?

Also, I have not started the lithium yet, I am going to wait till next week when work gets back to normal and I do not have to deal with people on a daily basis.

I already crave salt. Always have since about 13 or so, and at night I eat a chicken bouillon cube and drink a glass of water. Not every night but at I'd say 4 nights a week. I know it is weird but any idea how it will affect my lithium levels?



Link to comment
Share on other sites

If you eat a steady amount of salt on an ongoing basis, it will not matter. Major fluctuations in sodium intake, water intake, etc. - anything that disrupts sodium balance - can alter lithium level in varying ways, depending on what the lithium level is and assorted other things. Here's a quick explanation from Phelps (again.)

I would suggest taking in a list of three questions - in priority order - to each visit. Two if things are really tight for time. Actually, just start with two. (You can always have a third bonus question in reserve.)

One thing you can try is to say, "Hi, Dr. X, nice to see you, I have two questions from last time that I need to ask today. Do you want them now or 5 minutes before we're done?" as you're settling into the room. Your psychiatrist may want to wait til he's checked in on how you're doing before he gets to the questions, or he might want them from the start, so he can sort of address them as you go through the visit.

This means that you're partly responsible for timekeeping, and when it gets to about 7 min before the end of the visit (if it is a set block of time), nudge gently towards those two questions.

If you have a couple of visits where your questions don't get addressed, then just start asking them at the start of the visit.

If I remember, you're seeing him as he rotates through at the clinic, right? Remember also that lab-type questions might be something that your primary care provider will answer.

I'd suggest going back to the Phelps main site (www.psycheducation.org) and browsing around for a bit on a discussion of recurring depression and bipolar disorder/manic depressive illness. Lot of information there and fairly approachable.

Link to comment
Share on other sites


This topic is now archived and is closed to further replies.

  • Create New...