Lithium Formulation Change? Problem?

[SashaSue]

I usually get Lithium ER, lovely little pink pills. The last time I filled it, on Tues. or Wed., they gave me little pink capsules instead. Lithium not ER. Since it wasn't upsetting my stomach as it had in the past, I didn't think much of it. The last few days, though, my mood has been going nowhere good. It could be a stress thing, it could be a time of year thing, it could just be a random expression of neuronal hatred for me. But I'm wondering if at least part of it might be the lithium switch? Since starting lithium, I've been the most stable I've been in a long time, for longer than I've been in a long time. So, I'm kind of hoping it's about this, as that would be far and away the easiest to fix.

Left a message for pdoc, increased li as previously agreed upon w/pdoc, seroquel too. Made a big point of not staying home alone all day, told a couple people I was not so great, did, I think, all the things I'm supposed to be doing. Any suggestions for sanity would be welcome. Well, not those involving diet, exercise instructions, or vitamins. All set with those, thanks though. Anything else, bring it on.

[Silver]

Call the pharmacy first - make sure it wasn't a pharmacy error, and that they didn't fill the IR caps by mistake. If it was just a refill, not a new rx, it seems likely to be an error.

If your psyMD just switched to an electronic rx system, there are often errors while they get used to these... if you ever see how "CR"/"ER" etc. designations are on some of the screens, you'll see why. My psyMD and I gazed in wonder at the confusing array of options.

"How about I just write for Lithobid and put 'generic, Roxane preferred' in the Notes?" she said.

"Great," I said.

Otherwise, I'd change back to the CR first, yes - in theory, not a big difference; in practice, often a difference.

Til you talk to pharmacy/doc, you could try dividing the dose through the day a bit. Not sure it would make much difference, but worth a try.

[SashaSue]

It was a new script, but you're right that it may have been the pharmacy's error, they certainly make plenty. I'm guessing she just left the ER off the Lithium Carbonate ER. She was not at her best the last time I saw her, and writing a whole bunch of prescriptions at once, could happen easily enough.

I like the mixing it up throughout the day idea. I'd wondered about that, as I definitely seem to start out kind of ok, then am worse, & worse as the day goes on, which is not normal for me, at all. I'm usually at my peak at 2am, so it seemed like that might be part of the trouble.

It is ridiculous how happy I am, though, that it really might be the different Li. I'll have the ER by tomorrow night, and in a couple of days I'll be fine. I'm going with that. Sounds way better than any of the alternatives.