Lithium on the way up

[6un6silent6]

I've posted here several times, but wanted to get some insight from the board. I've been on 900-1050mg of Lithium with a blood serum of .5-.7 with minimal side effects. About 4 days ago my Pdoc put me up to 1200mg since I was becoming irritable often and feeling a bit hypomanic. I'm also on 100mg of Lamictal which I'm sure is not helping (yet). I'm having a lot of problems concentrating, reading, and I feel literally like a moron @ 1200mg. My hands are trembling more than they did at 1050mg and I just feel like anxious in general. I'm waiting to hear back from my Pdoc to see what he says, but can anyone offer advice or suggestions?

I'd be surprised if I'm toxic from a 150mg increase when my serum levels are always low, but as a precaution I'm keeping my salt stable and increasing my water as much as I can tolerate. But he suggested I wait till next Monday to pull blood to give the Lithium time to build. I just feel like I should draw blood today or tomorrow to see where I'm at. Obviously, I'm super-scared of becoming toxic on this stuff.

[nibblerd]

In my experience, upping your level (mine was up to 1.2 inpatient to bring me out of a mixed state) will result in a re-emergence of side effects, and it may or may not subside over time. My side effects were tremors in every limb and even my breathing was shaky. I couldn't really read a book, but it gradually improved over two weeks. Hopefully that's the case with you, and it most likely is seeing as how you're at a lower level than I was. Once I was feeling better we tapered the dose so I could hover at .72 to .8. Maybe this can be done for you, or you can have a PRN for hypomanic breakthroughs like Seroquel, Abilify, Haldol (okay, that last one was almost a joke, but it's been done before).

[6un6silent6]

In my experience, upping your level (mine was up to 1.2 inpatient to bring me out of a mixed state) will result in a re-emergence of side effects, and it may or may not subside over time. My side effects were tremors in every limb and even my breathing was shaky. I couldn't really read a book, but it gradually improved over two weeks. Hopefully that's the case with you, and it most likely is seeing as how you're at a lower level than I was. Once I was feeling better we tapered the dose so I could hover at .72 to .8. Maybe this can be done for you, or you can have a PRN for hypomanic breakthroughs like Seroquel, Abilify, Haldol (okay, that last one was almost a joke, but it's been done before).

I'm hoping this is all it is. I'm willing to deal with it in hopes that things subside a bit. He put me at a higher dose since the Lamictal (which I'm still titrating) was making me a bit hypo. He gave me 25mg Seroquel as a PRN but to be honest if I take an AAP or anything like that I'm a vegetable and can't function at all. Kind of a catch 22 it seems.

[6un6silent6]

I couldn't take it last night. My tremors got really bad, dizzy, confused, and nauseous. I dropped back down to 1050mg and I feel a little bit better. Haven't heard from my Pdoc yet, but damn 1200mg might be my breaking point.