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Good question. My doc just put me on Lithium a week ago, 300mg, to start, and I had my first blood level done today so it's likely my dose will be doubled to 600mg later this week. According to my pdoc, a good Lithium level is between .6-.8 but close to 1 is too high and less than .6 is too low for any good effects. Everyone is going to process the drug differently, so 900mg might be low for you but could be through the roof for me. The blood panels is what made me avoid Lithium for so long. I hate getting blood taken.

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Lithium is one of those unusual drugs that do not have a standard correlation between amount taken and blood level. Lamictal is another one. Each individual processes them at different rates.

Lithium also has a very narrow range between maximum effective dose and toxicity level. Therefore, blood levels must be checked approximately a week after dosages changes. (Lamictal is much safer and typically doesn't require blood monitoring.)

The manufacturers' PI sheet indicates that 0.6 - 1.2 milliequivalents (meq) is the "typically effective" blood level range. Toxic effects are expected 1.5meq, and negative effects may be experienced at lower levels. Typical starting dosage are suggested at around 300mg and 1800mg if overtly manic.

Now, these are numbers are guidelines. You and your doctor will determine what blood levels and dosages are best for you based on your brain and body responses.

Milliequivalents is a mouthful to say, so people usually just drop it and refer to the numbers "My level was 0.9".

a.m.

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well that is quite low, though some people experience a positive benefit at a low level

how do you feel? do you feel more stable?

If I were in your shoes I would not hesitate to increase to 1200 mgs.

Does your doctor want to increase your dose?

I have met bipolar people in support groups who took 1500 or 1800 mgs, though that would be too much for me.

Just make sure your doctor does frequent blook work until you have this figured out.

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My dad has had patients respond to as low as .4, but usually they had a brain injury (which made them more sensitive to it, please don't ask me to recall why). But .4 is as low as he has found therapeutic. I know he likes .6-.9, and is happier when it is closer to .6.

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I've had .3 at 900mg. I take 1200mg now and usually range between 0.6 and 0.8, though I've been as high as 1.4 as a result of taking ibuprofen (NSAIDs may raise your level and are best avoided when taking lithium). At 1500mg two days a week and 1200mg the rest of the week, I was between 1.0 and 1.2, but we went back to 1200 because I felt better.

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My last blood level was 0.7 at 750mg. My pdoc said she would prefer 0.8 as a minimum for the crisis period I've been in, but anything over 750mg instantly gives me bad oedema, so we're just sticking with this dose. It really is a drug that seems to react very differently for different people.

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