new to lithium; should I increase my dose or wait?

[Moody]

I have been taking 300mg of instant release lithium for four days now. I have been in a mixed state for the past month, so I have had horrible agitation/anxiety plus depression.

I am supposed to increase my lithium dose to 600mg tonight, but here's the thing, I could feel the lithium working after the second dose. I feel calmer and I have been able to cut my klonopin dose in half. My side effects are not bad so far, I am tired and my stomach feels a little upset, but thats about it.

So do you think it is a good idea to increase to 600 even though I seem to be having some results at 300mg? Should I stay at 300mg for a week and get a blood test? I have always responded to very low doses of ADs and AAPs, but I know lithium is a different type of med.

I am going to call my pdoc today and ask her, of course, but I always value the real life experiences of the folks here. Has anyone been at a lithium dose below 600mg?

[dedoubt]

I, too, respond to low doses of many meds. However, when I was only on 300 mg of IR lithium each day last winter, I'm not sure what it did. I was in a very bad mixed state, beginning to hallucinate, and then went into the hospital right after I increased my dose to 600 mg. I haven't gone back down below 600 since then, but I do know that 600 helped. Even so, it took getting to 900mg to really feel the difference-- it's like night and day. Obsessive thinking is pretty much turned off. There are other things I am still needing to work on (depression for one), but my brain does not feel as scrambled.

See what your pdoc says-- she might tell you to stay at 300 for awhile longer, or see how you feel at 600. Maybe you will have a noticeable difference with that dosage change that you like.

[SashaSue]

Definitely go ahead with the dosage increase. 600mg is still a pretty low dose. Your having had some response at 300mg suggests that you're likely to respond well to the increase.

[Moody]

Thanks for responding, my pdoc told me to go ahead and increase, so I took 600mg last night. Now I have a headache and feel like someone numbed my brain, ugh. Hopefully these side effects wont stick around.

[Anna]

i'd stick with it for a few days, knowing that if you respond better to low dose, you can always drop it back down.

Anna

[AnneMarie]

If your stomach is upset, make sure to take it with a meal.

[Moody]

Thanks guys, you are the best. I really appreciate your advice. I will stick it out at this dose for a while and see if it gets better.

I have been taking it at night with some yogurt or a piece of toast, and I do have some nausea/stomach upset, but it isnt that bad. It seems to help if I eat little snacks throughout the day, and dont let my stomach get too empty.

[Moody]

So I have been taking 600mg of lithium for 3 days now. The first few days were fine, I felt really good and didnt have any bad side effects. Yesterday I felt a little irritable, but nothing major.

I took my meds before bed last night (lithium/remeron/risperdal) and started feeling more anxious. I had trouble falling asleep until the lithium kicked in.

Today I am feeling awful, really agitated and anxious, I had to take more klonopin. I havent felt this bad since before I started the lithium. Any idea what is going on?? Could the dose increase have caused this? Is it normal to have a bad day after a bunch of good ones while starting lithium? I was doing so well, I dont know why I feel so bad today.