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Does this sound like a lot of Lithium to start on


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Your typing is a little garbled,  I think you meant  250mg A.M, 500mg PM ?

No, that is not excessive at all. I'm on 900mg  Eslkalith (extended release), which is two 450mg tabs, and that just barely gets me into the effective range of 0.6 - 1.2 (blood reading). I seem to be pretty sensitive to lithium effects and I think many people take a lot more.

Off the top of my head, I recall that the general dosing recommendations are something like 1800mg per day if patient is in a full manic episode then titrate as required after a week, and around 600 - 800mg per day (if memory serves) if not in acute phase and titrate as required after a week.

With the half life of lithium it takes five days plus to clear your system.  So the conventional procedure is to have a blood draw 7 days after starting to get a feel for your individual dosing vs. blood levels.  You can expect to have blood samples after major dosing changes.

Take it with food, drink lots of water (like 2 -3 quarts), and feel free to add a little extra salt to your food, or have a salty snack if you are having annoying side effects.

I found that the symptoms tend to fade over about a month. If you get to shaky, your Pdoc may prescribe a beta-blocker (blood pressure med) PRN.  Did wonders for me, minimal side effects.

Good luck.

A.M.

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I titrated way slower - 300mg nightly to start - but you shouldn't be in any danger as long as your blood levels are being monitored.

People freak about lithium but it was a way longer history (and is very safe almost all of the time) than almost anything else we take.

-

k

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I think that starting out at 750 mg a day is rather...up there.  I started at 300 a day, titrating up at 300/day a week.  I really think throwing that high a dose at someone that's already on another mood stabilizer that they're merely switching from is excessive.  But, it's probably no biggie.

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Yep, 900-1200 mgs. seems to be the average dose for serum levels around 1.0 but everyone is different. Some people have to take a lot more, some less. Plus the worse your mania, the more you need.

Some people do well @ 0.4, others need 1.2. Everybody's different but 750 is a little below average dosage.

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