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At what dose of lithium did you hit a halfway-therapeutic range?


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Disclaimer: I'm not bipolar, I'm SZA, but I felt that people here may have more experience with Li than those in the SZ forum.

I have been on lithium carbonate for a few months now (forgive me for not knowing how many exactly - five years of daily benzos and a year on a brutal first-generation AP, plus epilepsy and cysts in my brain, mean that I have a dreadful memory). It was started because I was in a bad mixed/depressive episode, and was not responding to Lamictal. I started off at 200mg, which my psychiatrist confessed was far, far sub-therapeutic, but was rather a tester dose to see if it had any effect on my seizures. Thankfully, I have suffered no serious seizures (nothing more than auras, and no more frequent than before I began the Li). I initially tested at 0.2. My dose was raised to 400mg, and I tested at 0.4. It was subsequently raised to 600mg. I just got my latest bloods back today. Still 0.4. My psychiatrist has said that I would probably begin to respond properly at around 0.8. 

I have responded to the Li to some extent: it has stopped my rapid cycling. Prior to starting it, I was in an almost weekly cycle between mixed/depressive and manic. Thus, I know that it will stabilise me someday. The question is: when?
 

My GPs apparently cannot raise my dose; it has to be my psych. I do not see him until December. I hope to dearest Jesus that the lithium will accumulate in my blood a little more in the liminal time, and that I will begin to almost, almost stabilise. However, if my level remained at 0.4 for almost two months, despite a dose increase during that time, I doubt that it will. My next increase will probably only be to 800mg. I am becoming desperate. I have even considered raising the dose myself, and pretending that I had lost some when I called in an early refill. 

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Hi,, certainly familiar with Li ... if you don't want to increase dose b4 seeing Dr.. you can..CAREFULLY  bring up your levels by reducing salt intake.. yup  that easy... Li is a salt.. salts exist together in equilibrium... so by slightly and s l o w ly    decreasing  table salt  , et el ,  you can push towards more Li+ in system...       

actually it is that some who are at thap dose.. and drop NaCl  :salt: levels quickly    have/can   get to Li  toxicity ...   i did...     :0   b carefull    best of lluckk

 

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Do you have a peer reviewed paper supporting that method?

You are *not* supposed to fuck around with your salt intake when you are on Lithium. I was told, and I know other were as well, that even if I generally eat too much salt (which I do), not to try to cut back.

You are giving bad advice. It is inappropriate to give medication instructions to another member. In fact, it breaks the rules, so please don't do it again.

If you can find a *peer reviewed* paper suggesting this method, than I am wrong. But I am going to wait for the paper before I make a final determination.

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Everybody is different, as we always say.  I was 1500 for 0.8
I have no memory of lower readings
or maybe it was 1200 for 0.8 and they'd bump me to 1500 on occasion
it's been years since I stopped

Edited by Will
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On 11/14/2015, 12:19:30, Will said:

Everybody is different, as we always say.  I was 1500 for 0.8
I have no memory of lower readings
or maybe it was 1200 for 0.8 and they'd bump me to 1500 on occasion
it's been years since I stopped

Why did you come off it, out of interest?

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I was on it for 25 years.  I was an excellent responder to it.  I had many good years on it.
First reason:  it seemed to be losing effectiveness because I started having severe psychotic episodes again.  Second reason:  my creatinine level  tested at 1.6 indicating some kidney issues which may be related to long term use.  
Aging is probably the explanation for the course of my illness.  Despite my kidney situation I am considering asking/demanding to be put back on it.  My manic episodes are very bad now and last months.  

In my opinion, lithium is an incredible drug for people who respond to it.  But it is very important to follow doctors' instructions regarding dosing and get periodic blood work done.

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