Lithium start up

[looking for answers]

Can you tell Me about your experiences starting the drug. Any side effects , experiences, things to look out for.

 

im dry everywhere, spacey, and headache, drowsy so far.....

 

but its early experiences would help

 

very worried about weight gain

[Iceberg]

Weight gain was minimal for me and is usually (usually) not as bad as the heavier antipsychotics. For me the start up stuff went away once I got to a stable dose. It's all based on blood level not actuall dose amount 

[Rabbit37]

I take lithium at night, I think it mildly makes me drowsy, but hard to say. Thirst is really the only issue, just drink lots, preferably water. Even more so if sweating. And don't reduce sodium intake, just eat normally. 

The least s/e med I've been on. 

[crtclms]

I think I told you elsewhere that I didn't gain weight. The two big side-effects for me are thirst, and a gross tremor, which is episodic. If I chug a bunch of water, the tremor usually goes away almost immediately. I drink between 3 and 4 liters of water a day, and if I don't drink any water for an hour or two, I get chapped lips from drying out! Oh, and I guess another side effect is I have to pee constantly.

[looking for answers]

28 minutes ago, Rabbit37 said:

I take lithium at night, I think it mildly makes me drowsy, but hard to say. Thirst is really the only issue, just drink lots, preferably water. Even more so if sweating. And don't reduce sodium intake, just eat normally. 

The least s/e med I've been on. 

S/e ????man I just jogged an hour guzzled and still dizzy/thirsty

48 minutes ago, Iceberg said:

Weight gain was minimal for me and is usually (usually) not as bad as the heavier antipsychotics. For me the start up stuff went away once I got to a stable dose. It's all based on blood level not actuall dose amount 

Heavier ap’s? I didn’t gain in seroquel

27 minutes ago, crtclms said:

I think I told you elsewhere that I didn't gain weight. The two big side-effects for me are thirst, and a gross tremor, which is episodic. If I chug a bunch of water, the tremor usually goes away almost immediately. I drink between 3 and 4 liters of water a day, and if I don't drink any water for an hour or two, I get chapped lips from drying out! Oh, and I guess another side effect is I have to pee constantly.

Lol prior to this I drank 1.5 -2 gallons a day I workout alota lot

[looking for answers]

Appears constipation is happening now, 

[crtclms]

That isn't that uncommon, but it is common with a lot of psych meds (I suspect you know this). Have you tried Miralax? I actually use docusate sodium as needed, myself, but I am under the impression that Miralax is considered safer, because you can use it every day forever, whereas the DS should be used more sparingly. It's good to have a laxative on hand when you take a lot of meds.

If you get so backed up that you are having real problems, try a tablespoon of mineral oil before you go to bed. It works really well, but I don't like the texture of the oil, so I use it only in emergencies. Mineral Oil should not be used as your main laxative.

[looking for answers]

23 minutes ago, crtclms said:

That isn't that uncommon, but it is common with a lot of psych meds (I suspect you know this). Have you tried Miralax? I actually use docusate sodium as needed, myself, but I am under the impression that Miralax is considered safer, because you can use it every day forever, whereas the DS should be used more sparingly. It's good to have a laxative on hand when you take a lot of meds.

If you get so backed up that you are having real problems, try a tablespoon of mineral oil before you go to bed. It works really well, but I don't like the texture of the oil, so I use it only in emergencies. Mineral Oil should not be used as your main laxative.

I have chronic gi issues to begin with. I use miralax twice a day already (double doses) and exlax extra strength(same as sennakot) so I’m well versed in laxatives lol

[crtclms]

[looking for answers]

Please tell me the start up is the worst part, im constipated, spacey, anxious, forgetting words, i just feel worse on a mere 300 mg, but is it true that start up is wicked, then its like the gates of heaven open

[jt07]

I don't recall it being difficult to start lithium. It certainly wasn't as difficult as starting tricyclic antidepressants which I was also on at the time.

[looking for answers]

i dunno maybe this isnt for me then

[jt07]

Give it a chance. You've only been on it a few days.

[looking for answers]

Please tell me the start up is the worst part, im constipated, spacey, anxious, forgetting words, i just feel worse on a mere 300 mg, but is it true that start up is wicked, then its like the gates of heaven open

 

trust me im going to...........

[jt07]

Everybody reacts to med differently. You won't know how things will be until you reach a therapeutic dose, and my experience with start-up effects is not going to be the same as yours.

I'm not sure what you are expecting the lithium to do for you but it works best to qwell mania and keep depression from getting too bad. That's what mood stabilizers do. I did not find it helpful for anxiety at all. If anything it aggravated my anxiety.

[looking for answers]

per the pdoc he feels my "anxiety" is more anger, and that this will help with that, although i do feel like my GA is exacerbated. i know i wont know what it does till therapeutic effect, and that my experience is different than everyone elses, still doesnt hurt to hear experiences. He feels its will qwell some depression and anger.

[Iceberg]

Yeah the only time lith helped my anxiety was when I was toxic and then I was just sick. As for anger it's a good shot at least...I need aps for that but many don't 

[browri]

I was never able to tolerate lithium. I got up to 600mg of the controlled release all at night and I would wake up drenched in sweat and would just feel downright ill throughout the day. It was certainly effective from what I recall but not worth the cost of discomfort. I tolerate Depakote much better than I did lithium. I actually am falling in love with Depakote tbh.

[looking for answers]

25 minutes ago, browri said:

I was never able to tolerate lithium. I got up to 600mg of the controlled release all at night and I would wake up drenched in sweat and would just feel downright ill throughout the day. It was certainly effective from what I recall but not worth the cost of discomfort. I tolerate Depakote much better than I did lithium. I actually am falling in love with Depakote tbh.

shows how everyone is different, i heard depakote is rough, and expect major weight gaian

[browri]

To be honest, I heard Depakote was rough as well. My pdoc suggested it a while back and I rejected the idea because of the risk of weight gain. However, over the time I've been treated for bipolar disorder I've come to realize that the meds that truly make me feel better are the sedating ones and the sedating ones are the ones that generally cause weight gain (the exception I guess being topiramate). We were using antipsychotics as my primary mood stabilizer, and they would work for the most part but I would still hit these rough patches of mixed states. We would increase the AP dose to compensate but the doses I would need to be at to control an episode always invariably caused akathisia. Lower maintenance doses when I wasn't experiencing an issue were usually fine. This time around I experienced a mixed state and we went up to 25mg of loxapine but it caused too much akathisia. So we decided that moving forward the anticonvulsant had to become the primary mood stabilizer but oxcarbazepine wasn't settling enough to be primary. Enter Depakote. Rapidly titrated across from 1200mg of Oxtellar XR to 750mg of Depakote ER and I had 2-3 days of some solid hypomania (which I must admit I enjoyed) but Depakote stabilized me pretty quickly......like REALLY quickly.

As for the weight gain, from what I've read Depakote isn't totally unyielding in that regard. It seems that 1000mg might be the threshold for weight gain in most people. That being said, I've been on Depakote now for over a month at least at 750mg and haven't gained a pound that I can tell. Then again I am taking Vyvanse, so I do have a bit of an unfair advantage. Nice thing is though that Vyvanse by itself had a very powerful grip on my appetite and Depakote has actually helped to improve my appetite while the Vyvanse helps keep off the pounds from Depakote. Win-win.

[jt07]

Depakote was rough for me. It made my depression worse and made me eat everything that wasn't nailed down, even things I would never normally eat. I was just famished all the time. It also caused hair loss. Granted, we all react to meds differently, this is only my experience, and YMMV. Tegretol is much more agreeable to me.

[browri]

30 minutes ago, jt07 said:

Depakote was rough for me. It made my depression worse and made me eat everything that wasn't nailed down, even things I would never normally eat. I was just famished all the time. It also caused hair loss. Granted, we all react to meds differently, this is only my experience, and YMMV. Tegretol is much more agreeable to me.

Never taken Tegretol but took the cousin, Trileptal, before switching to Depakote. I would go back to it in a heartbeat if I couldn't take Depakote anymore for whatever reason like if my liver decides to peace out on me. lmao.

[looking for answers]

1 hour ago, browri said:

To be honest, I heard Depakote was rough as well. My pdoc suggested it a while back and I rejected the idea because of the risk of weight gain. However, over the time I've been treated for bipolar disorder I've come to realize that the meds that truly make me feel better are the sedating ones and the sedating ones are the ones that generally cause weight gain (the exception I guess being topiramate). We were using antipsychotics as my primary mood stabilizer, and they would work for the most part but I would still hit these rough patches of mixed states. We would increase the AP dose to compensate but the doses I would need to be at to control an episode always invariably caused akathisia. Lower maintenance doses when I wasn't experiencing an issue were usually fine. This time around I experienced a mixed state and we went up to 25mg of loxapine but it caused too much akathisia. So we decided that moving forward the anticonvulsant had to become the primary mood stabilizer but oxcarbazepine wasn't settling enough to be primary. Enter Depakote. Rapidly titrated across from 1200mg of Oxtellar XR to 750mg of Depakote ER and I had 2-3 days of some solid hypomania (which I must admit I enjoyed) but Depakote stabilized me pretty quickly......like REALLY quickly.

As for the weight gain, from what I've read Depakote isn't totally unyielding in that regard. It seems that 1000mg might be the threshold for weight gain in most people. That being said, I've been on Depakote now for over a month at least at 750mg and haven't gained a pound that I can tell. Then again I am taking Vyvanse, so I do have a bit of an unfair advantage. Nice thing is though that Vyvanse by itself had a very powerful grip on my appetite and Depakote has actually helped to improve my appetite while the Vyvanse helps keep off the pounds from Depakote. Win-win.

just another example of YMMV. what is oxtellar???? never heard of it

1 hour ago, jt07 said:

Depakote was rough for me. It made my depression worse and made me eat everything that wasn't nailed down, even things I would never normally eat. I was just famished all the time. It also caused hair loss. Granted, we all react to meds differently, this is only my experience, and YMMV. Tegretol is much more agreeable to me.

how did it make depression worse???

[jt07]

32 minutes ago, looking for answers said:

jhow did it make depression worse???

I just became sadder and sadder on Depakote. Just generally felt more depressed.

[browri]

44 minutes ago, looking for answers said:

just another example of YMMV. what is oxtellar???? never heard of it

Oxtellar XR is the brand-only extended release formulation of oxcarbazepine (Trileptal). I really liked Trileptal when I started it but taking it 3 times a day was a pain. Switched to Oxtellar and was able to take it all in the morning. Loved it. But like I said, I hit a rough patch and it wasn't calming enough and the loxapine at the necessary dose was causing too much akathisia. Something had to change.

[looking for answers]

21 minutes ago, jt07 said:

I just became sadder and sadder on Depakote. Just generally felt more depressed.

That sucks I’ve responded good to seroquel but he doesn’t wanna go higher wants To add lithium I’m hopeful 

9 minutes ago, browri said:

Oxtellar XR is the brand-only extended release formulation of oxcarbazepine (Trileptal). I really liked Trileptal when I started it but taking it 3 times a day was a pain. Switched to Oxtellar and was able to take it all in the morning. Loved it. But like I said, I hit a rough patch and it wasn't calming enough and the loxapine at the necessary dose was causing too much akathisia. Something had to change.

Understood

[crtclms]

A lot of people get overly-sedated on Depakote, and I know there are people who got depressed on it. I took it for migraines, and took 1500mg a day, and for me the major side effect was loss of libido. I haven't taken it since 2012, but I used it off and on for 15 years, and did not gain weight. YMMV.

[looking for answers]

4 hours ago, crtclms said:

A lot of people get overly-sedated on Depakote, and I know there are people who got depressed on it. I took it for migraines, and took 1500mg a day, and for me the major side effect was loss of libido. I haven't taken it since 2012, but I used it off and on for 15 years, and did not gain weight. YMMV.

Isn’t that heavily ant manic,? Where lithium is ant Manic but has anti depressant S welk

[looking for answers]

i here it takes months to a year to find the "sweet spot" for lithium, is this true

[crtclms]

Every medication can takes months, your supposed to give a med 6-8 weeks, and for some meds you wait longer before you can decide whether to stay on it or not. I think it would be strange to keep someone on lithium for a year if it hadn't started working much earlier. Lithium squashes mania in a few days, but that probably wouldn't be a level you would want to stay at. What takes time is finding a good blood level for you, but no way is that going to take a year. You can bump your blood level up pretty quickly if a lower level isn't working for you. I am pretty sure you'd max out your blood level, and be taken off of it before a year has passed. 

None of this is easy. There's no psychiatric med that is a joy to take, it's all relative. I haven't been around for a while, and just came back last month, so I don't know when were you diagnosed? And what other meds have you tried?

[looking for answers]

6 hours ago, crtclms said:

Every medication can takes months, your supposed to give a med 6-8 weeks, and for some meds you wait longer before you can decide whether to stay on it or not. I think it would be strange to keep someone on lithium for a year if it hadn't started working much earlier. Lithium squashes mania in a few days, but that probably wouldn't be a level you would want to stay at. What takes time is finding a good blood level for you, but no way is that going to take a year. You can bump your blood level up pretty quickly if a lower level isn't working for you. I am pretty sure you'd max out your blood level, and be taken off of it before a year has passed. 

None of this is easy. There's no psychiatric med that is a joy to take, it's all relative. I haven't been around for a while, and just came back last month, so I don't know when were you diagnosed? And what other meds have you tried?

A billion AD , risperdal. Lots of benzos

 

now in an IOP program and in Seroquel XR 400 just added lithium last week , it’s only 150 twice a day I know it will take time

[crtclms]

I hope the IOP is helpful. You're still titrating the Seroquel, too, aren't you? You never know, you might respond to a very small amount of lithium, and some people do well on technically non-therapeutic levels. I only take 600mg, and my level is .7.

[looking for answers]

As of now they r sticking at 400 with seroquel and not going higher.

 

the iop is helping, meds and changing thoughts

im only on 150 2xday lithium right now, but I see the doc in a min

[browri]

48 minutes ago, looking for answers said:

As of now they r sticking at 400 with seroquel and not going higher.

 

the iop is helping, meds and changing thoughts

im only on 150 2xday lithium right now, but I see the doc in a min

let us know how your appt goes and what you guys end up deciding to do.

[looking for answers]

He wanting to not change meds. Said he was using lithium for irritability. Not maintanence and that I didn’t necessarily need a therapeutic level. Said he would be more prone to

change seroquel.

 

 

ive been in the iop 6 weeks with one med adjustment. My intial auth runs ou in 8 days, they can request more and are but no guarantee. The benefit of the iop is seeing a doc weekly. I’ve seen positives with each med change, I asked for another one so he went to

lithium 300 2xday . Then said with a guy my size and weigh drinking 1.5-2 gallons of water a day(always have) that it shouldn’t change much. I feel like I need to Press for changes. That’s why im here!

[Iceberg]

Stubborn pdocs...nothing quite so annoying 

[looking for answers]

He agreed to up it. I feel

like now is the time to act. And if it’s the wrong move fix it next week. I won’t have these chances soon

[Iceberg]

Unfortunately 600 is still pretty low but you should give it a week before any up/down change some people don't need a lot ...are you feeling overall better? 

[looking for answers]

Well only 300 as of now and mymlevels are very low I got blood work today. But I go up to 600 tomorrow.

 

i do feel a bit better . We would change week by week since I see weeekly now. 

 

I mean can u feel good with levels under the therapeutic range ?? Is it really doing anythibg

[Iceberg]

Yes you can. I kno someone who had a raging manic episode who is controlled by a barely therapeutic level 

[looking for answers]

7 minutes ago, Iceberg said:

Yes you can. I kno someone who had a raging manic episode who is controlled by a barely therapeutic level 

but still therapeutic...............so in that range, not under it gotta hit .7-1.2 right

[Iceberg]

I actually know many doc's who start at .6 or even.5. For me I think of it as .6-1.4

[looking for answers]

Hmm well good to know I probably heard wrong 

[Mogli]

I was on 600 mg lithium and it wasn't doing anything so they jumped me up to 1200 which I think was really dangerous. I didn't go toxic but I would have really bad nausea, dizziness, forgetting words (oh yeah and lovely constipation despite chugging water). The worst part was that it didn't make me feel any less suicidal. I have anger and irritability issues too and it seemed to actually make those worse. They brought me down to 900, and I was at 8.1, but I never felt better. In the end I'd given it 8 weeks which I feel like was a fair shot. 

[looking for answers]

I’m sorry it didn’t work for u. I’m trying to find out my level today. The inverse to 300 makes me feel weird and anxious and spacey again. If it subsides like it did after 3-4 days I’ll be happy. I felt great yeaterday

[browri]

Good thing to note is that not everyone needs a therapeutic level to maintain and may only require normal therapeutic level during an episode. The normal therapeutic range for valproate is 50-100mcg/ml but I maintain well at just above 40.

[looking for answers]

What do  u guys mean when U say maintain 300 2xday is awfully low. And to mIbtain at 150 2xday is doubtful I would think

Edited November 7, 2017 by looking for answers

[browri]

5 minutes ago, looking for answers said:

What do  u guys mean when U say maintain 300 2xday is awfully low. And to mIbtain at 150 2xday is doubtful I would think

A maintenance dose is not always the same as an acute dose. For example, I take 1000mg a day and that gives me a blood level of 40-43mcg/ml. During an acute episode like if I were to start rapidly cycling, we could increase to 1500mg to get me into the 50-100mcg/ml range while the episode is occurring and go back down to 1000mg when we've confirmed that the episode has passed.

The point being that you don't feel overly medicated in between episodes but you simultaneously run a higher risk of having episodes recur if you aren't within the normal therapeutic range all of the time. It's a trade-off.

That being said, 150mg 2x/day does seem low. 300mg 2x/day is low but not super low. I've heard some people staying at that dose for a while. But many can only maintain once they got to total doses of 900mg to 1200mg.

Edited November 7, 2017 by browri

[looking for answers]

3 minutes ago, browri said:

A maintenance dose is not always the same as an acute dose. For example, I take 1000mg a day and that gives me a blood level of 40-43mcg/ml. During an acute episode like if I were to start rapidly cycling, we could increase to 1500mg to get me into the 50-100mcg/ml range while the episode is occurring and go back down to 1000mg when we've confirmed that the episode has passed.

The point being that you don't feel overly medicated in between episodes but you simultaneously run a higher risk of having episodes recur if you aren't within the normal therapeutic range all of the time. It's a trade-off.

Sothe point where u feel good....I’ felt good on 300 but I wanna try higher doses it could be better

[browri]

Just now, looking for answers said:

Sothe point where u feel good....I’ felt good on 300 but I wanna try higher doses it could be better

I agree that it's good to test your limits and find out where the roof is. I've started to do this with antipsychotics. Increase until you hit akathisia, then back down and you know then how far you can go. Also balancing that with how flat your mood is.

[looking for answers]

10 minutes ago, browri said:

I agree that it's good to test your limits and find out where the roof is. I've started to do this with antipsychotics. Increase until you hit akathisia, then back down and you know then how far you can go. Also balancing that with how flat your mood is.

I’m currently in an iop, so I’m not exactly stable I 

[looking for answers]

25 minutes ago, browri said:

A maintenance dose is not always the same as an acute dose. For example, I take 1000mg a day and that gives me a blood level of 40-43mcg/ml. During an acute episode like if I were to start rapidly cycling, we could increase to 1500mg to get me into the 50-100mcg/ml range while the episode is occurring and go back down to 1000mg when we've confirmed that the episode has passed.

The point being that you don't feel overly medicated in between episodes but you simultaneously run a higher risk of having episodes recur if you aren't within the normal therapeutic range all of the time. It's a trade-off.

That being said, 150mg 2x/day does seem low. 300mg 2x/day is low but not super low. I've heard some people staying at that dose for a while. But many can only maintain once they got to total doses of 900mg to 1200mg.

How long does it take till u “feel” it

[browri]

5 minutes ago, looking for answers said:

How long does it take till u “feel” it

Well I'm taking Depakote at the moment. I only took lithium for like 10 days and I just couldn't tolerate it. It made me feel really sick but it did stabilize me quickly. Within 2-3 days if I recall correctly. I just wasn't myself though. It wasn't for me.

[looking for answers]

2 minutes ago, browri said:

Well I'm taking Depakote at the moment. I only took lithium for like 10 days and I just couldn't tolerate it. It made me feel really sick but it did stabilize me quickly. Within 2-3 days if I recall correctly. I just wasn't myself though. It wasn't for me.

See I hear that, and I read that it takes 2-3 weeks for effect

[Iceberg]

I've always heard AT LEAST one week probably more 

[crtclms]

For acute mania, it can be days. For maintenance it takes a little longer.

[looking for answers]

holy crap day 2.5 on the 600 per day and i feel like crap

[Iceberg]

What's ur latest blood level?

[browri]

Still kind of early for a level if he's only been on 600mg for two and a half days. Don't you need to wait 3-5 days after reaching a stable dose before you can check a level?

[looking for answers]

8 minutes ago, Iceberg said:

What's ur latest blood level?

They didn’t tel me just said very low

5 minutes ago, browri said:

Still kind of early for a level if he's only been on 600mg for two and a half days. Don't you need to wait 3-5 days after reaching a stable dose before you can check a level?

I sent get it on 600 I felt like this on 300 initially too

[browri]

1 minute ago, looking for answers said:

They didn’t tel me just said very low

I sent get it on 600 I felt like this on 300 initially too

Well then maybe this will calm down and you'll adjust. I was on 600mg of the controlled release all at night and I just couldn't tolerate it. I felt physically ill the entire time, and it didn't really ease up at all for me.

[looking for answers]

I hope I tolerate it I don’t wanna play medication roulette 

I’m 300 mg IR 2xday

[Iceberg]

Your right Typically probably don't need a level at 600 but just cuz they feel crappy 

[browri]

Just now, looking for answers said:

I hope I tolerate it I don’t wanna play medication roulette 

I’m 300 mg IR 2xday

Well then something to consider would be to move to the controlled release. My pdoc also seems to think that taking the CR all at night isn't as hard on your kidneys. At least that's what he told me. I stopped taking it before I ever got a level done.

[Iceberg]

I had much better luck with extended release...less side effects 

[looking for answers]

17 minutes ago, browri said:

Well then something to consider would be to move to the controlled release. My pdoc also seems to think that taking the CR all at night isn't as hard on your kidneys. At least that's what he told me. I stopped taking it before I ever got a level done.

Told me he didn’t want CR

[looking for answers]

My blood level was 0.16! Lol

[looking for answers]

need to quadruple to reach the low end

[browri]

Yeah that definitely is a really low level. But I really thinking the CR could help you get to the level you need to be at. I don't understand why the prescribing physician doesn't see that. Strange.

[looking for answers]

I can certainly ask on Monday. I feel awful.  Did last week for 3-5 days as wel adjusting to dose

[browri]

28 minutes ago, looking for answers said:

I can certainly ask on Monday. I feel awful.  Did last week for 3-5 days as wel adjusting to dose

when does your IOP end? And how often can you see a psychiatrist once you're fully OP?

[looking for answers]

Iop tbd, ive been in 6 weeks. I hope to be in another 4 weeks by wel see what they let me. They said 3-4 months , a longer than normal stay 2 weeks ago now have backed off that. Plus insurance dictates some

 

once out as often as the md wants I don’t have an OP md set up through the iop yet

[browri]

Just now, looking for answers said:

Iop tbd, ive been in 6 weeks. I hope to be in another 4 weeks by wel see what they let me. They said 3-4 months , a longer than normal stay 2 weeks ago now have backed off that. Plus insurance dictates some

 

once out as often as the md wants I don’t have an OP md set up through the iop yet

Yeah I was just thinking how long the insurance will let IOP go on for. Hopefully you can get an OP MD soon that knows what they're doing. How are you feeling today on the 600mg lithium? Any better?

[jt07]

47 minutes ago, looking for answers said:

I can certainly ask on Monday. I feel awful.  Did last week for 3-5 days as wel adjusting to dose

How are you feeling irrespective of the side effects? Is your MI better? How is the lithium working for irritability? 

[looking for answers]

10 minutes ago, browri said:

Yeah I was just thinking how long the insurance will let IOP go on for. Hopefully you can get an OP MD soon that knows what they're doing. How are you feeling today on the 600mg lithium? Any better?

No I still don’t feel good on th 600

i think mybinsurance will approve longer due to med changes:

what do u guys mean by maintenance at lower levels. Like that I could feel good at say 0.3 ??

 

thanks for all ur guys help btw

9 minutes ago, jt07 said:

How are you feeling irrespective of the side effects? Is your MI better? How is the lithium working for irritability? 

Ummm it’s a little better in irritability. I felt better pre lithium, but it’s the side effects the restlessness, anxiety, flushing, spacey. At 300 after 4-5 days I felt wonderful , we upped and then I feel shitty again. But I wanna push meds while I can

[Iceberg]

I was thinking like .5 

[looking for answers]

So basically it can be a little under the low therapeutic end but not .16

[browri]

1 hour ago, looking for answers said:

So basically it can be a little under the low therapeutic end but not .16

Based on empirical clinical evidence that has been reported, that would be too low. But some psychiatrists may be okay with levels like that in some patients. It really depends on the doctor. My pdoc always wants to know the blood level and he wants to get you close to it but not at the cost of tolerability. My pdoc says 1000mg is the average dose of Depakote and would like me to have a higher level but is fine with my 43mcg/ml.

[Iceberg]

I've heard of that level when it's an add on for depression 

[looking for answers]

24 minutes ago, browri said:

Based on empirical clinical evidence that has been reported, that would be too low. But some psychiatrists may be okay with levels like that in some patients. It really depends on the doctor. My pdoc always wants to know the blood level and he wants to get you close to it but not at the cost of tolerability. My pdoc says 1000mg is the average dose of Depakote and would like me to have a higher level but is fine with my 43mcg/ml.

Got yah I think he goal may be like

600-900 mg 2x a day I drink ALOt and metaboloze Meds fast so I usually take more of things for effect

17 minutes ago, Iceberg said:

I've heard of that level when it's an add on for depression 

What level

[Iceberg]

TAking only 300-600

[looking for answers]

1 hour ago, Iceberg said:

TAking only 300-600

Got yah

[crtclms]

I take 600mg per day, and have .7 or .8 blood levels. A long time ago, I was started at 900mg, and became toxic. The psychiatrist didn't order any blood tests.

[looking for answers]

14 hours ago, crtclms said:

I take 600mg per day, and have .7 or .8 blood levels. A long time ago, I was started at 900mg, and became toxic. The psychiatrist didn't order any blood tests.

Wel today is calming down a bit like last week the side effects r subsiding

[Rabbit37]

Good to hear, LFA. You've really been through the wringer. 

[looking for answers]

26 minutes ago, Rabbit37 said:

Good to hear, LFA. You've really been through the wringer. 

Yes, thank you!!

[looking for answers]

Not there yet but there is hope

[looking for answers]

Going to 300 mg 3xday

[Iceberg]

Great! Glad ur still tolerating it...keep us in the loop

[looking for answers]

Got some side effects and a feel

a

little goofy but gonna keep going

[looking for answers]

feel like im slipping backwards, upp to 300 mg 2x a day and level was 0.31, now started 300x3 a day

[looking for answers]

.31 is low for 600

mg isn’t itp

[Iceberg]

Ehh it depends on the person 900 mg is like .6 ish  for me but it isn't always linear as 1350 puts me at 1.0 and 1500 is like at the top of the scale 

Also it might still go up a little just cuz u still haven't been on it forever 

[looking for answers]

12 minutes ago, Iceberg said:

Ehh it depends on the person 900 mg is like .6 ish  for me but it isn't always linear as 1350 puts me at 1.0 and 1500 is like at the top of the scale 

Also it might still go up a little just cuz u still haven't been on it forever 

Yeah I’m sure I just almost feel worse, restless, anxious, foggy, lower mood 

 

klonopin sometimes cures the restlesness

 

told pdoc about the increased anxiety and restlessness he said akathisia doesn’t happen from Lithium 

[Iceberg]

No he's right cuz akathisia has to do with dopamine. U experienced the same thing when starting the other two doses right? 

[looking for answers]

Yes, it’s listed as a side effect for

lithium.

 

 

i fell all kinda of weird with dose increases. Just doesn’t seem to be leveling off, and the anxiety is increasing I’ve ready about it on other message boards similar situations and klonopin doesn’t touch the type of anxiety 80% time

[Iceberg]

Another benzo or anxiolytic maybe? 

[looking for answers]

I’m on klonopin n buspar

[Iceberg]

I meant like have you tried other anti anxiety drugs since the klonipin isn't working 

[looking for answers]

Not recently I have in the past