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Re: Olanzapine-Lithium and Emesis

Posted by Cam W. on July 30, 2000, at 20:00:35

In reply to Re: Olanzapine-Lithium and Emesis, posted by Jade on July 30, 2000, at 14:22:37

Jade - not to sound like a run-of-the-mill, old medical poop, but you should really have your son's lithium level checked at least 3 to 6 times a year (twice a year for adults) when stabilized. Lithium has a very small therapeutic window (difference between the minimal medically effective dose and the toxic dose). There are a number of situations that can change lithium blood levels, leading to some significant problems (fever, dehydration, vomiting, crash diets, and sodium restricted diets; among other things, usually dealing with reduced body fluid volumes).

Signs of toxicity with lithium are: worsening tremor, slurred speech, muscle weakness &/or twitching, and difficulty walking. It does not sound like your son is toxic, but he may be close.

If you had to do something and since the nausea is most likely due to the lithium, I would probably split the dose to morning and evening doses (breakfast and supper), with the larger dose in the evenings. Also, take the lithium with meals, but his olanzapine can be taken at bedtime.

I am not a doctor. You really should see a doctor and get a requisition for a blood test. He will eventually need one for a refill for his medications. I wouldn't decrease the lithium dose until you talk to a doctor, as well. If you lower the dose too much, you could drop his lithium blood levels below the effective concentration and place your son in a situation where he could have a relapse.

As for the nausea and vomiting, maybe try sipping ginger ale (stir the bubbles out), ginger from a health food store, peppermint candies, dry toast, crackers, or a little Gravol.

Good luck and keep us posted. - Cam


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poster:Cam W. thread:41733
URL: http://www.dr-bob.org/babble/20000729/msgs/41792.html