Posted by ed_uk2010 on February 28, 2012, at 1:22:47
In reply to Re: Saphris - more reactions - lithium question » Christ_empowered, posted by Solstice on February 27, 2012, at 19:27:47
> Thanks for the input CE.. she's been on Lithium about four or five weeks now. five days at 300mg, five days at 600mg, then five days at 900 mg. had a blood level done a week ago - it was real low - .7. Saturday night she had terrible tremors, so the on-call PDoc said to go down to 600mg.
0.7 isn't that low. It's certainly enough to cause adverse effects, and could be an effective level. I've noticed that guidelines from the US seem to recommend higher levels than elsewhere, which is probably why your doc considers it to be low.
Here, we tend to use 0.8-1.0 for acute manic episodes eg. in hospital, 0.6-0.8 for hypomania and bipolar prophylaxis. 0.4-0.6 is effective for prophylaxis in some cases, it might be suitable for Bipolar II cases where hypomania is relatively mild but an adjunct to antidepressants is required.High-dose lithium is no longer a popular first-line choice for acute severe manic episodes because it is not well tolerated. More moderate doses have a major prophylactic role, however. Acute mania is more likely to be treated with antipsychotics, which tend to work more rapidly. Now that lithium is mainly used for prophylaxis, 0.6-0.8 is the most commonly desired blood level in bipolar disorder.
Since your daughter dislikes lithium, perhaps your doc would consider stopping it and allowing her to try Saphris at the 5mg dose?
poster:ed_uk2010
thread:1011787
URL: http://www.dr-bob.org/babble/20120221/msgs/1011885.html