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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Squiggles on October 3, 2002, at 8:20:09
How often do you, of those who take lithium,
get your lithium blood levels measured? And
how long have you been taking it;thanks
Squiggles
Posted by Ginjoint on October 3, 2002, at 9:03:14
In reply to lithium monitoring schedule, posted by Squiggles on October 3, 2002, at 8:20:09
I'm no longer on lithium (had to stop because the tremors got so bad), but I was for about 13 years. At first, I had my blood checked about every three months. As time wore on, and it became apparent that I was on a good therapeutic dose, I had it checked once a year by my internist. BTW, lowering the dose didn't help with the tremors -- it was as if something just switched in my body after all those years and any amount of it caused me to shake very badly, which was a shame because it really helped level me out.
Posted by Squiggles on October 3, 2002, at 9:12:44
In reply to Re: lithium monitoring schedule, posted by Ginjoint on October 3, 2002, at 9:03:14
Hi Jinjoint,
What are you taking now?
My concern is that my dose is too high for me;
i tolerate the drug, but in the past two years
or so (taking it over 20 now) i have had some
symptoms, which i am pretty certain are due
to the lithium. The thyroid went down eons
ago (in the 4th yr of taking it and i am since
then taking Synthroid - this presents an
adjustment problem with the lithium);I asked for lowering of the li dose, but my blood
level (taken yearly) shows the therapeutic range -
i.e. 0.60 - 1.2;Nevertheless, i feel that the dose is too high
due to these symptoms i recognize; tremor in the
back of the head is one, but that may be due to
a withdrawal experience with clonazepam. There
are many others.I think this drug is about the best we have in
the "armamatorium" [great word - reminds me of
armadillos] of antipsychotics and antidepressants,
but i think on this side of the ocean they tend
to give too high a dose. I recall reading something
by Schou who advises a more liberal yet effective
dose regimen.(btw, it is through personal experience that i
know when the symptoms are due to li or not -
self-experimentation);Squiggles
Posted by Ginjoint on October 4, 2002, at 6:55:44
In reply to Re: lithium monitoring schedule » Ginjoint, posted by Squiggles on October 3, 2002, at 9:12:44
Hi Squiggles...
You asked what I'm on right now -- I take Trileptal, Prozac, and Buspirone. I'm not sure if this mix is really working, though. The Buspirone really helps with anxiety, but I may need to up my Prozac dose. Anyway, trust your instincts. You know your body better than anyone. I'd ask my doc again about trying to lower the dose. Unfortunately, in my experience lowering the dose didn't make the tremors go away, but that sure as hell doesn't mean it won't help you. Good luck.
Ginjoint
Posted by Squiggles on October 4, 2002, at 7:26:07
In reply to Re: lithium monitoring schedule, posted by Ginjoint on October 4, 2002, at 6:55:44
TRILEPTAL:
http://cpha.infinetcomm.c
om/content/hcp/tools/cps_cnp_updates/trileptal.cfmPROZAC:
http://www.mentalhealth.com/drug/p30-p05.html
BUSPIRONE:
http://www.biopsychiatry.com/buspir.htm
Ginjoint,I'm sorry you have to take so many drugs - i say
this because i don't like polypharmacy - but
i am certainly more ignorant than your doctors,
so they know what is good for you in general.I find lithium great, but because the toxic
side effects can go over the therapeutic limit,
what i do now (since my dr. refuses to lower
the dose) is skip one now and then. I skip one
of the 3 (900mg per day) when the diarrhea, and
the dry membranes and the extreme body heaviness,
very frequent urination, etc. increase.I would like to manufacture a li-detector, but
i don't know anyone with the technical expertise.Squiggles
Posted by Chloe on October 5, 2002, at 13:05:38
In reply to Re: lithium monitoring schedule » Ginjoint, posted by Squiggles on October 4, 2002, at 7:26:07
> I'm sorry you have to take so many drugs - i say
> this because i don't like polypharmacy - but
> i am certainly more ignorant than your doctors,
> so they know what is good for you in general.
>
> I find lithium great, but because the toxic
> side effects can go over the therapeutic limit,
> what i do now (since my dr. refuses to lower
> the dose) is skip one now and then. I skip one
> of the 3 (900mg per day) when the diarrhea, and
> the dry membranes and the extreme body heaviness,
> very frequent urination, etc. increase.
>
> I would like to manufacture a li-detector, but
> i don't know anyone with the technical expertise.
>
> Squiggles
>
>Squiggles,
Currently, I am not taking a very large dose of li, so my pdoc doesn't think it necessary to check it very often. I was taking 300/day, now it has been raised to 450/day due to rapid cycling and feeling of grandure...
You say your range is between .6 and 1.2. But there is a *huge* difference in how one feels depending where you are in that range. When my level (in the past) was up around 1.0, I was feeling really crummy. I had an awful tremor, diarrhea and felt kinda blah. I found if I decrease the dose the smallest bit, I felt better. If my level is over 0.8, I just feel awful. So maybe you could talk to your pdoc about being on the LOWER end of the therpeutic range? Also, I find the long acting forms of lithium are much more tolerable. "Lithobid" or "Eskilith CR" give a much smoother and gentler ride for me. Do you have the long acting forms where you are?
And yes, I definitely agree lithium is also good for distorted/mild psychotic type symptoms. This is a blessing for me since I can't take AP's anymore due to TD...Hope you feel better...
Chloe
Posted by Squiggles on October 5, 2002, at 14:37:24
In reply to Re: lithium monitoring schedule » Squiggles, posted by Chloe on October 5, 2002, at 13:05:38
Hi Chloe,
How did you get TD? Was this from another
anti-psychotic?I would like to lower the li dose; yesterday i experimented
with lowering even more, but unfortunately my
head started feeling very funny. Since my
cerebral episode (when withdrawing from
clonazepam), i will do anything to avoid
that stroke/seizure thing... maybe i am in the right
range. I really don't know. I feel so much
better when i lower the lithium dose, but then
my head might explode.I have asked my dr. 3x i think - i don't know
why he does not lower it - maybe it has something
to do with vagueness in adjusting the Synthroid
with it ... it is a curiousity to me that the
Synthroid was reduced so greatly and yet the
lithium kept at the same level;Anyway, i appreciate your reply on this.
Squiggles
Posted by Chloe on October 5, 2002, at 18:39:28
In reply to Re: lithium monitoring schedule » Chloe, posted by Squiggles on October 5, 2002, at 14:37:24
> Hi Chloe,
>
> How did you get TD? Was this from another
> anti-psychotic?Hi Squiggles,
I got TD from years of Mellaril use. It worked so well in controlling my distorted thinking, it was really tough to stop. Ever since D/Cing it, I have never really been "right." My thinking is just a little off. Lithium is the next best thing...Unfortunately even the atypical AP's cause my tongue to go.> I would like to lower the li dose; yesterday i experimented
> with lowering even more, but unfortunately my
> head started feeling very funny. Since my
> cerebral episode (when withdrawing from
> clonazepam), i will do anything to avoid
> that stroke/seizure thing... maybe i am in the right
> range. I really don't know. I feel so much
> better when i lower the lithium dose, but then
> my head might explode.Gee, let's not have your head explode! That would be awful. I do think it's too bad, though, that you doc won't really sit down and discuss stragedies to make you feel more comfortable...
> I have asked my dr. 3x i think - i don't know
> why he does not lower it - maybe it has something
> to do with vagueness in adjusting the Synthroid
> with it ... it is a curiousity to me that the
> Synthroid was reduced so greatly and yet the
> lithium kept at the same level;Have you ever asked you doc for the controlled release or long acting form of lithium? This way you don't have to lower your daily dosage. But you might feel better. The controlled release goes into the blood stream at a more even pace and doesn't give me the shakes as badly. If you get "Lithobid" the pill is enteric coated, so it's not even digested in the stomach so there is no nausea and for me no diarrhea. You might ask about it...
> Anyway, i appreciate your reply on this.
>
> SquigglesNo problema! ;)
Chloe
Posted by Squiggles on October 5, 2002, at 18:53:41
In reply to Re: lithium monitoring schedule » Squiggles, posted by Chloe on October 5, 2002, at 18:39:28
Hi Chloe,
Mellaril rings a bell - it think something
problematic; here is a link:http://www.fda.gov/medwatch/safety/2000/mellar.htm
With lithium dose is important - yup, each individual
can function best at a different dose on it.Thank you for all your constructive comments;
I have asked for the slow-release, but it is not
available in Canada, at least not 3 yrs ago when
I asked.I may be really off on whether i need a lower dose
or not; after all the daily diarrhea may be because
of something else - but there are marker lithium
dose symptoms from what i have read.My husband says i read to much and it has turned
me into a hypochondriac. That's possible.Anyway, thank you again.
Squiggles
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