Posted by Ritch on May 24, 2002, at 23:31:50
In reply to Re: Lithium appointment - combined doses? » BarbaraCat, posted by Chloe on May 24, 2002, at 17:54:00
> > Well, I'm still taking the generic for Lithonate, which I guess is plain ol' lithium carbonate. Big Brother HMO's don't encourage any new-fangled meds, I guess.
> >
> > I expressed concern about raising the levels from my current 600mg per day any higher because I don't want to incur any renal damage or otherwise. He suggested taking a full dose at one time, preferably at night. Apparently some new data has shown that taking the full dose at once rather than spreading it out avoids alot of the tremors, renal damage and otherwise. I don't quite get it, but was loath to waste any more of my allotted 20 minutes every 2 months appointment time by asking silly time consuming questions. So, I ask you, my friends - anyone have any data on combined dosing for lithium?
>
>
> Hi Barbara,
> Well, I guess you pdoc had other lithium ideas... I have never heard of taking all the lithium in one dose. I suppose it would not hurt, as (Mitch informed me :)) Lithium does have over a 24 hour half-life. So spreading it out is not essential.
>
> My concern, is the stress the body must endure taking all the lithium at one time. Common sense tells me my kideys would be more traumatized by a huge bolus of lithium in one shot, than smaller amounts throughout the day. But I am no scientist! More like a guinnea pig!
>
> I also know, from personal experience, that when I raised my lithobid to 300 mgs am/600 mgs pm, I began waking up in the morning with a red rash on my face. It seemed to fade as the day went on. I reported this to the pdoc, and she said take the lithobid TID, 300 am 300 eve 300 bedtime, and my mysterious morning rash went away! But 900 mgs was really too much for me to tolerate. I do better at lower li level. More is not always better in my humble opinion...
>
> If you do combine the doses, do let us know it you notice any difference or change. I am glad you are staying at the current dose. I don't always think the blood level (within reason) is as important as how you FEEL when you are BP2.
>
> Yours,
> Chloe
Hi Chloe..Barb,I just *read* stuff a long time ago about combining all of the Li dose at bedtime was a preferred way of doing it. It is supposed to reduce the overall burden on your kidneys' elimination of the lithium. All I can say in personal experience is after 20 years I did *happen* to get a thyroid tumor, and also *happened* to have elevated serum calcium levels (which *can* be indicative of kidney problems). I got CAT-scans done of my kidneys and they were OK. The associated? transient hypercalcemia problem still remains unexplained and is no longer a concern (I have normal serum calcium levels). My advice is to be sure to routinely check your kidney function, TSH, and serum calcium (and other electrolytes) while you are undergoing lithium therapy.
Mitch
poster:Ritch
thread:107313
URL: http://www.dr-bob.org/babble/20020517/msgs/107564.html