Posted by CareBear04 on March 18, 2005, at 17:52:45
In reply to Lithium poisoning on low dose??, posted by sac on March 12, 2005, at 12:45:30
hey stacey-- i take 450mg of eskalith cr, too. regular lithium makes me sick as a dog so i can only take brand-name.
lithium is a crazy drug. last summer, i was on a dose of 1800mg, and my lithium level was only 1.12. even so, the side effects like thirst and tremor got a lot worse, so i dropped to 1350mg, which has been my dose for most of two years. in the fall, i started having symtpoms like yours, and i had a lithium level of 1.7. my pdoc had me go off lithium for a few days, then restart at 900mg. at that dose, i got severely toxic at 2.7. no doctor has been able to explain the wacky levels. during that period, i was losing weight, but there's not a clear connection between nutrition and lithium levels in the way that there is with hydration.
i stayed off lithium for a few months and took lamictal. in january, i restarted lithium and went as high as 750mg (450 eskalith and 300 lithobid). i'm at 450mg currently, and i think i'm going to stay put. my level at this dose is around .5 like yours. i wish i knew why my body could metabolize a lot more lithium previously.
regarding lithium poisoning on 450mg-- it's possible but not likely. things that would increase the likelihood include dehydration, pain meds like advil or motrin, and water losses from sweating. since lithium is like a salt, if you have low sodium levels, your body will hang onto more lithium. since lithium is renally excreted, if your kidney function is decreased, your body can't clear out lithium properly and your levels will be higher.
diarrhea and fatigue happen when you're toxic, but, unfortunately, they're also side effects that occur with a therapeutic lithium dose. both eskalith and lithobid are easier on the stomach than regular lithium, but some people do better with one or another. taking lithium on a full stomach helps me. i don't think it affects the level; it just impacts the rate of absorption.
even at only 450mg, my doctor has me get a level every week, but i think that's excessive. my previous doctor had me get a lithium level, electrolytes, and kidney function tests once every 3-4 weeks and thyroid tests maybe every six months. at that point, we were experimenting with different lithium levels, but once you have stable levels at a dose, you don't need tests as often.
usually people start getting toxic around 1.5, but maybe you're very sensitive to lithium and are having symptoms at a lower level. between .5 and 1.5, there's a lot of room so i would guess you're not toxic, but if you're worried, definitely get it checked. oh, here's a determining factor for me-- how's your coordination? can you walk in a straight line? do you have tremors? can you speak clearly? can you focus your eyes? at higher doses but no toxicity, i was sleepy and foggy-headed but not looking intoxicated. if you look and feel drunk, your level is probably too high.
i hope you're feeling better by now!
poster:CareBear04
thread:470052
URL: http://www.dr-bob.org/babble/20050317/msgs/472597.html