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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Greg on August 12, 2000, at 12:16:01
Cam, Sunnely or anyone,
I started Lith on Thursday, 600mgs am, 600mgs pm. 2 questions, is this a high dose? I've had 2 very conflicting reactions ot it, first time I got a little looped but very relaxed, second time I almost went into a panic attack. Are these normal reactions? You know, for a pretty smart guy, I am so uninformed when it comes to meds...
Thanks in advance for the help.
Peace,
Greg
Posted by Cam W. on August 12, 2000, at 12:53:07
In reply to CAM, SUNNELY.....et al - Lithium, posted by Greg on August 12, 2000, at 12:16:01
Greg - Lithium is usually dosed according to a doctor's clinical experience. Many docs use a dose of 15 to 20mg/kg (900mg to 1800mg) in divided doses for acute mania and tend to lower the dose in maintenance therapy; once the acute episode resolves (usually in a week or two). Consider your side effects as transient and should resolve upon maintenance dosage adjustment.
Hang on for a couple of weeks, unless the side effects become intolerable, then call your doc to see how he/she prefers to handle this situation. Usually this involves a slight lowering of dose, but don't do it on your own because of the narrow therapeutic window that lithium has (narrow range between minimum effective dose and toxic dose).
The doc will then adjust your dose to keep you in a therapeutic range of 0.8 to 1.2 mmol/L.
Greg, you say you are uniformed when it come to drugs. That's why we all hang out here. Even textbooks and journals usually don't give an accurate view of how drugs work in the real world. Here is where we hear how these drugs affect people. If it wasn't for boards like this and clinical experience, Effexor™ would have not withdrawl effects, Zyprexa™ would not cause weight gain, and SSRIs would not cause sexual dysfunction (yeah, right! - sarcasm).
Hope this helps - Cam
Posted by danf on August 12, 2000, at 13:05:08
In reply to CAM, SUNNELY.....et al - Lithium, posted by Greg on August 12, 2000, at 12:16:01
greg,
this site has good drug info, as good as you will get. you will have to register, but that is no big deal. it is free.
pretty much normal reactions.
the dose is reasonable but can be reduced for a few days during startup, given your symptoms.
say 300mg 2x a day for a few days.
Posted by danf on August 13, 2000, at 10:01:04
In reply to CAM, SUNNELY.....et al - Lithium, posted by Greg on August 12, 2000, at 12:16:01
greg,
I made the assumption that this was not for an acute manic episode.
the side effects are most likely due to a high peak blood level of Li as it gets into your system.
some times taking it with food helps, as food slows the absorption some but does not affect the total amount absorbed (for all practical purposes).
once the concentration has stablized, the side effects should decrease.
some times the slow release version has less side effect as it does not produce as high a peak in blood levels.
Posted by Greg on August 13, 2000, at 10:50:33
In reply to Re: CAM, SUNNELY.....et al - Lithium, posted by Cam W. on August 12, 2000, at 12:53:07
Cam,
As usual your advice is right on the money. I will watch everything very closely and stay in contact with my doc if things get out of control. I also have my first therapy tomorrow afternoon and I'm hoping that will help. The last 3 times I've taken the Lith I haven't had any noticible side-effects, so maybe things are start to level out. I'm actually feeling better than I've been in many weeks.
Thank you, my friend for your always sage and dependable advice! I will always feel better knowing that I can lean on you for help.
If you EVER need to know anything about Document Control...I'm your man!
You, sarcastic? I can't believe that would ever happen..... ;^)
Peace,
Greg
This is the end of the thread.
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