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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Bob on April 18, 2005, at 16:38:02
I have been prescribed Eskalith CR 450mg per day, and I was wondering what the better way to take it would be: the whole 450mg tablet at bedtime, or 225mg at night, and 225mg in in the morning or middle of the day? It seems to me that the first scenario would be the best for keeping drowsiness at bay, but the latter split dose would keep the blood levels more constant.
Any thoughts?
Posted by Lazarus on April 19, 2005, at 20:31:19
In reply to Ideal Lithium dosing?, posted by Bob on April 18, 2005, at 16:38:02
I take 600mg (two 300 mg tablets) lithium daily, all at bedtime, and it does the job of keeping me emotionally stable.
Lazarus
Posted by Bob on April 19, 2005, at 22:41:33
In reply to Re: Lithium-600mg daily, posted by Lazarus on April 19, 2005, at 20:31:19
> I take 600mg (two 300 mg tablets) lithium daily, all at bedtime, and it does the job of keeping me emotionally stable.
>
> LazarusThanks for your response. Since my posting, I read that Lithium is commonly dosed all at bedtime, so that's what I'll do.
Does the 600mg of Lithium make you tired?
Posted by Lazarus on April 20, 2005, at 20:06:05
In reply to Re: Lithium-600mg daily » Lazarus, posted by Bob on April 19, 2005, at 22:41:33
> Does the 600mg of Lithium make you tired?No it doesn't. I just makes me feel calm.
Lazarus
Posted by anneL on April 20, 2005, at 23:47:15
In reply to Re: Lithium-600mg daily, posted by Lazarus on April 19, 2005, at 20:31:19
Hi Lazarus and other Lithium users,
My pdoc is starting me on Lithium to augment Effexor. He is starting me on 300 mg. at bedtime x 4 days, then 600 mg. at bedtime x 4 days, then 300 mg. in the morning and 600 mg at bedtime x 5 days at which time I am supposed to get my blood tested.
What do I need to know about taking Lithium? Any precautions, side effects, etc? I have an upcoming surgery will I need to stop Lithium prior to surgery?
I don't need any other disturbances in body image presently. Is it a big weight gainer? Is weight gain dose dependent? Thanks for all responses.
:) anneL
Posted by ed_uk on April 21, 2005, at 7:44:34
In reply to First-time Litihuim user - What do I need to know? » Lazarus, posted by anneL on April 20, 2005, at 23:47:15
Hi Anne,
>He is starting me on 300 mg. at bedtime x 4 days, then 600 mg. at bedtime x 4 days, then 300 mg. in the morning and 600 mg at bedtime x 5 days at which time I am supposed to get my blood tested.
In the treatment of depression, 600mg/day Li carbonate may often be adequate to 'augment' an antidepressant. Side effects are milder on low doses.
Regards,
Ed.
Posted by Bob on April 21, 2005, at 9:13:11
In reply to Re: First-time Litihuim user - What do I need to know? » anneL, posted by ed_uk on April 21, 2005, at 7:44:34
Check this out - it's a good summary of the issues, etc. with Lithium.
Posted by Cathybddmom on April 21, 2005, at 10:54:59
In reply to First-time Litihuim user - What do I need to know? » Lazarus, posted by anneL on April 20, 2005, at 23:47:15
Anne, is there any chance that you might have a thyroid problem? The reason I ask is because taking Lithium can make a thyroid problem much worse!
I posted this info on another thread today but Lithium can definitely affect your thyroid! we learned the hard way! If there is even a chance that you might have a thyroid problem I would really encourage you not to take Lithium but to find something else to take instead.
Cathybddmom
Here is a copy of some things I have copied about Lithium.
Lithium
Lithium is the most frequent mood stabilizer prescribed to those with bipolar disorder (manic depression). Lithium helps to even the highs and lows of mood associated with this disorder.
Major Precautions and WarningsDietary
Because lithium is related to sodium, it is important to drink plenty of fluids (avoid caffeinated beverages) and have an adequate supply of dietary salt. Too little salt can cause the body to hoard lithium instead, and too little water will decrease urination, which again can lead to lithium buildup.Pregnancy/Breast-Feeding
Experts recommend that lithium use be discontinued during at least the first trimester of pregnancy, and throughout pregnancy if possible. Breast-feeding mothers should not take lithium.Drug Interactions
Medications that can interact badly with lithium include:
· ibuprofen (Advil, Motrin)
· naproxen (Aleve)
· diuretics
· SSRI antidepressants (Prozac, Luvox, etc.) and several others.Make sure your doctor has a complete list of both prescription and over-the-counter medications you take regularly or occasionally. Also be sure to tell other doctors who may prescribe for you that you are taking lithium.
The combination of haloperidol (Haldol) and lithium has caused extremely serious complications in a small number of patients. When these two medicines are prescribed together, the patient should be monitored very closely for rigidity and/or very high fever.
Geriatric Use
Elderly patients may develop lithium toxicity at much lower serum levels and so should be monitored appropriately.Miscellaneous Cautions
Patients with psoriasis should use lithium with caution, as this medication is known to make psoriasis worse.
Care should be used if the patient has:
· cardiovascular disease
· ANY THYROID DISEASE, or
· leukemia.
This is not an all-inclusive list. Read patient information that accompanies prescription and discuss this medication with your doctor.these were comments made on a board about thyroid problems & lithium:
1. I have been on lithium for just about 5 years. I didn't like it at first, but now, it is great. I did gain about 15 pounds at first, but it could have been cause I was in my late 30's to begin with. I gradually took off the 15 pounds by joining weight watchers and exercising more. I am now going to try to lose about 5 more pounds as I was slightly overweight when I first got on the lithium and I am small framed with not a whole lot of muscle. I am presently 5'4" and 116 pounds and 43 years old. I daily take 1 to 1-1/2 of the 450mg escolith time released form. My blood level ranges from .29 to .33 which my psychiatrist approves of, even though it is lower than the recommended standard. I did develop a thyroid problem from the lithium and now take synthroid, but it is an ok trade off, side effect wise. I have no hand tremors or other major side effects associated with lithium. Let me know if you have any more questions.
2. I was on lithium and depakote at the same time. Now I'm off depakote. Between the two of them, I've gained 70 pounds, and I've tried everything to get it off-it's impossible. Something won't let me. On lithium i got a goiter and i turned hypothyroid. It sucks. I seriously don't recommend lithium to anyone. I know it is a good drug and it also helps a lot, but to me its not worth it. Now it is too late.
3. Anyway regarding the question you asked re the Lithium and does it affect the thyroid gland ... yes, it can do. It's called Hypothyroidism and means the thyroid gland is underactive and not producing enough thyroid hormones through your body. The main effect or symptom is excessive tiredness to the point where you can even feel depressed if you weren't already. This is easily fixed. Your doctor should be giving you regular blood checks to check your thyroid hormone replacement level about every 4-5 months. You can be given replacement hormones in the form of pills which are called levothyroxine. This is very very common among people on Lithium and if it is going to be a problem then usually will start to play up sometime after the first 6 months, and is more prevalent in women.
Posted by anneL on April 22, 2005, at 1:31:22
In reply to Re: First-time Litihuim user - What do I need to know?, posted by Cathybddmom on April 21, 2005, at 10:54:59
Thanks Cathy!
I have been treated for hypothyroidism for the last 20 years. I take Synthroid 0.15 mg. every day and my TSH is always within normal limits. My pdoc said we will check my TSH again in a few weeks. We can always adjust my Synthroid dose as needed. I hope that this medication is not more of a pain than it is helpful! Thanks again for the comprehensive information. Very helpful,
anneL
Posted by anneL on April 22, 2005, at 1:46:33
In reply to Re: First-time Litihuim user - What do I need to know? » anneL, posted by ed_uk on April 21, 2005, at 7:44:34
Thanks so much Ed. I think this will be a good target dose for now. :) anneL
Posted by anneL on April 22, 2005, at 1:49:35
In reply to Re: First-time Litihuim user - What do I need to know?, posted by Bob on April 21, 2005, at 9:13:11
Bob, Excellent link. Thank you very much. anneL
Posted by Bob on April 22, 2005, at 16:02:51
In reply to Re: First-time Litihuim user - What do I need to know?, posted by Cathybddmom on April 21, 2005, at 10:54:59
Cathy, do you know why caffeinated drinks should be avoided when taking Lithium? I've never actually heard that before.
Posted by Lazarus on April 22, 2005, at 17:55:44
In reply to First-time Litihuim user - What do I need to know? » Lazarus, posted by anneL on April 20, 2005, at 23:47:15
Your doctor is right when he increases your dosage gradually; 300 to 600 to 900 mg is standard practice for the drug.
Lithium has a few side effects. I have found them to be:
1. Slight weight gain (not much, but noticeable).
2. Loss of libido.You may be able to get by with only 600 mg instead of 900 mg. Using the lowest possible dosage which is effective will minimize the above-noted side effects.
Lazarus
This is the end of the thread.
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