Question:
I was diagnosed with manic depression a year ago and since then I was on tegretol and now lithium. I was started at 900 miligams a day and since then it has been raised two more times to 1500 miligrams. My doctor expressed a concern that there was no change in my blood level from 1200
to 1500 and its still much to low I believe he said it was 3 or.3. Today
he increased my level again to 1800 miligrams a day. I go for another
blood level in a week. My doctor didn't sound too encouraging that one
more pill would change my level he also was very concerned about the fact
that I am taking so much. Has anyone had this problem? has there been
anyone who has taken lithium with another manic depressive drug and it
works?
Answer:
My own experience is that your levels should be higher than .3. The
therapeutic range is considered .7 to 1.3 or so. You may well have to go
to another med, sad to say. that'd probably be depakote. Don't be
scared, however. There are always options.I tried Lithium for a while and had no positive results, if anything they
were negative. At that time I was seeing a general practioner but he knew
more than a lot of family doctors would about this but he was rather
conservative in his approach since he isn't a psych doctor. After Lithium
he switched me to Tegretol, I took it for several months and it did
absolutly nothing for me. It was then that I decided to find, and I did, a
psychiatrist who of course would have a more specialized education to
treat this illness. I am now on Depakote, for the last month and a half or
so. So far it is doing better than the other meds but still have a way to
go.
If the doctor seems uncertain about your treatment or is not a doctor who
specializes in medical/psychiatric illnesses I would consider swiching
docs.
0.3 is a really low level, especially for the amount you are taking in.
How long has it been since you started the lith? If it's any
consolation, my lith was recently increased to 1200mg a day. I'm working
with two doctors. The one who takes my levels said that we should wait a
month before taking blod, he hinted it would take that long for my body
to adjust to the extra 300mg.
For now, just enjoy the relief your getting from the lith. I know, it's
a hell of a lot easier said than done, especially when you have a worry
you might end up off of it and on another. Sounds to me like you're
doing pretty damn good.
I wouldn't worry too much about switching meds. Maybe Depakote or
something might work *even better* than the lithium? or, maybe the
lithium, even at the low levels, might stabilize you wtih the addition of
something else, like tegretol.
I'm in a bit of transition myself right now. Although none of the doctors
explicitly said this, but it looks like I'll be on lith. and tegretol in
a couple of months, when things stabilize a little bit. I hope this was a
little helpful. Until then, take it one day at a time.
