Litihium

Hi Jamison,

Lithium is dosed by blood testing. It is the only psychiatric medication handled this way. It allows for accurate dosing for each individual patient. Every body processes medications a little bit differently. I tend to be sensitive to medications and get a therapeutic dose of lithium at 600mg, but I can go as high as 1200mg (when symptomatic) and stay within a good blood serum level.

How the body uses lithium changes along with episodes. The following quote is from the official FDA information on lithium: "The ability to tolerate lithium is greater during the acute manic phase and decreases when manic symptoms subside."

Also from FDA official drug info:


developed is not known. Recovery followed discontinuance.



Lithane Dosage and Administration


Acute Mania

Optimal patient response to lithium carbonate usually can be established and maintained with 600 mg t.i.d. Such doses will normally produce an effective serum lithium level ranging between 1.0 and 1.5 mEq./l. Dosage must be individualized according to serum levels and clinical response. Regular monitoring of the patient's clinical state and of serum lithium levels is necessary. Serum levels should be determined twice per week during the acute phase, and until the serum level and clinical condition of the patient have been stabilized.


Long term Control

The desirable lithium levels are 0.6 to 1.2 mEq./l. Dosage will vary from one individual to another, but usually 300 mg t.i.d. or q.i.d will maintain this level. Serum lithium levels in uncomplicated cases receiving maintenance therapy during remission should be monitored at least every two months.

Patients abnormally sensitive to lithium may exhibit toxic signs at serum levels of 1.0 to 1.5 mEq./l. Elderly patients often respond to reduced dosage, and may exhibit signs of toxicity at serum levels ordinarily tolerated by other patients.


N.B.

Blood samples for serum lithium determinations should be drawn immediately prior to the next dose when lithium concentrations are relatively stable (i.e., 8–12 hours after the previous dose). Total reliance must not be placed on serum levels alone. Accurate patient evaluation requires both clinical and laboratory analysis

Is he using caffeine to cope with stress? That may play a significant role in anxiety and sudden mood changes.