Lithium Question

Hi everyone,

I know I don't come around much any more.

I was started on Lithium again about 2 weeks ago. This time I really glad because I felt horrible and I didn't realize how horrible I felt. I feel a lot better.

Right now I'm on 300 mg. I know that's a low dose but I'm extremely sensitive to medicines and also very allergic and have horrible reactions to lots of medicines, chemicals, and even foods.

Anyway, I'm allowed to titrate up to 600 mg. I took 600 mg last Sunday and felt terrible, just feeling loopy and out of it. I took it 12 hours away from my first dose as instructed. So, I went back to 300 mg the next day.

The thing is, I'm having a lot of irritation in the evening. I have dysphoric mania so irritation and intense anger is pretty common, it's what I need relief from. I'm so much better during the day, but around 4:00 p.m. I start to get irritated again.

I see my doctor at the end of the week, but until then I'm wondering if anyone else notices this happening? I'm wondering if I need to take my 2nd dose at around 4:00 p.m. (my first dose I take at about 7:30 a.m.)

I really like the nice calm wall I get that keeps my emotions in check and I don't like getting irritated in the evening. I'm also worried about increasing since it makes me feel terrible.

(((Faerie moon x))) One thing I know about Lithium is you have to drink incredible amounts of water so that your body can metabolize it and so that you don't become toxic. I'm sure your Dr. has informed you of the lab tests (serum levels) that will need to be done at regular intervals. It's very important you don't miss them.

You could ask you DR. for the extended release form if he/she thinks that would be of any benefit. In the meantime ask your pharmacist if taking the med closer together would be safe.

Feeling loopy is a listed side effect [cognitive impairment, impaired coordination, weakness] symptoms that may go away with continued use of the medication.

I hope this helps you in some way. Best wishes.

Hi there, are you taking lithium alone? I get the same thing - my irritation gets worse as the day goes on and late afternoon can skyrocket into a full blown meltdown. I found that if I take my lithium before bed and my other med (abilify) in the morning, I'm a little more leveled out. I dont know if this is an option for you, but it might be something to talk to your dr about. I know how you feel and I'm sorry this is happening to you, it's not fun. I'm also very sensitive to meds and can't tolerate a lot and so it's a bit of a tight rope walk trying to figure everything out. Let me know how it goes okay?

I get the super irritation and intense anger too. More often than not, it starts for me a bit later in the day too. My theory is that people with bipolar are more sensitive to weather changes and time of day. But anyways, I would say go ahead and take that 2nd dose at 4pm. That's not too far off. Stay hydrated. Maybe take it with a big glass of water and a bit to eat. Maybe even take it with dinner. If taking it with food doesn't help, I would suggest talking to the doc.

I believe there are some people that take their doses three times a day. I love Lithium for my moods but wrecked havoc on my body. I'm now on Depakote.

Thank you for all the responses. It's good to hear that others have a similar issue.

I do drink a lot of water all day long. I started cutting back on soda last year and now I'm down to maybe 1 or 2 a month as part of my attempt to lose weight. (Which hasn't really worked.) The only other thing I drink is one cup of tea in the morning after I get to work. (I don't drink coffee that often either.)

I also take my lithium in the morning with my breakfast. The label says to take it with food, so I do that.

I'm supposed to titrate up to 900 mg taking one a.m. and one noon-ish, and the last in the evening. I think it will be too much for me. I was on 1200 mg in 2010 for about a month and I couldn't handle it. From before I know 600 mg gives me tremors after a few weeks.

I'm also supposed to be taking clonezapan at night but I have been too afraid to take it. The pharmacist said it will make me sleepy at first and decrease over time. I want to take it on a night when I don't have to get up for work in the morning because I'm afraid it's going to make me sleep and I'll be too loopy to drive in the morning. I had a co-worker get arrested for DUI and child abuse because she was sort of loopy from her Xanax and had her kids in the car. She spent over a month in jail from it and lost her job. Anyway, I'm the only driver in my household so I freak out when I'm worried I'll be incapacitated.

That's the great irony, I have too much anxiety to take my anxiety medicine. But I feel it might help the evening irritation without having to increase my lithium dose.

So an update.

Yesterday I felt like I was heading down the road to another mixed explosion. I was getting so irritated at work and then crying in the car on the way home. I was getting confused from so many racing thoughts, etc. So when I got home I took a 2nd dose of lithium with my dinner.

This time I didn't feel loopy and crazy, and before bed I was already feeling more even and better. So maybe I just titrated up too fast last time, I just needed to adjust to 300 mg before jumping up to 600 mg.

I'm still nervous to take the anxiety med. I think I'll try it either tomorrow night or Saturday night.

Thanks for all the advice.