How often should you get your lithium levels checked?

I've been on lithium for about 1 1/2 years now. My pdoc has only ordered blood work once. I'm on 450mg 4 times a day. Is this normal or should I mention it?

I believe when I was on it, it was every 6 weeks. Yea you definitely need it checked!! From what you've mentioned, I really think you need a new pdoc. Lithium toxicity is serious. I got it and my friend had to get a transfusion because of it. Watch out for tremors.

I get mind checked whenever I am IP, about to have dose increased or if I haven't had one in 3 months even if I'm feeling fine. Be careful.

I didn't realize it had to be so often. I'll definitely mention it my next visit. I think I need a new pdoc too but with insurance and the awkwardness of them all being in the same office my mom doesn't want to switch. My current pdoc visits are cheap.

My former pdoc only checked my level once and she didn't recheck until I was inpt and I was toxic. My level was 2.9 and I think therapeutic is 0.4-0.9

I had vomiting, diarrhea and my whole body itched and it took several days of being off it before I felt better.

Oh really. I'll definitely have mine checked soon. I don't want to be toxic at all.

You're on a really low dose but you should still get it checked more often. I was on 1800 mg and ended up in the ICU for a week and on dialysis and I my levels were around 4.6 which is extremely toxic. My doctor didn't know what what the heck she was doing.

I'm on Depakote now, and have a better doctor.

I get my levels done every 6 months. I've been on 900 mg lithium for 6 years.

My pdoc checked it about every other month. So did my husband's pdoc, and he STILL ended up with toxicity. 1800mg/day is a pretty high dose to not be monitored regularly. I would insist on being checked at least every 90 days at a minimum.

Sorry to say it, but IMHO your psychiatrist is an idiot. Lithium levels should be checked regularly, regardless the dose. The reason isn't only for toxicity, but also to see if you're in the therapeutic range (which is pretty narrow).

In all seriousness, your situation is pretty fuked up. Who gives a flying flip if your mother doesn't think you should see another doc? You're 23 years old. You're an adult. If you're as sick as you seem and your parents aren't able to take care of you, the government will. Get on a computer. Apply for social security benefits - that's what they're there for. Your entire life needs a reboot.

ETA: Sorry for being so blunt - I'm not trying to criticize and of course I'm not walking in your shoes - but better to put it straight than to have someone commit suicide because of this illness.

I want to add how I got toxicity... my pdoc was doing blood work but didn't follow up with results in a timely way. He ended up calling me two weeks later and told me I'm toxic and my thyroid is being effected. I had to take thyroid meds for years after that. So my point is, when you get tested then YOU call the pdoc in 2-3 days and you ask about your levels. I've worked with many doctors and trust me, blood work just floats around the office and doesn't get looked at unless the patient calls! A few offices were like this. Yea, time for a better system people!

Your dose is high. I would never take that much.

Your Pdoc sounds reckless and stupid

My thoughts exactly. This dr doesn't seem to take much care in his patients. Going that long without blood work is insane after what I went through. Can you call you pdoc this week and just ask for a slip to get blood work done?? You need it so bad.

Thanks everyone. I'll mention it in my note when I see him Monday.

I also don't know anyone that take lithium 4 times a day.

That's weird. He gave me the option of taking 2 at a time twice a day or 1 every 3 hours. It's hard for me to swallow pills so I chose the 1 at a time.

I think it depends on whether you are on the time released or not. I was always on time released and just took it all at the same time. My husband was on immediate release and took it twice a day.