Lithium at low doses for a soft bipolar II. Just how low can you go?

Question

I have tried Lamictal. While it worked on my mood, I really could not tolerate it at all, twitching all over, and an intractable chronic headache. Depakote did nothing on my mood, I was just sleeping and eating. Lithium had really helped my mood, but had caused hypothyroidism for me. I still went back to it after trying the Lamictal and the Depakote, along with a synthetic thyroid hormone. I also am going to try to stick to 450 mgs, I read so much about how it can help at even low doses. Still, I have a new set of side effects, perhaps toxicity. I will be testing tomorrow. I feel like I am trembling all over, very shaky, foggy brain, and this is at only 450 mgs. Would I possibly get any benefits on my moods at just 300 mgs?

Answer 1

Hello.  I have been on Lithium for over 10 years.  I am currently on 900 mgs with a blood level of 1.0.  I have taken doses as high as 1350 mg.

I doubt that you are experiencing Lithium toxicity because 450 mgs is a low dose.  The side effects that you mention could just be side effects.  When I first started, I had trembling, diarrehea, extreme thirst and felt foggy.  All my side effects went away with time.  I also take my medication with food and milk and that helps as well.

I am also hypothyroid as a result of 10 years of Lithium.  I take synthroid every morning.

300 mg might help...but it is hard to say.  What matters it what the level of lithium is in your blood.  MOST studies say the "therapeutic level" that is needed is 0.8-1.2 in your blood.  But that is probably more accurate for traditional Bipolar disorder.

But, since you are "soft bipolar 2," a low dose might help you.  

There are different "forms" of Lithium.  It sounds like you are trying Eskalith ER.  If that does not work or if the side effects are too much, as for another version.  I tried two versions until I got settled and I take Eskalith ER now.  It is better on my stomach.

Also, have you tried Abilify?  That is an anti-psychotic but is used in treating Bipolar with some pretty decent results.

Lithium takes some time to get used to, but it has been so helpful in my treatment of moods that I would not change it.  Good luck.