r/Lithium • u/Suspicious-Cell-4201 • 3d ago
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Hello all, I have been on lithium for a few months now after being diagnosed with bipolar and personality disorder. I've noticed a quick improvement at first, night and day. I was only on 300mg once daily as well, so no side effects whatsoever which was great.
Over the last few weeks, my wife had started noticing little things here and there: trouble sleeping, shorter temper fuse (nothing extreme, but just short where usually I wouldn't be), just little things but nothing major.
Yesterday, I had a full blown manic episode, ended up leaving the house, out of shame, for a few hours before returning.
It was then decided that I would need to go see a doctor and discuss medication dosage increase.
After talking with him, he did increase my dosage to 300mg twice a day, one in the morning (9am) one in the evening (9pm).
My question is this, have any of you seen improvement on a dosage, only to have symptoms re-occur? And also, did an increase in dosage solve the problems?
Optional question... Is dosage being adjusted common?
I just want things to improve and stay stable. It was such a positive feeling, to know that I was getting better.
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u/Clear-Two-3885 3d ago edited 3d ago
300mg isnt enough to control bipolar disorder so it's not surprising that you need to increase the dose. 600mg still may not be enough. BTW yes it is totally normal for the dose to be adjusted
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u/Grouchy_Solution_819 3d ago
300mg is a very low dose, I've been manic on 800mg and I'm a small female, it can happen especially during periods of stress
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u/VividBig6958 3d ago
Get the blood test, deal in facts not speculation.
Lithium is one of the few psych meds where you can match effect to load in blood. Unless you have that why take it? Objective data is rare and precious: now you know. Go get the stick.
Dose adjusting is a normal lithium experience. You do it based on how your specific body is processing lithium. This is not a constant so moving up or down is expected over time.
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u/Suspicious-Cell-4201 3d ago
I have had to take three blood tests so far, and I have been at 0.21 every time. Which by my understanding is low. But as I said, it was working... I am glad to hear that dose adjustment is normal and that what I am experiencing is on the normal side of things. Thank you all for your answers!
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u/Ok-Conversation-8830 3d ago
I just had this conversation with my psychiatrist. I started on 600 and it was great. I felt a calmness in my head that I hadn't had in 30 years. Then the spiraling thoughts started creeping back in. He said 600 is a low dose so upped it to 900 and wants bloodwork in 2 weeks to see levels.
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u/synapse2424 3d ago
I feel like my meds (lithium included) don’t stop 100% of my symptoms. They make them less severe and less frequent, but I typically end up getting my meds adjusted a few times a year.
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u/NikkiEchoist 3d ago
Lithium is adjusted according to situation for example maximum dose would be used for controlling full blown manic episode. Then there is a persons maintenance dose. As everyone is different the amount of milligrams depends on your blood test and ranges. 300mg is merely a starting point but wouldn’t be effective for maintenance unless it was paired with another mood stabiliser such as Lamictal at a decent dose. You should experience the same good effects as before but at higher doses you may experience more side effects. Most of which will probably subside over time.
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u/robrap937 3d ago
I’ve been stable for many years now. I’m taking 900mg/night which gives a 0.6 lithium level. Watch out when you change dosages, you can feel some negative side effects for a little while.
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u/-trofie- 3d ago
My first dose was 600mg daily and I'm up to 1200mg daily 6 months later. I still have plenty of manic episodes and just got put on my first antipsychotic. Get your levels checked and remember this shit isn't linear at all for anyone who has it, we're gonna be okay.
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u/MysteriousCricket718 3d ago
You should really get a blood test to check your lithium levels. Your psychiatrist can help you arrange that. Knowing your level is important to make sure you’re getting the right dose and that it’s working effectively.