Posted by linkadge on August 3, 2011, at 10:11:19
In reply to Re: unsure about dropping eskalith (lithium) » linkadge, posted by SLS on August 3, 2011, at 9:18:11
I think that the anti-manic effects of lithium take a little longer to kick in than those of valproate.
The whole "theraputic" blood level thing is a bit controversial. Yes, many studies indicate that patients tend to respond better when they are within a certain blood range. However, this is not a certainty for all patients. My psychiatrist found that lithium blood levels are "highly individual".
I personally don't think its a binary thing. I.e. as soon as you drop below a certain level, you're going to go into intense mania.
Lower doses would probably still have a preventitive effect on mania (IMHO).
You are a bit atypical in that you have not experienced major depression. Another strategy might simply be to slowly taper the lithium down to a level where the side effects are more tollerable. In conjunction you could keep a secondary antimanic substance (i.e. olanzapine, depakote, clonazepam, magnesium) on hand if you have a breakthrough episode.
I still think though that any breakthrough episodes you have on lower lithium doses, would be much less insense than those that happen on no lithium.
Linkadge
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