Lithium level wont go up

[electric moon]

Hey guys, ive got a bit of a strange situation and was hoping some of you could shed some light on it, as my pdoc is baffled by it. My lithium level wont go up, even though my dose is increasing. I started on 300, then got bumped to 600 and had a level. It was .4, then I went to 900 and it was .6, then went to 1050 still .6, now im at 1200 and its STILL .6. Shes not going any higher until we figure out whats going on with the level. My diet has been steady the entire time ive been on the script. Then only thing I can think is that the lab is messing up. Anybody ever hear of this happening before?

 

[Kittycat5]

Do you take other meds? Things like diuretics, theophylline, and even caffeine may lower levels. Do you consume larger amounts of caffeine? Also what form of lithium (tab, capsule, IR, ER etc.) are you using and how quickly are the doses being increased? Lastly, what is the target level you are shooting for? Sometimes 0.6 MeQ/L is acceptable for maintence therapy.

 

[electric moon]

I take 4 300 mg er tabs a day. I drink a few cokes a day, so I don't think my caffeine level is too terribly high. The thing is, my diet hasent changed since I started. My level was increasing like normal, then just stopped with no changes to my diet. It just doesn't make any sense at all. I don't have a target level in mind.

 

[Kittycat5]

How quickly were the doses being increased? And are you on other meds? Yeah, a few cokes probably isnt enough to make a difference unless a few is like 8 . Have you increased your water/fluid intake significantly? I know you say your diet has been relatively consistent, but sometimes we neglect to consider water as a part of the diet.

 

[electric moon]

Doses were being increased every month. I just started lamictal, but the level was stalling before I started it. Uhhh, well when I say a few cokes, theyre like 32 ounces each, lol. Is that enough to throw it off? Water is steady, like 5 or 6 12 ounce glasses a day.