Factors that affect a person's lithium dosage include their response to the drug, the particular lithium product being used, and if other medical conditions are present. Ultimately, the dose will depend greatly on lithium blood levels, which is why regular testing is important. The lithium dosage is typically taken two to four times a day, and is available in several forms, including tablets, capsules, and syrup.
Lithium Dosage: An IntroductionThe dose of lithium (Eskalith®, Eskalith CR®, Lithobid®) that your healthcare provider recommends will vary, depending on a number of factors, including:
- How you respond to lithium
- The particular lithium product being used
- Other medical conditions you may have
- Other medications you may be currently taking.
As always, do not adjust your lithium dose unless your healthcare provider specifically instructs you to do so.
Lithium Dosage for Acute ManiaThe recommended starting dose for acute mania is lithium 600 mg three times daily (for immediate-release lithium tablets, capsules, or syrup). For extended-release lithium tablets, the recommended starting dose is lithium 900 mg twice daily. Starting at such high lithium doses helps to produce an effective lithium blood level quickly (which is needed to control the severe symptoms of mania), although the risk of lithium side effects and lithium toxicity is also increased.
Lithium Dosage for Maintenance TreatmentMaintenance treatment for bipolar disorder is used when no acute mania or depression is present. This helps to stabilize the mood, preventing episodes of mania or depression. Maintenance can be thought of as long-term control of bipolar disorder symptoms. If you do not have severe symptoms of bipolar disorder when starting lithium, your healthcare provider may recommend starting with a low lithium dose and slowly increasing it while frequently checking the level of lithium in the blood. This helps prevent lithium toxicity.
Ultimately, your maintenance dose will depend greatly on your lithium blood levels, which is why regular testing is important. Some people may experience relief from their symptoms of bipolar disorder with low lithium blood levels (and are less likely to experience side effects), while others require higher lithium blood levels (and are more likely to experience side effects).