Eyestwo22's Journal

There is a therapeutic range for serum lithium and it's significance for management of bipolar disorder. And for that matter,a control of lithium’s side effects.

Normal therapeutic range: 0.7 to 1.2 ng/dl, although some labs report ranges at .06 to 1.0 ng/dl.

Several large research studies have been done looking at relapse rates (episodes) and relating those rates to people's blood levels at the time. In the biggest such study, the one that really defined the bottom of this range, patients with levels of 0.7 and up had significantly lower relapse rates than those with 0.5 and less. So generally, in bipolar I, it is preferable to shoot for a blood level of 0.7 or higher (limiting at 1.0 or 1.2) to be sure the person is protected, as best as these studies could tell.

Note, that if a person has continuous symptoms,one can basically forget about the lower number, because you're going to go by their symptoms, not some reference range, in deciding what is enough dosage, however, she or he still needs lab testing to make sure that his/her blood level doesn't go too high. This is generally the case in bipolar II

Now, as in my personal case, if my serum Lithium (personal) therapeutic history is extremely will documented, (and it is), then my level at .08 is my base line. Any level dropping below or higher than .08 will indicate the possibility of an episode to occur. (and a change in side effects). For example when the therapeutic level drooped to .02 , mania was induced rapidly and my hand tremors increased. This type or Lithium monitoring requires a open and continued communication with the pdoc and the patient, in order to produce accurate controls over the serum lithium and consistent potential episodes along with increases of side effects.

In my next Journal I will discuss two persistent side effects I have had to deal with in my 25 years of stability. Using the the above information I have been able to control hand tremors and weight gain.