Hello,

My husband's father is a 70 year old man that has been diagnosed with bipolar disease 5 years ago. My husband and I live in Canada, but his family are all in Italy. His father is taking 450mg of lithium carbonate daily, and is a very large (overweight) man. He has recently been in a manic period of extreme energy, productivity (he tries), and has been extremely abusive verbally to his wife and daughters at home. He is constantly angry and has been recounting to anyone who will listen to him how unhapppy he is with his life, including his wife and all he has done in the past. He is nagging about people who are dead and what they did to bother him. He is also keeping a journal writing his life story. He has told a close family friend that he "doesn't have much time left". He is out all day so we are not sure that he takes his medicine in th pm. He will not go to see doctor, and we think he may be suicidal....what to do?
Is his medication too light?
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replied May 13th, 2008
Extremely eHealthy
Manic episodes are treated primarily with lithium or other medications, such as neuroleptics and anticonvulsants.
The basic drug treatment for bipolar disorder is lithium, that can stabilize mood and reduce the frequency of manic and depressive episodes in about 80% of the people who suffer from this disease.

For how long is he taking Lithium?
Does he undergo regular blood test to control the level of Lithium in his blood?
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replied May 13th, 2008
Extremely eHealthy
I agree 100% with Mand above. His levels might be a little out of wack if not checked recently. Something that needs to be followed with caution. To much is a bad as to little.
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replied May 18th, 2008
only 450?
I am bipolar and my doctor just added 360mg of Lithium carbonate to start off a couple weeks ago. She already wants me to increase it by 180mg. She said that the average dose of lithium people can be on is 1800-2400mg! I was suprised to hear that number, but she mentioned it a few times. Someone should check with your father-in-laws doctor. I am not sure about the age factor (I am only 23)--something to look into. I do know that there is a fine line between a level that is too high and too low, as it was mentioned in the lithium medication leaflet...
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replied May 18th, 2008
Extremely eHealthy
Yes that is a very high dose. If you make it even near there, demand to have your lithium level drawn on a regular basis please.
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replied January 22nd, 2019
Thank you for asking at Ehealth forum!

I read your question and I understand your concern.
His lithium dose is not optimal. Lithium dose can be increased upto 1.5g/day. He can be given antipsychotic to combat this manic episode.
I hope it helps. Stay in touch with your healthcare provider for further guidance as our answers are just for education and counselling purposes and cannot be an alternative to actual visit to a doctor.
Take care
Khan
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