So tired, does Lithium ever get better?

The end of September I started on 600 mg of Lithium for the first time, two capsules at night. That seemed to do nothing or was taking too long to do well so I ended up in the hospital where my Lithium was upped to 900 mg (300 mg 3x a day) and then when I left they upped it to 1200 mg (600 mg 2x a day). I was having major stomach issues and shaking at the 1200 mg level so my new pdoc dropped me down to 900 mg (300 mg in the morning, 600 mg at night). The problem is that when I take the Lithium, it always makes me tired, sluggish, hard to think and concentrate. It wasn't an issue when I was taking it just at night, but taking it in the day, even just the 300 mg now in the morning, makes me feel sluggish, tired, and unproductive, and I just want to know, does this ever get better?

I guess the Lithium is helping my mixed episode, I'm not as bad as I was, but it's hard for me to get anything done when I take it. I also don't feel comfortable driving during the day, which is why I make appointments in the morning and take my meds when I come back. And as much as I've told myself I have to stay on my meds, sometimes I will skip it, not often, but just because I'm tired of being tired! In addition to the 300 mg of Lithium, I'm also supposed to take 30 mg of Abilify (which I do take all the time) and 1 mg of Klonopin (which I take sometimes but I hate how it makes me drowsy as well) every morning, as well as 600 mg Lithium (which I do take every night) 300 mg Trazodone (haven't taken that in over a week because it turns me into a zombie), 1 mg of Klonopin, and 10 mg Ambien at night to help me sleep. I feel okay in the morning but always feel worse after I've taken my morning dose of meds.

Will this tiredness with Lithium go away? I've been taking it in some form since the end of September, I should be through early side effects, shouldn't I? Does anyone take 900 mg of Lithium at night and none in the day? I'm taking extended release Lithium, I just wonder if it's something worth bringing up with the pdoc. I really don't want to abandon the Lithium if it's helping, but I just can't take feeling like this either. So frustrating.

3 months is usually the adjustment period for new meds. You're coming to the end of that with med changes and increases along the way, but you say you're still too tired. It might magically go away after a few more weeks, but if I were in your shoes (I am impatient with side effects) I would want to switch by now. Definitely bring it up with your pdoc and see what he can do about that. I have never taken all my lithium at once during the night, not sure if that can be done but you can certainly ask. If you can't you could always try other meds that may work with more tolerable side effects.
The med go around is frustrating, I know, but it'll be worth it in the end when we reach stability.

I take 1200mg extended release Lithium all at night. Have you had your thyroid levels checked? Lithium can lower your thyroid levels making you tired. I take 100mcg levothyroxine to counteract the Lithium.

I am currently on lithium 600 mg twice daily. I was started on the medication 300 mg twice daily while inpatient, then my levels were too low and they increased it. initially this dosage made me toxic (however I was drinking a fair amount of alcohol at this point). after I got toxic my dose dropped and the tremor I had improved quite a bit (900 mg daily). this dose wasn't enough for me I started becoming depressed again... so my pdoc increased me slowly back up to 1200 daily and so far no problems (no sleepiness) - I do have a tremor, and it is affecting my memory/thinking some I think, but its helping my depression again so i am going to stick with it. but you should probably get your thyroid checked and levels as well. hope things improve for you. also make sure your drinking a lot of water, thats what I had to do and when i don't i start feeling more side effects and dizzy..

I take 600mg in the morning and 900mg at night. I have to make sure I take it with food or I will get an upset stomach. I also get extremely thirsty on it. I'm not sure if it ever made me shake because it was originally diagnosed and the dosage upped IP when I had other med changes going on. Whenever I've had the shakes they went away within 2—3 weeks.

I have had really heavy depression and hypersomnolence in the last year. I believe lithium prevented me from fully coming out of that. It leveled me out but my baseline was low. Luckily, I've been able to tolerate an increase in Cymbalta, and those together keep me mostly level with better energy. That said, I have fibromyalgia and I'm pretty sensitive to anything that causes sedation. I've personally never noticed that with lithium. It takes me about 2—3 weeks to adjust to the sedative effects of meds like Seroquel or Zyprexa. Any longer than that and I would request a med change because I am afraid of wasting time on something that I might just not be able to tolerate.

Make sure:
-you are very well hydrated with the lithium. Drink lots of water, not too much of course but heaps.
-get your blood levels checked regularly
--get your thyroid hormone levels checked (monitor for hypothyroidism)
-maybe eat something with the medication.

Consider also whether you are having residual symptoms. bipolar does cause cognitive issues in-between episodes. There can be residual mild depression also.

Most of all make sure you are still working closely with the pdoc.

Maybe I will see if taking it all at night will help. I when I had blood drawn while in the hospital, about a month ago, there weren't any problems with my thyroid, assuming they checked that. I just had labs done today so hopefully my pdoc will let me know next week if there is a problem.

I'm just frustrated because I know the Lithium is helping a little, and if I stop it I don't know what else there is for me to take. I stopped Lamictal months ago because it was making me more depressed, and Depakote causes tons of weight gain with me, when I'm already overweight, I'm never going back on that again. I need a mood stabilizer, and I'm running out of options. When I first take Lithium, it does make me feel more depressed, or maybe it's just not helping the depression? I feel like I have a clearer head and don't feel as down and unmotivated once I'm coming up to my next dose to take, I don't know what that means. My depression feels better when I don't take the Lithium, it makes me feel so sluggish, but I know my manic symptoms have gotten better. So I'm at this point where I'm afraid to take the Lithium, but also afraid not to. I am supposed to go back to work in a month, and I'm just stressed my meds still aren't where they need to be, I'm nowhere near in any condition to work soon. I'm tired all the time and can barely think. It's so frustrating.