i have bipolar disorder. I am taking lithium 300am/600hs,depakote 750bid,atenolol 25qd,pristique 100am and wellbutrin 450 qam. about 2 months ago my work was affected by shaking,spacy,cant stay on task (i am a mental health social worker). My boss told me today that if I dont figure out what is wrong and get better i will lose my job. also they want me to take a medical leave of absence. help.
Thank you for your query. It seems you are on the higher side of dosages of all the Chat Doctor.  Moreover, valproate (separate) inhibits lithium metabolism and can raise lithium levels further. If you are shaky, and having any of tremors, or difficulty in walking or standing, reeling sensation, slurring of speech, visual difficulty, loose stools, you may be having lithium toxicity. If a patient had come to me with your complaint, I would have requested for a serum lithium estimation, along with liver function test, sodium, potassium and creatinine estimation. If the lithium levels appeared to be in a higher range (>1.2mEq/Lt), I would have decreased the dose of lithium or stopped it for the time being, along with advising adequate HY