LITHIUM FOR PTSD: A LITTLE BIT GOES A LONG WAY

For a couple of years I have been prescribing low doses of lithium carbonate to help people with PTSD [post traumatic stress disorder] not react as much to past traumatic experiences when they are recalled.  Those who respond report feeling less anxious and less reactive when they think about past stressful events. It is like they are not as on guard and overall more able to experience events throughout the day without having to react with anxious feelings and a need to be vigilant.  

Unfortunately it has been hard to determine a range of optimal dosing as many of my patients do not respond to the lowest lithium carbonate dose of 150 mg [in a capsule]. Therefore, I have started prescribing a liquid form of lithium to see if a dose range from 6 mg to 120 mg would be helpful. I am also prescribing compounded doses of lithium. Once my patients respond to a specific dose range, I ask them if they are willing to change their doses to see if a small change leads to improvement and then seeing if their most positive response is replicable with repeated trials. This can lead to important information about the range of optimal dosing for lithium in treating PTSD.