Acute mania Individualized dose based on patient's blood conc & clinical response. Adjust dose to obtain serum conc between 0.8 & 1.2 mEq or mmol/L.
Properly screened adult w/ good renal function Initial daily dose: 900-1,800 mg (15-20 mg/kg) divided into 3 doses. Can be started as 600-900 mg/day, reaching gradually a level of 1,200-1,800 mg in 3 divided doses.
Elderly Usually 600-1,200 mg/day.
Maintenance therapy Rapidly reduce dose after acute manic episode subsides to achieve serum conc between 0.6 & 1 mEq or mmol/L. Average suggested dose: 900 mg/day (approx 25 mEq), divided into 3 doses, w/ range usually between 500 & 1,200 mg/day. Once stabilized on maintenance dose & stable therapeutic blood levels are reached, dosage schedule may be changed to once daily administration. Total daily dose when administered as a single daily dose may be approx 5-30% lower than when given in divided doses.