Lithium level dropping

shalom to all. i am the father of yaron who was diagnosed 3 years ago as being bipolar. yaron is 27 and showed no visible sighns of bipolar disorder until 3 years ago when he returned home from trip abroad. since then  we have been riding the bipolar roller coaster. yarons last manic "attack" was about 6 weeks ago, this despite the fact that he was on lithium with a level of .8 on a blood test taken on the day he was admitted to the hospital. my question is the following: yaron is currently taking a daily "coctail" of 1800mmg Lithium,400mmg tegratol, 15mmg Zyprexa, and .5mmg Clonex(before bedtime}. his lithium level after initialy climbing to.9 has for the last 4weeks continued to drop until the current level of .48... assuming that he his taking his pills as required why the drop? is there evidence anywhere that coctails such as his can can act as lithium blocks? and if so what to do.

[Roger Gould, M.D.]

There is no evidence that these cocktails block lithium uptake, but it is quite common to see lithium levels drop when the patient is in a manic state, at which time the neurochemistry seems to take over.

Also, to ensure that the proper dose is actually being taken, switching to the liquid form of lithium is recommended, especially when in the hospital.