Thank you for your query. It seems you are on the higher side of dosages of all the drugs you are taking. moreover,
valproate (depakote) 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 would have come to me with your complaint, I would have requested for a serum lithium estimation, along with liver function test, sodium, pottasium 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 hydration.
I would request you to consult your
psychiatrist urgently for your symptoms and management of the same.
Hope I've been able to satisfy your query. please feel free to ask for any further clarifications. Best of luck.
Dr. Sourav.