A reminder about lithium

Lithium is prescribed and monitored in primary care under shared care arrangements. If you are concerned about a patient’s lithium level, renal function or thyroid function, contact the specialist mental health team for advice

Lithium is commonly used to treat bipolar disorder and is a long-term treatment for episodes of mania, hypomania and depression.

For lithium to be effective, the levels of lithium in the patient’s blood must be within a certain range.  Patients require regular (3 monthly) blood tests to ensure lithium levels are not too high or too low. Too high and the patient may experience lithium toxicity (severe hand tremor, sickness, diarrhoea, muscle weakness, slurring of words, blurred vision, confusion, fatigue). Too low and symptoms will not be controlled and the patient may suffer a relapse in mental state.

Kidney and thyroid function must also be checked every 6 months.

While taking lithium, patients should avoid using non-steroidal anti-inflammatory drugs (NSAIDs), ACE inhibitors and diuretics.