The clinical use of lithium carbonate in old age: a review

The authors review the available data concerning the pharmacokinetics and clinical use of lithium carbonate in old age. Guidelines for lithium prophylaxis are provided including a recommendation to maintain 12 hour blood levels at approximately 0.5 mmol/l using a single bedtime dosing regimen. The value of a specialized clinic to manage and monitor elderly patients maintained on lithium is discussed. Empirical clinical findings on the use of lithium may help to elucidate issues of classification in the affective disorders of old age. Increasing clinical data supports a spectrum theory of affective disorder.