Lithium monitoring

Lithium is the drug of choice for treatment of mania and for long-term maintenance to prevent both depressive and manic episodes in bipolar disorders. A thorough knowledge of lithium is necessary for its safe and effective use. It must be used with caution owing to its narrow therapeutic range and significant toxicities. Patients should be screened prior to initiating lithium therapy. The drug-drug interactions must be appreciated, and it is recommended that the lithium concentration, thyroid function, and renal function be monitored in addition to the clinical progress. Blood samples for lithium monitoring should be obtained 12 hours after the evening dose.