Lithium Therapy Considerations

Special Considerations

• Lithium should be used with caution in patients with renal impairment, as recommended by the American Journal of Kidney Diseases 1
• For patients with GFR <30 ml/min/1.73 m², lithium should be temporarily discontinued during serious intercurrent illness that increases risk of acute kidney injury, according to the American Journal of Kidney Diseases 2

Clinical Pearls

• Lower doses (blood levels 0.2-0.6 mEq/L) may be adequate when lithium is used to augment antidepressants, as suggested by the American Academy of Family Physicians 3
• NSAIDs should be avoided in patients taking lithium as they can decrease lithium clearance and increase toxicity, as warned by the American Journal of Kidney Diseases 4

Lithium Therapy Monitoring and Safety

Introduction to Lithium Monitoring

• Mandatory monitoring is required because toxicity occurs at doses close to therapeutic levels, as stated by the Dialogues in Clinical Neuroscience 5