Lithium Dose Titration for Subtherapeutic Levels

Monitoring Requirements

• The American College of Physicians recommends monitoring renal function, thyroid function, and urinalysis every 3-6 months during maintenance therapy, with a strength of evidence level of high 1, 2

Common Causes of Subtherapeutic Levels

• Poor medication adherence, which can be verified through direct questioning about missed doses, pill counts, review of refill history, and discussion of barriers to adherence, is a common cause of subtherapeutic levels, according to the National Institute of Mental Health 1, 3