Lithium Therapy Monitoring and Management

Baseline and Ongoing Monitoring Requirements

• The American Academy of Child and Adolescent Psychiatry recommends baseline testing to include complete blood count, thyroid function tests, renal function tests, serum calcium, urinalysis, and pregnancy test in females of childbearing age, as well as an ECG to assess for baseline QT interval 1, 2
• The American Academy of Child and Adolescent Psychiatry suggests monitoring every 3-6 months during maintenance therapy, including serum lithium levels, renal function tests, thyroid function tests, urinalysis, and annual serum calcium tests 1, 2, 3

Important Clinical Caveats

• Early toxicity warning signs include tremor, nausea, diarrhea, and polyuria-polydipsia, which can indicate toxicity even before reaching steady-state 2