Antihypertensive Therapy in Bipolar Patients on Lithium

Patient Selection and Monitoring

• The American Academy of Child and Adolescent Psychiatry emphasizes that lithium should only be used where close clinical and laboratory monitoring are available 3
• Baseline assessment before starting any antihypertensive should include complete blood count, thyroid function tests, urinalysis, BUN, creatinine, serum calcium, and current lithium level 2, 3

Medication Considerations

• Thiazide diuretics should be avoided in patients with obesity and bipolar disorder due to additional concerns about dyslipidemia and insulin resistance 1