• Introduction & Key Points
• Indications for Lithium
• Dosage and administration
• Averse effects of lithium
• Pharmacokinetics and serum concerntrations
• Baseline tests and monitoring
• Drug interactions
• Continuation and maintenance treatment
• Cautions and contraindications to lithium treatment
• Cases
• References
• Issue 3 Contents

Cautions and contraindications to lithium treatment

Lithium is contraindicated in patients with renal failure, cardiovascular insufficiency, Addison’s disease and untreated hypothyroidism. For patients with less severe renal impairment, careful consideration of the risks and benefits of lithium treatment is required. Consultation with a renal physician may be of assistance.

It is strongly recommended that lithium therapy be carefully reviewed on an individual patient basis before a planned pregnancy. This will need to be done in liaison with a psychiatrist and/or maternal mental health services.

Care should be taken in patients who have vomiting or diarrhoea or if fluid or salt (sodium) intake is increased or decreased. This may include situations where patients have increased sweating such as during summer when exercise is increased, with infection or illness or if sudden dietary changes are made. Lithium serum levels may change significantly in these circumstances so more frequent monitoring may be required.