Lithium in clinical practice

Lithium has been used for bipolar disorders more than 40 years, although it has adverse effects especially to the kidney and thyroid. There are many guidelines about using lithium, however, uncertainty remains about the optimal serum level for prophylaxis in terms of the risk benefit ratio. The long term medical consequences, such as renal failure or hypothyroidism, might be under recognised because of poor follow up. Several previous studies suggested that monitoring is not carried out efficiently; for example, one study reported that only about 50% of samples reached the NICE standard. This project aims to understand current lithium monitoring practice in the South London and Maudsley NHS Foundation Trust (SLaM) catchment area by evaluating the monitoring in patients on lithium from outpatient services within the catchment area.