CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Bipolar disorder - Management
What advice should I give to someone taking lithium?
- People taking lithium should be advised:
- To carry a lithium card.
- That regular blood tests are important and the results should be recorded in their lithium record booklet.
- About what adverse effects to expect.
- How to recognize the symptoms of lithium toxicity.
- Not to take over-the-counter nonsteroidal anti-inflammatory drugs.
- That episodes of diarrhoea or vomiting, or any form of dehydration, will lead to sodium depletion and therefore increased plasma lithium levels.
- To maintain their fluid intake, particularly after sweating (for example, after exercise, in hot climates, or if they have a fever), if they are immobile for long periods, or — in the case of older people — if they develop a chest infection or pneumonia.
- That if a dose is missed they should take it as soon as possible; but if yesterday's dose was missed then they should not double today's dose.
- Not to stop taking lithium abruptly, and that non-compliance may lead to a relapse.
- Women of childbearing age should be advised to use reliable contraception.
[National Collaborating Centre for Mental Health, 2006; National Patient Safety Agency, 2009]
© NHS Institute for Innovation and Improvement