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The Edinburgh Lithium Register

Published online by Cambridge University Press:  02 January 2018

Robert E. Kehoe
Affiliation:
University of Edinburgh, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF
Anthony J. Mander
Affiliation:
University of Edinburgh, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF
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Lithium is widely used in psychiatry, mainly in the prophylaxis of manic-depressive illness. It is usually prescribed long term and because of its side effects, low therapeutic index and the possibility of toxicity, it is necessary to monitor serum lithium levels, thyroid function and renal status. Clinical guidelines are unclear; Vestergaard et al (1982) recommended that serum lithium and creatinine be checked every two to four months and thyroid function every six months. However, Crammer et al (1982) suggest that once stable levels are established, serum lithium need be checked only in response to clinical indications. The most recent edition of a widely read psychiatric text states that levels should be checked each six to eight weeks for as long as the patient continues on lithium (Loudon, 1988). Accepted standard clinical practice is thus unclear. It should be emphasised that these guidelines are not based on research evidence.

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Articles
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1989

References

Crammer, J., Barraclough, B. & Heine, B. (1982) The Use of Drugs in Psychiatry. London: Gaskell (Royal College of Psychiatrists).Google Scholar
Loudon, J. B. (1988) Drug treatments. In Companion to Psychiatric Studies (eds. Kendell, R. E. and Zealley, A. K.). Edinburgh: Churchill Livingstone.Google Scholar
DHSS (1989) Working for Patients. London: HMSO.Google Scholar
Vestergaard, P., Shou, M. & Thomsen, K. (1982) Monitoring of patients in prophylactic lithium treatment – an assessment based on recent kidney studies. British Journal of Psychiatry, 140, 185187.Google Scholar
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