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One of the drugs of choice in the treatment of bipolar disorder. The dose must be personally adjusted for every different patient on the basis of both blood concentration and the patients clinical response. Lithium enters erythrocytes and its levels in this compartment should be monitored to prevent toxicity, to follow compliance and to investigate either deliberate or accidental overdosage. Its half-life is between 18 and 36 hours but increases in patients on long term lithium therapy. A stable concentration is reached within 5 to 10 days. It is eliminated via the kidneys in a process in which it competes with sodium ions therefore both renal insufficiency and sodium deficiency will result in the accumulation of lithium. The blood should be drawn before the first dose of the day is taken. This test should be repeated every week at the beginning of treatment and regularly but less often thereafter.
Sample must be collected 4-6 hours after dose. Toxic if more than 1.5 mmol/L
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