PsychEd episode 52: How to Use Lithium

Welcome to PsychEd — the psychiatry podcast for medical learners, by medical learners. This episode is an introduction to the use and monitoring of lithium in bipolar disorder. Join Tingting Yan (CC4) and Dr. Alex Raben (staff psychiatrist at CAMH and lecturer at the University of Toronto) for a lively case-based discussion.

Learning Objectives

The learning objectives for this episode are as follows:

 

By the end of this episode, the listener will be able to…

1. Describe the indications and process for starting lithium

2. Monitor and interpret serum lithium levels

3. List short and long-term adverse effects of lithium

Produced by: Tingting Yan CC4, Dr. Alex Raben (staff psychiatrist)

 

Hosts: Tingting Yan, Alex Raben

 

Audio editing by: Alex Raben

 

Show notes by: Alex Raben

 

Contents:

• Learning objectives: 00:44

• Lithium background and brief history: 2:48

• Women’s health and lithium: 5:28

• Underutilization of lithium: 8:02

• Baseline blood work for lithium: 11:32

• Choosing a lithium starting dose: 14:32

• Lithium serum levels: 16:17

• Lithium titration: 20:46

• Lithium toxicity: 23:48

• Lithium side effects: 26:52

• Summary: 32:11

 

References

1. Baastrup PC, Poulsen JC, Schou M, Thomsen K, Amdisen A. Prophylactic lithium: double blind discontinuation in manic-depressive and recurrent-depressive disorders. Lancet. 1970;2(7668):326-330. doi:10.1016/s0140-6736(70)92870-9

2. Bauer LA. Chapter 17. Lithium. In: Bauer LA. eds. Applied Clinical Pharmacokinetics, 2e. McGraw Hill; 2008. Accessed March 16, 2023. https://accesspharmacy.mhmedical.com/content.aspx?bookid=510§ionid=40843106

3. Chokhawala K, Lee S, Saadabadi A. Lithium. StatPearls.

4. Davis J, Desmond M, Berk M. Lithium and nephrotoxicity: a literature review of approaches to clinical management and risk stratification. BMC nephrology. 2018 Dec;19:1-7.

5. Draaisma D. Lithium: the gripping history of a psychiatric success story. Nature. 2019 Aug 1;572(7769):584-6.

6. Hedya SA, Avula A, Swoboda HD. Lithium toxicity.

7. Malhi GS, Bell E, Outhred