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Example Lithium Monitoring Plan

LITHIUM (for example, Lithobid, lithium carbonate)

Before starting lithium obtain baseline complete blood cell counts with differential (CBC with diff); urinalysis; blood urea nitrogen; creatinine; serum calcium levels; thyroid function tests; and pregnancy test for females of childbearing age. Monitor for lithium toxicity at every visit. Once stable lithium dose is obtained, monitor lithium levels; renal and thyroid function; and urinalyses every 3 to 6 months or whenever clinical status changes.

Based on: Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder. McClellan J, Kowatch R, Findling RL; Work Group on Quality Issues. J Am Acad Child Adolesc Psychiatry. 2007 Jan;46(1):107-25. Erratum in: J Am Acad Child Adolesc Psychiatry. 2007 Jun;46(6):786.