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Supervising Lithium a Comparison of a Lithium Clinic, Psychiatric Out-patient Clinics, and General Practice

Published online by Cambridge University Press:  02 January 2018

George Masterton*
Affiliation:
Yeovil District Hospital and Tone Vale Hospital, Bishop's Lydeard, Taunton
Mary Warner
Affiliation:
Yeovil District Hospital
Brian Roxburgh
Affiliation:
Tone Vale Hospital
*
Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3

Abstract

Supervision of lithium treatment among three groups of patients treated in different settings – at a lithium clinic, as hospital out-patients, and by a GP – was studied. The lithium clinic maintained lower levels and checked these more frequently. Elevated lithium levels were most frequent in the GP-supervised group, which also included the 13 patients with the most impaired glomerular filtration. In hospital settings GFR-impaired patients received a lower daily dose of lithium; in general practice, affected patients had a higher mean serum lithium level and were more frequently prescribed lithium once daily. We conclude that patients with glomerular impairment who require lithium should be supervised by a specialist, or at least prescribed lithium in divided daily doses.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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