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administer and dispense lithium, identify potential lithium toxicity, monitor serum levels and adjust lithium therapy if necessary. This guideline aims to provide guidance on how to
updated with the latest monitoring results, including details of lithium brand, formulation, dose, target levels (upper and lower), and test results (as listed in Table 1 – “monitoring guidance”).
Patients prescribed lithium are monitored in accordance with best practice guidance. Prescribers check that blood tests are carried out and monitored regularly and that it is safe to issue a repeat prescription.
The Lothian lithium guidelines include a lithium treatment plan (see Fig. 1); advice for clinicians on managing patients' lithium levels; and pointers for counselling patients on lithium (to be used in conjunction with a patient information leaflet).
Patients prescribed lithium must have a medication alert activated on their electronic patient record and must be easily identifiable by search on GP clinical records (i.e. lithium added to their repeat prescription) .
These guidelines include advice to prescribers and other healthcare professionals on managing patients on lithium, e.g. monitoring requirements, managing lithium levels and also counselling points for patients.
clear standards for lithium monitoring, including measure-ment of serum lithium concentrations every three months and assessment of thyroid and renal function every six months.3 These guidelines are more stringent than the cur-rent quality outcome framework targets for England. A quality improvement programme showed that mental
