Before commencing lithium treatment
Measure:
- thyroid function - management of any hypothyroidism should be addressed before starting lithium.
- renal function - a sufficient guide to renal function is provided by serum creatinine. If serum creatinine is abnormal then measurement of creatinine clearance may be required. A lower dose of lithium will be required if there is evidence of renal impairment.
- ECG - recommended by some specialists if there is a history of cardiac abnormality.
With respect to lithium treatment in women:
- lithium treatment should be avoided during the first trimester.
- reliable contraception should be used by women of child- bearing age.
Reference:
- Drug and Therapeutics Bulletin 1999; 37 (3): 22-24.
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