The treatment regime is adjusted for each patient according to blood levels and side effects. Renal and thyroid function should be assessed before starting the first week of treatment with lithium carbonate. Subsequent doses depend on the blood levels.
As a prophylactic, blood levels of 0.4 to 0.8 mmol per litre may be continued for months or years provided there are regular lithium estimations.
Blood levels of lithium should be measured weekly until a steady-state is reached. Thereafter, estimations may be less frequent e.g. 6-12 weekly. Blood for lithium estimation should be taken 12 hr after the last dose.
Thyroid function should be checked every 6 months.
A delayed release preparation (Priadel) is available though its pharmokinetics are similar to those of lithium carbonate.
Lithium is normally given in divided doses (at least twice daily) to reduce peak levels in glomerular filtrate.
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