Abstract

About one person in two thousand in Britain is prescribed lithium carbonate.^{1 2} The main indication is recurrent endogenous affective disorder but it has also been tried in other psychiatric and non-psychiatric conditions.³ Lithium has a very low therapeutic index, and any doctor looking after a patient taking lithium needs to watch for unwanted effects and the early symptoms of toxicity. He should also be alert to the many drugs and diseases that predispose to toxicity. It is now possible to select patients likely to respond more reliably, and this is important since concern has arisen about renal damage during prolonged treatment with the drug.⁴ This article reviews the progress with these problems since our last article.⁵