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Br J Psychiatry. 1988 Apr;152:535-8.

Supervising lithium. A comparison of a lithium clinic, psychiatric out-patient clinics, and general practice.

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  • 1Yeovil District Hospital.


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.

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