Copyright People’s Pharmacy

Q: My brother took lithium for many years to treat bipolar disorder.  Apparently, the dose was too high, as he now has badly damaged kidneys.  While it helped his bipolar disorder tremendously, the effects on his body should have been monitored closely, and the dosage should have been as low as possible.  Please warn your readers about this danger.

A: Lithium is considered a first-line treatment for bipolar disorder, but kidney damage is a potential complication of this medication.  The prescriber must monitor lithium levels and kidney function frequently to detect problems before they become irreversible.  Some psychiatrists may not be aware of recommendations to use estimated glomerular filtration rate (eGFR) rather than just creatinine (BJPsych Bulletin, August 2017).  Monitoring should be conducted at least twice a year and possibly as often as every two to three months for high-risk patients.