Three recommendations for addressing the ongoing lithium underutilization crisis in bipolar disorder.

Abstract

Lithium is the gold standard treatment for bipolar disorders yet remains underutilized. Concerns among both patients and prescribing clinicians about Lithium's narrow therapeutic index and potential for toxicity, necessitating blood level monitoring, is well documented. So too are serious long-term side effects, for which psychiatrists must be ever vigilant and adequately trained to both prevent and mitigate, particularly in patients for whom Lithium has facilitated optimal functional recovery. This key aspect of treatment requires time intensive coordination of care and collaboration in health care systems that may not facilitate such training and educational efforts. Well marketed atypical antipsychotics seem, in comparison, a less convoluted treatment option.