Comparative Study

| Published: November 25, 2017

Standards of Lithium Treatment Monitoring In a Teaching Hospital in South India among Bipolar Affective Disorder

Dr. Sureshkumar Ramasamy

Assistant Professor, Dept Of Psychiatry, PSG Medical College, Avinashi road, Coimbatore, Tamilnadu, India Google Scholar More about the auther

, Dr. Shilpa Srinivasan

Senior Resident, Department Of Psychiatry, Shri Sathya Sai Medical College And Research Institute, Kancheepuram, Tamilnadu, India Google Scholar More about the auther

, Dr. Shree Aarthi Ramanathan

Consultant Psychiatrist, GR Hospital, Coimbatore, Tamilnadu, India Google Scholar More about the auther

DIP: 18.01.098/20170501

DOI: 10.25215/0501.098


Background: Lithium is a commonly used drug with a narrow therapeutic index, it has significant adverse effects on kidney and thyroid, and is life threatening during intoxication. Maudsley guidelines on managing bipolar affective disorder patients (BPAD) with lithium recommends checking weight at baseline and every 3rd month, serum lithium after 7th day thereafter 3 months once, renal function test and serum thyroid stimulating hormone (TSH) at baseline and 6 months once. Aim: To evaluate whether Pre-Lithium workup and monitoring is done in Bipolar affective disorder (BPAD) patients initiated on Lithium as per Maudsley prescribing guidelines in psychiatry. Method: Retrospective audit conducted in a tertiary care hospital on lithium monitoring in BPAD patients treated with lithium atleast for six months compared against Maudsley prescribing guidelines. Results: Among medical records of 114 bipolar patients fulfilling study criteria, weight and serum lithium at baseline was checked in 100% of patients; serum creatinine and TSH at baseline along with lithium at 3rd month was done in 83.3%, 78.9% and 68.4% of patients respectively. Maudsley guidelines for serum creatinine, TSH and lithium level at 6th month were met only in 43.8%, 43.8% and 72.8% of patients respectively. Conclusion: The quality of lithium monitoring in bipolar patients falls well short of accepted standards; Hence addressing the issues in monitoring and following a standard protocol can improve the effectiveness of treatment and quality of life of patients.

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ISSN 2348-5396

ISSN 2349-3429



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Published in   Volume 05, Issue 1, October-December, 2017