The importance of safe lithium plasma monitoring in older people (Birgi, Sachdev, 2025)

Rubinsztein JS; Willis S; Birgi H; Sachdev K; Southwell C; Stewart AP; O'Brien JT

BJPsych bulletin [BJPsych Bull] 2025 Oct 23, pp. 1-3. Date of Electronic Publication: 2025 Oct 23.

Available online at this link

We consider that the current National Institute for Health and Care Excellence (NICE) guideline CG185 on bipolar disorder does not provide sufficiently specific guidance for the safe monitoring of plasma lithium levels in older people. We feel this needs correction, and laboratories across the UK should lower the range recommended for monitoring older people's lithium levels in line with guidelines from the International Society for Bipolar Disorder. This would provide a safety net in older people in order to prevent lithium toxicity without compromising efficacy.