Lithium treatment: Are the present schedules optimal?

Lithium treatment is a proven and effective prophylactic treatment of bipolar affective disorders. To day patients receive their lithium in one or two daily doses, and the dosage level in the individual patient is adjusted to the lowest possible level in order to reduce side effects. In the present article we suggest an alternative treatment strategy also aiming at reducing side effects but not involving the slow process of finding the lowest possible effective lithium dose. We suggest prophylaxis may be obtained by giving lithium every second day in a dose producing 12 hour serum lithium concentrations between 0.6 and 0.9 mM, and leading to very low lithium concentrations every second day. This treatment schedule is at present being tested in the clinic.