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.
