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Lithium, one of the most effective medications for bipolar disorder, is associated with several adverse effects requiring medical monitoring. Although psychiatrists are very familiar with lithium-linked nephrogenic diabetes insipidus, they might be less familiar with the stable reduction or progressive decline in glomerular filtration rate (GFR) associated with chronic lithium treatment (JW Psychiatry Oct 20 2008). In this important review, the authors provide guidelines for the practicing clinician.
Because relevant cardiovascular risk factors are highly prevalent in psychiatric patients, attempting to attribute renal function decline solely to lithium is of dubious value. A GFR below 60 mL/minute warrants further evaluation. Protein detect…