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Recommencing lithium in Older Adults with Bipolar I Disorder

Objectives: This paper addresses considerations in recommencing lithium in elderly patients with Bipolar I Disorder and medical comorbidity. We focus on nephrotoxicity and cognitive impairment. Methods: Case reports and review of relevant literature. Results: Three elderly psychogeriatric inpatients admitted with severe manic relapse following lithium cessation are described. In all cases, lithium was recommenced safely with good response. Conclusions: Even with medical comorbidity it may be possible to recommence modified lithium therapy.