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.