title: The lithiumeter: a measured approach.
abstract: BACKGROUND
  Lithium has long been recognised for its mood-stabilizing effects in the management of bipolar disorder (BD) but in practice its use has been limited because of real and 'imagined' concerns. This article addresses the need for lithium to be measured with respect to its clinical and functional effects. It introduces a visual scale, termed lithiumeter, which captures the optimal lithium plasma levels for the treatment of BD.
  
  
  METHODS
  Key words pertaining to lithium's administration, dosing, and side effects as well as its efficacy in acute and long-term treatment of BD were used to conduct an electronic search of the literature. Relevant articles were identified by the authors and reviewed.
  
  
  RESULTS
  This paper outlines the considerations necessary prior to initiating lithium therapy and provides a guide to monitoring lithium plasma levels. Current recommendations for optimal plasma lithium levels in the management of BD are then discussed with respect to indications for use in the acute phases of the illness and maintenance therapy. The risks associated with lithium treatment are also discussed.
  
  
  CONCLUSIONS
  The lithiumeter provides a practical guide of optimal lithium levels for the clinical management of BD.
authors.affiliation: CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, University of Miami, Miller School of Medicine, Miami, FL, USA. gin.malhi@sydney.edu.au
authors.forename: Gin S
authors.initials: GS
authors.lastname: Malhi
authors.forename: Michelle
authors.initials: M
authors.lastname: Tanious
authors.forename: Samuel
authors.initials: S
authors.lastname: Gershon
mesh_terms: D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood; D001714:Bipolar Disorder / Q000188:drug therapy*; D016208:Databases, Factual / Q000706:statistics & numerical data; D017408:Guidelines as Topic; D006801:Humans; D018021:Lithium Chloride / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood; D017063:Outcome Assessment, Health Care
chemical_list: D018692:Antimanic Agents; D018021:Lithium Chloride