In this episode, we break down lithium — how it works, when it’s used, how to monitor it safely, and how to counsel a patient in an OSCE station.

Lithium is one of the most effective long-term treatments for bipolar disorder and significantly reduces suicide risk — but it requires careful monitoring and patient education.

We cover:

• Indications for lithium (bipolar disorder & treatment-resistant depression)
• How lithium stabilises mood
• Therapeutic range and toxicity levels
• Baseline investigations (U&Es, TFTs, calcium, ECG)
• Ongoing monitoring schedule
• 12-hour lithium level timing
• Common side effects
• Lithium toxicity signs and triggers
• Drug interactions (NSAIDs, ACE inhibitors, diuretics)
• Pregnancy risks and counselling
• OSCE counselling structure

This episode is ideal for:

• Medical students

• OSCE preparation

• Psychiatry placements

• Foundation doctors

• GP rotations

Lithium is powerful — but only safe when monitored correctly. This episode helps you understand both the science and the counselling.