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= Paid-up subscribersLithium toxicity presenting as delirium in an older patient
21 May 2009
Around 1 in 400 adults suffer from bipolar disorder at some point during their lives although it is unusual for the condition to develop after the age of 40. The prevalence of bipolar disorder in the elderly is reported to be 1%.Medical management with lithium, valproate or olanzapine is recommended as first-line therapy by NICE. Careful monitoring of lithium levels is essential, in particular to prevent toxicity as lithium has a low therapeutic index. Older patients are especially vulnerable, with one study reporting that over a period of 9 years 4% of elderly patients on lithium were hospitalised because of lithium toxicity.
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