“Tips for using lithium in bipolar disorder” by West Magnon, MD (Pearls, CURRENT PSYCHIATRY, September 2003) was right on track.
I, too, have found that repeatedly measuring lithium levels is rarely warranted. The exception is when a manic patient is leaving the office and feels compelled to tell a joke. To me, this is suspiciously indicative of a bipolar illness and uncovers the need for a new lithium level determination in a previously diagnosed bipolar individual.
Leonard R. Friedman MD Revere, MA