Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
4.2.3 Antimanic drugs
Bipolar Disorder
Initiation of lithium therapy is the responsibility of Somerset Partnership NHS Foundation Trust after which care may be transferred to general practice under shared care guidance. All healthcare organisations in the NHS where lithium therapy is initiated, prescribed, dispensed and monitored are asked to ensure that:
• Patients prescribed lithium are monitored in accordance with NICE guidance.
• There are reliable systems to ensure blood test results are communicated between laboratories and prescriber.
• At the start of lithium therapy and throughout their treatment patients receive appropriate ongoing verbal and wrttten information and a record book to track lithium blood levels and relevant clinical tests.
• Prescribers and pharmacists check that blood tests are monitored regularly and is is safe to issue a repeat prescription and/or dispense the prescribed lithium.
• Systems are in place to identify and deal with medicines that might adversely interact with lithium therapy.
Supplies of record books and alert cards are available from: Primary Care Support England
Tel- 0333 0142884
LithiumLithium carbonatePreparations vary widely in bioavailability:
Lithium must be prescribed by brand for safety reasons (in line with national guidance)

NPSA ‘Safer Lithium Therapy’ guidance must be followed
as Camcolit 250®250mg: £48.18 (100)Li+ 6.8mmol/tablet
as Camcolit 400®400mg: £48.18 (100)
Li+ 10.8mmol/tablet
as Liskonum® 450mg450mg: £2.88 (60)Modified-release.
Li+ 12.2mmol/tablet
as Priadel® 200mg

200mg: £2.76 (100)Modified-release.
Li+ 5.4mmol/tablet
as Priadel® 400mg

400mg: £4.02 (100)
Li+ 10.8mmol/tablet
QOF requires a register of lithium patients and also the percentage of patients on lithium therapy with a record of serum creatinine and TSH in the preceding 9 months. Also the percentage of patients on lithium therapy with a record of lithium levels in the therapeutic range in the preceding 4 months.(2016/17)