Table 7.

Lithium use in elderly and adolescents

Elderly individuals at lower doses of lithium to attain adult serum concentrations

Bioavailability of lithium not altered by increasing age

Elderly have ↓ volume of distribution and ↓ GFR; this ↑ S. Li levels

Higher incidence of neurotoxicity in elderly

65 to 75 years – dose 300 to 600 mg/day; maximum 900 mg/day >80 years or frail elderly – 150 to 300 mg/day and rarely exceed 450 mg/day

Cannot be recommended for children under 12 years of age

Adolescents dosage and serum levels comparable with those of adults