The prescribing of lithium for bipolar disorder

We have launched an investigation that explores the use of lithium for the treatment of bipolar disorder.

Bipolar disorder is a mental illness characterised by severe mood swings. Around 1 in 50 adults experience bipolar disorder within their lives. Lithium is a mood stabiliser and national guidance recognises it as the initial recommended medication for long-term treatment of bipolar disorder.

Whilst the number of people with bipolar disorder has remained consistent over time the prescribing of lithium has been in decline for decades.

We identified the need for this investigation after engagement with stakeholders, including representatives from national bodies and patient representative groups, to seek their insights in relation to patient safety issues associated with the decline in the prescribing of lithium for bipolar disorder. There was widespread concern about the decline of lithium prescribing due to the effectiveness of lithium as a treatment for bipolar disorder.

We triangulated this evidence with additional sources including frontline staff, national prescribing datasets, national guidance documents and academic literature.

The investigation will seek to understand the use of lithium for diagnosed bipolar disorder, including:

• decision making when considering whether to prescribe lithium for bipolar disorder
• discussions with patients in relation to lithium as a treatment option for the management of bipolar disorder.

We are keen to hear from anybody with an interest in this subject matter. This includes patients, families, carers and health and care professionals who may wish to share their experience. If you would like to speak to us about this investigation before we publish the final report, please email enquiries@hssib.org.uk.