Utilisation of Lithium in Psychiatry in Lubumbashi. Case of the Jason Sendwe Provincial General Referral Hospital
Abstract:
Introduction: Lithium is regarded as the primary pharmacological intervention for managing bipolar disorder and various other psychiatric conditions. Nevertheless, owing to its limited therapeutic window, diligent monitoring is imperative to avert toxicity, even when administered at therapeutically effective doses. The present investigation was undertaken to explore the utilization of lithium in psychiatric practice within the context of Lubumbashi. Method: A hospital-based cross-sectional descriptive observational study was conducted on 22 patients undergoing lithium therapy at the Neuropsychiatry Department of HPGR Jason Sendwe between January and December 2023. The sample was inclusive, and data, anonymised, were sourced from patient consultation and follow-up records, subsequently input and analysed using Epi Info 7.2 and Microsoft Excel 2019 software. Results: The prescription rate of lithium was 4.17%. The primary indications included bipolar disorder and schizoaffective disorder (50.00%). No preemptive identification of high-risk patients was conducted. Lithium was predominantly prescribed in a sustained-release formulation (100%) at a daily dosage of 400 mg for the majority of patients (80.95%). Furthermore, a significant portion of cases exhibited psychotropic polypharmacy. Lithium was frequently co-prescribed with Haldol (50.00%), Chlorpromazine (40.91%), and Artane (22.73%). Treatment duration averaged 5.64 ± 4.45 days, with patients lacking any monitoring protocol. Conclusion: Our findings highlight the administration of lithium without adequate patient monitoring or follow-up. This deficiency in monitoring poses potential health risks to patients, including drug interactions and adverse effects. Substantial enhancements are essential to ensure the safe and efficacious utilisation of lithium in clinical settings.
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