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Some New Thoughts on Lithium


This webinar will provide the latest information on lithium, focusing on new insights into the use of lithium during pregnancy and breastfeeding, and lithium's renal related risks. Important points of emphasis will include the modest effects of lithium on renal function when dosed once daily and 12h outpatient levels are maintained in recommended range of 0.60 - 0.80 mEq/l, and never > 1.00 mEq/l. Attendees will also learn about the importance of the epithelial sodium channel (ENaC), how lithium enters ENaC on distal tubule prinicipal cells and induces polyuria, and why this is the harbinger of renal related adverse effects. Importantly, attendees will be provided modern methods for polyuria monitoring (e.g. Early Morning Urine Osmolality) and its treatment with amiloride, and occasionally adjunctive acetazolamide. As use of VPA has fallen out of favor in the use and has been banned in women of reproductive potential in Western Europe and the UK, clinicians must become adept at using lithium for patients with a history of mania. 


Recorded webinar 

Learning Objectives 

  • Describe the evidence supporting lithium utilization in patients with bipolar spectrum disorder. 
  • Implement outpatient 12h trough serum lithium levels and once daily dosing to decrease renal impact. 
  • Describe the management of common nonrenal adverse effects. 
  • Evaluate recent findings on lithium use in pregnancy and during breastfeeding. 

Target Audience 

Psychiatrist, Physician (Non-psychiatrist), Physician Assistant, Psychiatrist, Nurse/Nurse Practitioner, Pharmacist 

Instructional Level 


Estimate Time to Complete 

Estimated Duration: 1.5 hours
Program Start Date: October 25, 2023 
Program End Date: October 25, 2026 

Ongoing Interdisciplinary Discussion Board 

After completing the course, engage with colleagues in the mental health field through SMI Adviser's Webinar Roundtable Topics discussion board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. Access through the discussion tab.  

How to Earn Credit 

Participants who wish to earn AMA PRA Category 1 Credit™, nursing continuing professional development contact hours (NCPD, formerly CNE), CE credit for pharmacists, or a certificate of participation may do so by viewing the live presentation and completing the evaluation. Participants claiming CE credit for pharmacists must have full attendance to claim credit. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians), CPE certificate (pharmacists), NCPD certificate (nurses) or certificate of participation (other disciplines) showing the event date and hours earned.  

Continuing Education Credit 

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.    


The APA designates this live event for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

Nurses/Nurse Practitioners    

The American Psychiatric Association (APA) designates this activity for 1.5 Nursing contact hours. Nurses should only claim credit commensurate with the extent of their participation in the activity.    


This curriculum has been approved for 1.5 contact hours (.1 CEU) by the American Psychiatric Association.  The American Psychiatric Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. The Universal Activity Number for this program is UAN JA0000145-0000-23-010-H01-P. This learning activity is knowledge based. Your CE credits will be electronically submitted to the NABP upon successful completion of the activity. Pharmacists with questions can contact NABP customer service (

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity. 


Jonathan Meyer, MD is a Clinical Professor of Psychiatry at UC San Diego, and a Distinguished Fellow of the American Psychiatric Association. Dr. Meyer has teaching duties at UC San Diego and the Balboa Naval Medical Center in San Diego, and is a psychopharmacology consultant to the California Department of State Hospitals.  Dr. Meyer has lectured and published extensively on psychopharmacology. Along with Dr. Stephen Stahl he is co-author of the Clozapine Handbook published by Cambridge University Press in May 2019, and the recently published book The Clinical Use of Antipsychotic Plasma Levels released in September 2021 by Cambridge University Press. Dr. Meyer reports no financial relationships with commercial interests.  


  • Teri Brister, PhD, LPC, National Alliance on Mental Illness. Dr. Brister has no relevant financial relationships to disclose. 
  • John Torous, MD, Beth Israel Deaconess Medical Center. Dr. Torous has no relevant financial relationships to disclose. 
  • Donna Rolin, PhD, APRN, University of Texas at Austin. Dr. Rolin has no relevant financial relationships to disclose. 
  • Megan Ehret, PharmD, BCPP, University of Maryland, Baltimore. Dr. Ehret has no relevant financial relationships to disclose. 

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar. 

Technical Requirements 

This internet-based CME activity is best experienced using any of the following: 

  • The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari 
  • Internet Explorer 11+ 

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player. 

Optimal System Configuration: 

  • Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version) 
  • Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version) 
  • Internet Connection: 1 Mbps or higher 

Minimum Requirements: 

  • Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content 
  • Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content 

For assistance: Contact for questions about this activity | Contact for technical assistance 

Availability: On-Demand
Access expires on 10/25/2026
Credit Offered:
1.5 CME Credits
1.5 NCPD Credits
1.5 Pharmacy CE Credits
1.5 COP Credits
Funding for SMI Adviser was made possible by Grant No. SM080818 from SAMHSA of the U.S. Department of Health and Human Services (HHS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, SAMHSA/HHS or the U.S. Government.
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