BAP Summer Internship Scheme award: Elliot Aspery

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The BAP Summer Internship Scheme was awarded to Elliot Aspery for the project 'Lithium Dose Optimisation (LiDO)', working with Dr Victoria Wing and collaborators. A summary of the proposed project is included below:

Lay summary: Lithium has been used to treat bipolar disorder for over 70 years and remains one of the most effective treatments for stabilising mood. Lithium can be a difficult to prescribe because each patient responds differently, and at varying doses. Lithium has a narrow ‘therapeutic window’ meaning that only small increases in blood levels can result in side effects (e.g., kidney damage) and ‘toxicity’. Therefore, careful monitoring of blood lithium levels is needed, especially when beginning treatment. Repeated blood tests are burdensome for patients and clinicians as it can take months to identify the optimal dose. Some researchers have attempted to create equations to predict the ideal dose based on patient factors such as age, weight, sex and kidney function. Unfortunately, studies have drawn different conclusions regarding their usefulness in clinical practice. These inconsistencies may be due to the small number of patients included in studies, or differences in lithium dosing regimens. For example, twice daily dosing is favoured in some parts of the world whilst once daily dosing is commonplace in the UK. Our study aims to better understand the potential utility of lithium dose prediction equations and their application in the UK. First, we will critique the literature on lithium dose prediction equations and test them in computer simulated patients. Second, we will test the accuracy of these equations in predicting lithium dose in patients using an existing research sample. Lastly, we will begin to explore the clinical utility of dose prediction equations within the National Health Service (NHS).