NCMD Seminar Series presents 'An update on the revised BNF monograph for lithium salts’

This weeks seminar welcomed Dr David Cousins to present a talk on ‘An update on the revised BNF monograph for lithium salts’

Dr Cousins is a Clinical Senior Lecturer and Honorary Consultant Psychiatrist at the Regional Affective Disorders Service. As Director of Newcastle Magnetic Resonance Centre, he leads a research team developing advanced multinuclear magnetic resonance techniques (7Li-MRI) capable of directly determining the distribution of lithium in the human brain in vivo. These techniques are being applied to important questions such as the prediction of response and the investigation of tissue-level pharmacokinetics in a coordinated group of centres across Europe (and increasingly further afield). His interest in lithium is enduring and not restricted to esoteric imaging, but also to seemingly simple matters such as treatment initiation, dosing schedules and the optimisation of monitoring.

In 2020, the UK was served notice that the most common brand of lithium was to be discontinued. Given the recommendations that lithium should always be prescribed by brand, this caused considerable disquiet. In this presentation, Dr Cousins discussed how this proposed discontinuation was navigated, the challenges faced in developing guidelines for switching and the uncertainties in the BNF recommendations for lithium that the process uncovered. As a direct consequence, a change in the BNF monograph for lithium was proposed and has now been completed. Dr Cousins discussed the implications for prescribing, together with the rationale for the more notable changes.