Psych CASC / OSCE · Emergency psychiatry
Lithium toxicity counselling — CASC communication station
MRCPsych/FRANZCP-style communication station: explain lithium toxicity, interaction precipitants, sick-day rules, EXTRIP-level seriousness without jargon overload, and shared restart decision including anti-suicide context.
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Station brief
Format. Communication and psychoeducation station, approximately 7–10 minutes after reading time. You are the psychiatry registrar on the medical ward. [1]
Candidate instructions. Explain what lithium toxicity is in plain language, why ibuprofen and dehydration mattered, what warning symptoms to report, how blood tests are timed, and how the team will decide about restarting lithium. Involve the partner’s concerns about safety without inventing legal statutes. Avoid false reassurance and avoid permanent nihilism. [2][4]
References5ShowHide
- [1]Gitlin M Lithium side effects and toxicity: prevalence and management strategies Int J Bipolar Disord, 2016.PMID 27900734
- [2]Finley PR Drug Interactions with Lithium: An Update Clin Pharmacokinet, 2016.PMID 26936045
- [3]Decker BS, Goldfarb DS, Dargan PI, et al. Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup Clin J Am Soc Nephrol, 2015.PMID 25583292
- [4]Cipriani A, Hawton K, Stockton S, et al. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis BMJ, 2013.PMID 23814104
- [5]Nolen WA, Licht RW, Young AH, et al. What is the optimal serum level for lithium in the maintenance treatment of bipolar disorder? A systematic review and recommendations from the ISBD/IGSLI Task Force on treatment with lithium Bipolar Disord, 2019.PMID 31112628