What are the guidelines for pts on Lithium because of bipolar disorder.
For example: a woman has had a bipolar disorder for 10 years and is currently taking lithium. she has had 2 episodes of mania but has returned well for 4 years. she is now planning pregnancy...

OHCS p 21 and 355 says that in such cases we should consult specialist and lithium is teratogenic so should be avoided in 1st trimester, and we can not stop it immediately so it should be a gradual decrease in dose before stopping it.

and another type of Q where same patient but without 4 years of remission. what to do in that case?