Lithium carbonate therapy has proved to be extraordinarily effective in controlling the manic phase of manic-depressive psychosis, especially when the mania is acute and severe. In such cases, treatment is usually started with 900 mg of lithium carbonate in divided daily doses. Serum lithium levels are evaluated daily, and, if necessary, the dose of the drug is increased gradually until the serum lithium value approximates 1.5 mEq/liter. Toxic effects are usual if the level exceeds 2.0 mEq/liter.1
As noted by Almy and Taylor,2 some writers have stated that manic patients retain more lithium in the body than do other patients, whereas other writers have disputed that idea. To settle the question, Almy and Taylor administered a single dose of 900 mg of lithium carbonate to ten acutely manic patients and a similar dose to ten matched nonmanic patients having characterological disorders.
Output of lithium ion in the urine
Hussey HH. Lithium Retention. JAMA. 1973;226(9):1115. doi:10.1001/jama.1973.03230090039010