Lithium treatment for affective disorders: Exploring the potential of salivary therapeutic monitoring

Lithium is one of the most effective medications for treatment-resistant depression and bipolar disorder. However, lithium has a narrow therapeutic window: overdosing can lead to life-threatening lithium intoxication while underdosing results in a lack of desired therapeutic effects. Therefore, lithium treatment requires close monitoring with regular laboratory assessments of blood serum concentrations. An alternative method for monitoring lithium at home would increase the safety and empowerment of patients. In our project, we are investigating the potential of saliva as a readily accessible medium. We are exploring a) the best method for collecting and processing saliva, b) methods to measure salivary lithium levels, and c) the correlation between blood serum and saliva concentrations of lithium, and influencing factors; with the aim to develop a Point-of-care home testing device.