Which of the following is the therapeutic serum lithium level for acute mania?

Explanation

## Therapeutic Lithium Levels **Key Point:** The therapeutic serum lithium concentration for acute mania is **1.2–1.5 mEq/L** (or mmol/L). ### Lithium Serum Level Classification | Serum Level (mEq/L) | Clinical State | Monitoring Interval | | --- | --- | --- | | 0.5–0.8 | Maintenance (bipolar disorder prophylaxis) | Every 3–6 months | | 0.8–1.2 | Maintenance (some patients); mild toxicity risk | Every 1–3 months | | 1.2–1.5 | **Acute mania treatment** | Weekly during initiation | | 1.5–2.0 | Toxicity risk; rarely used | Avoid if possible | | > 2.0 | Severe toxicity (neurotoxicity, renal damage) | Emergency intervention | **High-Yield:** Maintenance therapy for bipolar disorder prophylaxis typically targets **0.5–0.8 mEq/L**, which is lower than acute mania dosing and reduces long-term adverse effects. **Clinical Pearl:** Serum levels should be drawn **12 hours post-dose** (at steady state, typically 5–7 days after initiation or dose change) to ensure accurate measurement and comparability across visits. **Mnemonic: LITH** — **L**ow (0.5–0.8) for **L**ong-term, **I**ntermediate (0.8–1.2) for **I**nitial stabilization, **T**herapeutic (1.2–1.5) for **T**reatment of acute mania, **H**igh (>1.5) = **H**azard.