BMC Psychiatry (Mar 2025)

Challenges of lithium prescription in bipolar disorders in Nigeria

  • Frances Nkechi Adiukwu,
  • Mumeen Olaitan Salihu,
  • Nafisatu Hayatudeen,
  • Yesiru Adeyemi Kareem,
  • Benjamin Olamide Adegoke,
  • Ijeoma Chinanuekperem Charles-Ugwuagbo,
  • Emmanuel Effiong Uwah,
  • Ismail Olaiitan Adesina,
  • Abba Mohammed Ibrahim,
  • Muhammad Abba Fugu

DOI
https://doi.org/10.1186/s12888-025-06736-0
Journal volume & issue
Vol. 25, no. 1
pp. 1 – 9

Abstract

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Abstract Background Lithium prescription rates have witnessed a significant downward trend over the years in different continents despite evidence of its clinical efficacy in the acute and long-term maintenance treatment of Bipolar Disorder (BD). Nigeria has a paucity of data on lithium use in BD management. Hence, we aim to investigate the lithium prescription rate and factors influencing its use among Nigerian psychiatrists and trainee psychiatrists. Methods A cross-sectional survey involving 203 respondents working in different accredited psychiatric training facilities in Nigeria was conducted between April and May 2024 using a predesigned online Google form. Information relating to lithium use in managing the different phases of BD and factors influencing its use were assessed. Results The mean age of the respondents was 37.98 (± 6.85) years. The lithium prescription rate is low (10.89%). There is a significant association between the respondents’ awareness of clinical practice guidelines (CPG) and good adherence to CPG (p = 0.003), but this did not significantly influence lithium prescription among them. Older years of practice influence prescribing lithium (p = < 0.001). Monitoring and availability of lithium constituted significant concerns for lithium use, among other factors (p = 0.032). Conclusion The study revealed a low lithium prescription rate among Nigerian psychiatrists and trainee psychiatrists compared to international studies. There is a need for concerted efforts towards addressing the identified factors. A review of the existing local CPG in line with the best evidence is warranted for improved clinical outcomes. Ethics registration The study was approved by the Hospital Research and Ethical Committee (HREC) of the University of Port Harcourt Teaching Hospital (UPTH) with approval protocol number (UPTH/ADM/90/S.11/VOL.XI/1688). Clinical trial number Not applicable.

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