A practical approach to management of lithium concurrent with hyponatremia, diuretic therapy and/or chronic renal failure.

Lithium therapy concurrent with hyponatremia, thiazides and possibly other diuretics and/or chronic renal failure has generally been avoided. However, despite greater risk for lithium toxicity, such combinations are feasible with appropriate precautions, especially lower lithium dosage and closer follow-up. Under the right circumstances hyponatremia, diuretics, and/or chronic renal failure are only relative lithium contraindications.