Lithium use in females of childbearing potential

Because first-trimester lithium use is associated with an increased risk of rare cardiac malformations, discuss the importance of effective contraception with a female of childbearing potential. Lithium and hormonal contraceptives can be used concurrently.

If a patient taking lithium wishes to plan a pregnancy:

• see Principles of psychotropic use in females of childbearing potential for advice on preconception planning
• see lithium use during pregnancy for management considerations
• inform the patient that after the infant is born, breastfeeding is incompatible with lithium
• liaise with the patient’s psychiatrist for advice if the decision is made to stop lithium.