ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Psychopharmacology

Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1609038

Attitudes Toward Lithium Prescription Among Psychiatrists in Saudi Arabia: A Cross-sectional Study

Provisionally accepted
Mohammad  AlolayanMohammad Alolayan1Ahmad  H. AlmadaniAhmad H. Almadani1*Ghada  AlrashedGhada Alrashed2Jamal  AlothaimJamal Alothaim2Weam  HusseinWeam Hussein3
  • 1Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 2Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
  • 3College of Medicine, King Saud University, Riyadh, Saudi Arabia

The final, formatted version of the article will be published soon.

Background: Bipolar disorder (BD) is a mental illness with an estimated overall lifetime prevalence of 2.4% worldwide. Various pharmacological agents are available for treating BD, one of which is lithium. Lithium is commonly recommended as a first-line treatment during the maintenance phase of BD. However, prescribing patterns for mood disorders vary among countries, with notable regional differences in lithium use. Methods: This cross-sectional study included 287 psychiatrists and psychiatry trainees in Saudi Arabia. A survey consisting of 22 multiple-choice questions was sent via WhatsApp to all participants. Data were collected between January and May, 2024. Results: Lithium was prescribed to BD patients by 72.5% of the participants. Most participants (70.7%) prescribed lithium to up to 25% of their patients. The primary reasons for not prescribing lithium were concerns about its adverse effects (64.8%), followed by the need for monitoring (53.7%), and the unavailability/shortage of lithium supply in Saudi Arabia (45.6%). Psychiatrists working in general hospitals (p=0.017) were more likely to prescribe lithium to patients with BD. In contrast, psychiatrists with limited experience or those who were unfamiliar with lithium treatment (p=0.001) were less likely to prescribe lithium. Conclusion: The use of lithium in Saudi Arabia is often influenced by concerns about its side effects, the need for monitoring, and product availability. Psychiatrists’ familiarity with lithium and the settings in which they practice are significant factors shaping prescribing behavior. Future efforts should focus on addressing the barriers to lithium prescription, including enhancing clinician training and improving access to lithium.

Keywords: Lithium, Bipolar Disorder, Psychiatrists, Residents, Attitude, Prescription, Saudi Arabia

Received: 09 Apr 2025; Accepted: 29 May 2025.

Copyright: © 2025 Alolayan, Almadani, Alrashed, Alothaim and Hussein. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ahmad H. Almadani, Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia

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