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Peer response to this post At this time, he is in a euthymic state and it would be a good time to start a mood stabilizer instead of waiting until he has a depressive state. This is of course after ruling out any other medical issues/conditions or contraindications to starting a mood stabilizer. I would start him on lithium 300 mg PO BID (depending on his weight) (Goldin, 2023). Lithium does have a low therapeutic threshold and will require multiple lab (trough)levels weekly and then monthly to maintain the therapeutic index and prevent toxicity. This medication is an FDA-approved mood stabilizer for bipolar in adults. It can also be used for bipolar depressive depression and has been known to decrease suicidal ideations. Lithium is considered a first-line treatment for recurrent depressive disorders and bipolar disorder (Goldin, 2023).

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