Introduction
manic, bipolar disorder, depressive disorder, depressive, treatment-resistant major
Lithium carbonate is the most effective mood stabilizer in patients with bipolar disorder. It prevents both manic and depressive episodes and is an augmenting agent for recurrent or treatment-resistant major depressive disorder [Previous studies have shown that quality improvement programs such as active monitoring and reminder systems increase the serum lithium monitoring rate [Therefore, we mounted the Kyoto-Toyooka nested controlled trial of reminders (KONOTORI) trial to examine whether the use of the EHR-nested reminder system for serum lithium monitoring can help achieve serum lithium concentrations within the therapeutic range for patients on lithium maintenance therapy.