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Sir: Dr. Shammi points out affirmatively the advantages of single as opposed to multiple daily dosing of lithium. Indeed, a number of reports concluded that taking lithium in a single dose prevents, or at least limits, the increase in urine output (and the reduction of osmolality) and subsequent thirst.1 It also would prevent, to a certain degree, the morphological changes of tubular atrophy and interstitial fibrosis.

It is, however, important to note that those favorable effects of a single-dose schedule are tempered by a number of facts.' ‹