Q. I just saw my psychiatrist and he is contemplating putting me on lithium. I was wondering how often this medication is used in treating BPD? Also, I am a juvenile diabetic, and am worried about lithium causing kidney damage. Is this worry unfounded?

A. Lithium has been shown to be effective in a study by Art Rifkin and colleagues in New York about 30 years ago. Effective does not mean well tolerated. It causes weight gain, polyuria, and lethargy. If you have not been on Effexor, Prozac, or Zoloft, they seem better places to start. They work better, have fewer side effects, and would be better indicated in a type 1 (juvenile) diabetic. Kidney damage with lithium is not really an issue at all. It does not occur. Thyroid damage with time does, and this would be of concern in your case.