Can an NP prescribe Lithium in North Carolina?

Yes — North Carolina nurse practitioners may prescribe lithium, which is not controlled, when it is within their population focus, education, national certification, competence, and collaborative practice agreement. Controlled-substance DEA registration, CSRS review, and STOP Act opioid limits do not apply to noncontrolled lithium. An NP must have active North Carolina NP approval with prescriptive authority for legend drugs, and lithium prescribing must remain within the NP’s scope, education, and national certification.¹

For lithium prescribing, the NP’s collaborative practice agreement must identify the applicable psychiatric medication authority and describe how the supervising physician will be continuously available for supervision, consultation, collaboration, referral, and evaluation.² The agreement cannot expand the NP’s practice beyond the NP’s population focus, training, national certification, or lawful scope.³