Lithium toxicity

Lithium toxicity
Other namesLithium overdose, lithium poisoning
A bottle of lithium capsules
SpecialtyToxicology
SymptomsTremor, increased reflexes, trouble walking, kidney problems, altered level of consciousness[1]
ComplicationsSerotonin syndrome, brain damage[1]
TypesAcute, chronic, acute on chronic[1]
CausesExcessive intake, decreased excretion[1]
Risk factorsDehydration, low sodium diet, kidney problems[1]
Diagnostic methodBased on symptoms and a lithium level[1][2]
TreatmentGastric lavage, whole bowel irrigation, hemodialysis[1]
PrognosisLow risk of death[3]

Lithium toxicity, also known as lithium overdose, is the condition of having too much lithium. Symptoms may include a tremor, increased reflexes, trouble walking, kidney problems, and an altered level of consciousness. Some symptoms may last for a year after levels return to normal. Complications may include serotonin syndrome.[1]

Lithium toxicity can occur due to excessive intake or decreased excretion.[1] Excessive intake may be either a suicide attempt or accidental.[1] Decreased excretion may occur as a result of dehydration such as from vomiting or diarrhea, a low sodium diet, or from kidney problems.[1] The diagnosis is generally based on symptoms and supported by a lithium level in blood serum of greater than 1.2 mEq/L.[1][2]

Gastric lavage and whole bowel irrigation may be useful if done early.[1] Activated charcoal is not effective.[1] For severe toxicity hemodialysis is recommended.[1] The risk of death is generally low.[3] Acute toxicity generally has better outcomes than chronic toxicity.[4] In the United States about 5,000 cases are reported to poison control centers a year.[2] Lithium toxicity was first described in 1898.[1]

  1. ^ a b c d e f g h i j k l m n o p Hedya, Shireen A.; Avula, Akshay; Swoboda, Henry D. (2019). "Lithium Toxicity". StatPearls. StatPearls Publishing. PMID 29763168. Retrieved 22 December 2019.
  2. ^ a b c "Lithium Toxicity | California Poison Control System | UCSF". calpoison.org. Retrieved 22 December 2019.
  3. ^ a b Baird-Gunning, J; Lea-Henry, T; Hoegberg, LCG; Gosselin, S; Roberts, DM (May 2017). "Lithium Poisoning". Journal of Intensive Care Medicine. 32 (4): 249–263. doi:10.1177/0885066616651582. PMID 27516079. S2CID 22678221.
  4. ^ Waring, WS (2006). "Management of lithium toxicity". Toxicological Reviews. 25 (4): 221–30. doi:10.2165/00139709-200625040-00003. PMID 17288494. S2CID 22844004.