Lithium is a medication used to treat Bipolar disorder (manic depression). This article focuses on lithium overdose, or toxicity.
This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.
See: Overdose
Alternative NamesEskalith toxicity; Lithane toxicity; Lithobid toxicity; Lithonate toxicity; Lithotabs toxicity
Poisonous IngredientLithium, a soft metal
Where FoundLithium is sold under various brand names, including:
Note: Lithium is also commonly found in batteries, lubricants, high performance metal alloys, and soldering supplies. This article focuses only on the medication.
SymptomsACUTE TOXICITY
After taking too much lithium you will have symptoms such as:
You may also have some of the following nervous system symptoms, depending on how much lithium you took:
Heart problems may occur in rare cases.
CHRONIC TOXICITY
You will likely not have any gastrointestinal symptoms. Symptoms that may occur include:
In severe cases, you may also have nervous system and kidney problems such as:
ACUTE ON CHRONIC TOXICITY
You will likely get some gastrointestinal symptoms and many of the severe nervous system symptoms listed above.
Before Calling EmergencyDetermine the following:
The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
See: Poison control center - emergency number
What to expect at the emergency roomThe health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. You may receive:
If you have acute lithium toxicity, how well you do depends on how much lithium you took and how quickly you get help. Those who do not develop nervous system symptoms usually have no long-term complications.
If serious nervous system symptoms occur, you may have permanent neurologic problems.
Chronic toxicity is sometimes difficult to diagnose until late in the course. This delay can lead to long-term problems. If dialysis is performed quickly, you may feel much better, but symptoms such as memory and mood problems may be permanent.
Acute on chronic overdose often has the worst outlook. Nervous system symptoms may not go away even after many rounds of dialysis.
ReferencesThundiyil JG, Olson KR. Lithium. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 30.
Ibuprofen incraeses Lithium levels
HCTZ will increase the reabsorption of ions like sodium and lithium. For this reason, your doctor should consider reducing administration of Lithium by 50-75%. You should also monitor for toxic effects of Lithium, which can develop slowly but with long-term use of Lithium. There is a long list of symptoms from toxicity; these would include mania and muscle rigidity. Lithium has a Black Box warning that says that Lithium toxicity can occur even at therapeutic doses and that a patient need to visit his or her doctor and get serum Lithium levels to make sure that Lithium levels are adequate for treatment of their disorder. I would take the FDA up on their suggestion.
"oversedation, confusion, incoordination, seizure, and coma" (Preston, O'Neal, & Talaga, 2008, p. 222).
Lithium is used to treat bipolar disorder that can cause liver toxicity. Drinking alcohol will give more damage to the liver.
Depending what other medications you are taking Lithium will work the same way. However Lithium is note just for bipolar affective disorder is can in certain circumstances be used for other conditions. Try to think about it like this; if you have a sore head you might take some pain relief (Tylenol etc) if you have a fever you might also take Tylenol. When you have the fever you might not have a sore head, the Tylenol will help the fever but because your head isn't in pain there is no need for it to act on it. Lithium is the same, if you do not have bipolar there is no need for the anti-manic action of Lithium BUT if you have other symptoms that may need Lithium then it will work on them. Remember if your taking Lithium to look after your kidneys and be familiar with the signs of Lithium Toxicity.
Yes, Lithium can be quite toxic.Neurologic effects of lithium toxicity include tremors, lethargy, confusion, seizures, and coma.GI effects of lithium toxicity include nausea, vomiting, crampy abdominal pain, and diarrhea.Mild-to-moderate lithium toxicity is characterized by tremor, weakness, and mild confusion.Moderate-to-severe lithium toxicity is characterized by altered mental status, muscle fasciculations, stupor, seizures, coma, hyperreflexia, and cardiovascular collapse.ReferencesLinakis JG, Savitt DL, Wu TY, Lockhart GR, Lacouture PG. Use of sodium polystyrene sulfonate for reduction of plasma lithium concentrations after chronic lithium dosing in mice. J Toxicol Clin Toxicol. 1998;36(4):309-13. [Medline].Menghini VV, Albright RC Jr. Treatment of lithium intoxication with continuous venovenous hemodiafiltration. Am J Kidney Dis. Sep 2000;36(3):E21. [Medline].van Bommel EF, Kalmeijer MD, Ponssen HH. Treatment of life-threatening lithium toxicity with high-volume continuous venovenous hemofiltration. Am J Nephrol. Sep-Oct 2000;20(5):408-11. [Medline].Alexander MP, Farag YM, Mittal BV, Rennke HG, Singh AK. Lithium toxicity: a double-edged sword. Kidney Int. Jan 2008;73(2):233-7. [Medline].Aral H, Vecchio-Sadus A. Toxicity of lithium to humans and the environment--a literature review. Ecotoxicol Environ Saf. Jul 2008;70(3):349-56. [Medline].Burkhart, K. Lithium. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. Sixth Edition. Mosby Elsevier; 2006:2442-2444.Chen KP, Shen WW, Lu ML. Implication of serum concentration monitoring in patients with lithium intoxication. Psychiatry Clin Neurosci. Feb 2004;58(1):25-9. [Medline].Eyer F, Pfab R, Felgenhauer N, et al. Lithium poisoning: pharmacokinetics and clearance during different therapeutic measures. J Clin Psychopharmacol. Jun 2006;26(3):325-30. [Medline].Freeman MP, Freeman SA. Lithium: clinical considerations in internal medicine. Am J Med. Jun 2006;119(6):478-81. [Medline].Giles JJ, Bannigan JG. Tetatogenic and developmental effects of lithium. Curr Pharm Des. 2006;12(12):1531-41.Gitlin M. Lithium and the kidney: an updated review. Drug Saf. Mar 1999;20(3):231-43. [Medline].Greller, H. Lithium. In: Goldfrank's Toxicologic Emergencies. Eighth. McGraw-Hill; 2006:1052-1058.Groleau G. Lithium toxicity. Emerg Med Clin North Am. May 1994;12(2):511-31. [Medline].Hsu CH, Liu PY, Chen JH, Yeh TL, Tsai HY, Lin LJ. Electrocardiographic abnormalities as predictors for over-range lithium levels. Cardiology. 2005;103(2):101-6. [Medline].Juurlink DN, Mamdani MM, Kopp A, Rochon PA, Shulman KI, Redelmeier DA. Drug-induced lithium toxicity in the elderly: a population-based study. J Am Geriatr Soc. May 2004;52(5):794-8. [Medline].Lee DC, Klachko MN. Falsely elevated lithium levels in plasma samples obtained in lithium containing tubes. J Toxicol Clin Toxicol. 1996;34(4):467-9. [Medline].Ng YW, Tiu SC, Choi KL, Chan FK, Choi CH, Kong PS. Use of lithium in the treatment of thyrotoxicosis. Hong Kong Med J. Aug 2006;12(4):254-9. [Medline].Rosenqvist M, Bergfeldt L, Aili H, Mathe AA. Sinus node dysfunction during long-term lithium treatment. Br Heart J. Oct 1993;70(4):371-5. [Medline].Scharman EJ. Methods used to decrease lithium absorption or enhance elimination. J Toxicol Clin Toxicol. 1997;35(6):601-8. [Medline].Timmer RT, Sands JM. Lithium intoxication. J Am Soc Nephrol. Mar 1999;10(3):666-74. [Medline].Zimmerman JL. Poisonings and overdoses in the intensive care unit: general and specific management issues. Crit Care Med. Dec 2003;31(12):2794-801. [Medline].
5-fluorouracil, gentamicin, cisplatin, acetaminophen, para-aminophenol, potassium dichromate, ibuprofen, doxorubicin, cyclosporine, citrinin, puromycin Acyclovir Aminoglycosides Cisplatin Mercury Chloride Potassium Bromate Cadmium chloride Amphotericin B Lithium Calcineurin Inhibitors amongst others
Lithium Bromine
lithium is lithium
lithium hydroxide + carbon dioxide --> lithium bicarbonate
Lithium carbonate (Li2CO3), lithium citrate (Li3C6H5O7), lithium sulfate (Li2SO4), lithium aspartate and the lithium orotate are classified as mood stabilizers.
Lithium is a chemical element and it is simply called Lithium, its symbol is Li.