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Lithiumtoxicity:MedlinePlusMedicalEncyclopedia

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Lithiumtoxicity
Lithiumisamedicationusedtotreatbipolardisorder(manicdepression).Thisarticlefocusesonlithiumoverdose,ortoxicity.
Acutetoxicityoccurswhenyouintentionallyoraccidentallyswallowtoomuchofalithiumprescription.
Chronictoxicityoccurswhenyouslowlytakealittletoomuchofalithiumprescriptioneverydayforawhile.Thisisactuallyquiteeasytodo,asdehydration,othermedications,andotherconditionscaneasily
interferewithlithiuminyourbodyandcauseittobuildup.
Acutechronictoxicityoccurswhenyoutakelithiumeverydayforbipolardisorder,butonedayyoutakeanextraamount(aslittleasacoupleofpillsorasmuchasawholebottle).
Thisisforinformationonlyandnotforuseinthetreatmentormanagementofanactualpoisonexposure.Ifyouhaveanexposure,youshouldcallyourlocalemergencynumber(suchas911)ortheNationalPoison
ControlCenterat18002221222.
See:Overdose

PoisonousIngredient
Lithium,asoftmetal

WhereFound
Lithiumissoldundervariousbrandnames,including:
Cibalith
Carbolith
Duralith
Eskalith
Lithane
Lithobid
Lithonate
Note:Lithiumisalsocommonlyfoundinbatteries,lubricants,highperformancemetalalloys,andsolderingsupplies.Thisarticlefocusesonlyonthemedication.
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Symptoms
ACUTETOXICITY
Aftertakingtoomuchlithiumyouwillhavesymptomssuchas:
Diarrhea
Dizziness
Nausea
Stomachpains
Vomiting
Weakness
Youmayalsohavesomeofthefollowingnervoussystemsymptoms,dependingonhowmuchlithiumyoutook:
Coma(decreasedlevelofconsciousness,lackofresponsiveness)
Handtremors
Incoordinationofarmsandlegs(ataxia)
Muscletwitches
Seizures
Slurredspeech
Uncontrollableeyemovement(nystagmus)
Heartproblemsmayoccurinrarecases.
CHRONICTOXICITY
Youwilllikelynothaveanygastrointestinalsymptoms.Symptomsthatmayoccurinclude:
Increasedreflexes
Slurredspeech
Tremors
Inseverecases,youmayalsohavenervoussystemandkidneyproblemssuchas:
Kidneyfailure
Memoryproblems
Movementdisorders
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Problemskeepingsaltsinyourbody
Psychosis(thoughtdisturbance,unpredictablebehavior)
ACUTEONCHRONICTOXICITY
Youwilllikelygetsomegastrointestinalsymptomsandmanyoftheseverenervoussystemsymptomslistedabove.

BeforeCallingEmergency
Determinethefollowing:
Patient'sage,weight,andcondition
Nameoftheproduct(ingredientsandstrengths,ifknown)
Timeitwasswallowed
Amountswallowed
Whetherthemedicationwasprescribedforthepatient

PoisonControl
TheNationalPoisonControlCenter(18002221222)canbecalledfromanywhereintheUnitedStates.Thisnationalhotlinenumberwillletyoutalktoexpertsinpoisoning.Theywillgiveyoufurtherinstructions.
Thisisafreeandconfidentialservice.AlllocalpoisoncontrolcentersintheUnitedStatesusethisnationalnumber.Youshouldcallifyouhaveanyquestionsaboutpoisoningorpoisonprevention.ItdoesNOTneed
tobeanemergency.Youcancallforanyreason,24hoursaday,7daysaweek.
See:Poisoncontrolcenteremergencynumber

WhattoExpectattheEmergencyRoom
Thehealthcareproviderwillmeasureandmonitorthepatient'svitalsigns,includingtemperature,pulse,breathingrate,andbloodpressure.Symptomswillbetreatedasappropriate.Youmayreceive:
Activatedcharcoal,especiallyifothersubstanceswerealsotaken
Bloodteststomeasurelithiumlevelsandotherbodychemicals
EKG(hearttracing)
Fluidsthroughavein(byIV)
Kidneydialysis(machine)
Medicinestocontrolsymptoms
Tubethroughthemouthintothestomachtoremovesomeofthepillsbeforetheyareabsorbedbythestomach(gastriclavage)onlyifyourecentlyswallowedalargeamountoflithium

Outlook(Prognosis)
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Ifyouhaveacutelithiumtoxicity,howwellyoudodependsonhowmuchlithiumyoutookandhowquicklyyougethelp.Thosewhodonotdevelopnervoussystemsymptomsusuallyhavenolongterm
complications.
Ifseriousnervoussystemsymptomsoccur,youmayhavepermanentneurologicproblems.
Chronictoxicityissometimesdifficulttodiagnoseuntillateinthecourse.Thisdelaycanleadtolongtermproblems.Ifdialysisisperformedquickly,youmayfeelmuchbetter,butsymptomssuchasmemoryand
moodproblemsmaybepermanent.
Acuteonchronicoverdoseoftenhastheworstoutlook.Nervoussystemsymptomsmaynotgoawayevenaftermanyroundsofdialysis.

AlternativeNames
EskalithtoxicityLithanetoxicityLithobidtoxicityLithonatetoxicityLithotabstoxicity

References
ThundiyilJG,OlsonKR.Lithium.In:ShannonMW,BorronSW,BurnsMJ,eds.HaddadandWinchester'sClinicalManagementofPoisoningandDrugOverdose
HungO.Lithium.In:MarxJA,HockbergerRS,WallsRM,etal.,eds.Rosen'sEmergencyMedicine:ConceptsandClinicalPractice

UpdateDate1/19/2014
Updatedby:JacobL.Heller,MD,MHA,EmergencyMedicine,VirginiaMasonMedicalCenter,Seattle,WA.AlsoreviewedbyDavidZieve,MD,MHA,IslaOgilvie,PhD,andtheA.D.A.M.Editorialteam.

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Theinformationprovidedhereinshouldnotbeusedduringanymedicalemergencyorforthediagnosisortreatmentofanymedicalcondition.Alicensedphysicianshouldbeconsultedfordiagnosisandtreatmentofanyandallmedicalconditions.Call911forallmedicalemergencies.Links
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