Title:Insights into Chronic Lithium Toxicity - A Case Report
Volume: 18
Issue: 1
Author(s): Giphy Susan Varghese*, Karthikkeyan Rajachandran and Indhupriyadharshini Murugesan
Affiliation:
- Clinical Pharmacist, Medical Intensive Care Unit, PSG Super Speciality Hospital, Coimbatore, India
Keywords:
Bipolar disorder, lithium carbonate, chronic lithium toxicity, serum lithium levels, seizures, renal insufficiency, hemodialysis.
Abstract:
Background: Bipolar disorder is a chronic psychological disorder, and lithium remains
the mainstay of therapy. Lithium toxicity can be acute or chronic and the effects may be disabling
or life-threatening. The presence of risk factors can increase the chances of lithium toxicity in a patient
on long-term lithium therapy. We hereby report a case of chronic lithium toxicity in a patient
with a known case of bipolar disorder.
Case Presentation: A 44-year-old female patient with a known case of bipolar disorder presented
with altered sensorium, seizures, and renal insufficiency. On admission, the patient was severely
dehydrated and the serum lithium level was 3.43 mEq/L. Hemodialysis was performed and she improved
gradually.
Conclusion: Lithium has constantly proven to be beneficial in lowering suicide rates in bipolar
disorder patients over the years since its approval. However, its use is limited due to the risk of
toxicity. The chances of developing toxicity are higher in patients on long-term lithium therapy.
Patients with high risk factors for toxicity should be monitored frequently as the effects of lithium
toxicity can be fatal.
