Lithium toxicity

Lithium toxicity
Other names	Lithium overdose, lithium poisoning
A bottle of lithium capsules
Specialty	Toxicology
Symptoms	Tremor, increased reflexes, trouble walking, kidney problems, altered level of consciousness[1]
Complications	Serotonin syndrome, brain damage[1]
Types	Acute, chronic, acute on chronic[1]
Causes	Excessive intake, decreased excretion[1]
Risk factors	Dehydration, low sodium diet, kidney problems[1]
Diagnostic method	Based on symptoms and a lithium level[1][2]
Treatment	Gastric lavage, whole bowel irrigation, hemodialysis[1]
Prognosis	Low 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]