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Side effects and signs of toxicity of lithium treatment
What are some common adverse effects and signs of toxicity of lithium treatment and at what serum lithium levels may they be seen?
Common side effects of lithium at therapeutic levels (∼0.6 to 1.0 mEq/L) include
- acne,
- weight gain,
- edema,
- changes in the glomerular filtration rate,
- hypothyroidism (necessitates monitoring thyroid-stimulating hormone levels when on lithium),
- tremor,
- GI (nausea, diarrhea, cramping), and
- cognitive complaints
Initial signs of lithium toxicity typically begin to manifest when serum lithium levels are above 1.5 mEq/L, but can be present above 1.0 mEq/L.
- Visual changes (blurring),
- slurring of speech,
- hyperreflexia,
- dysarthria,
- ataxia,
- confusion,
- fever,
- autonomic instability,
- leukocytosis, and
- limb rigidity can develop.
- Arrhythmias, seizures, and coma can develop at levels above 2.5 to 3 mEq/
For what phases of bipolar disorder (mania, depression, and maintenance) is lithium an effective treatment?
Lithium is an effective and first line treatment of all bipolar disorder phases.
