What is Lithium Toxicity

Lithium toxicity which is also called lithium poisoning, is the condition of having too much lithium in the blood. Lithium is a medicine that is used to treat bipolar disorder. Lithium toxicity can be life-threatening.

What are the causes?

This condition is caused by:

• Ingesting too much lithium, causing levels of lithium to rise in your body.
• Taking lithium on a regular basis and:
  • Having a condition that raises lithium levels in the body.
  • Taking another medicine that raises lithium levels in the body.
• Taking excess amounts of lithium in trying to take one’s life (suicide attempt).
• A decrease in kidney (renal) function because of dehydration, or as a side effect of another medicine.

What increases the risk?

This condition is more likely to develop in people:

• Who are young or old.
• Who have kidney disease.
• Who have heart disease.
• Who have dehydration that is caused by sweating or diarrhea.
• Who have low sodium levels in the body.

Certain medicines can increase the risk for this condition. They include:

• Water pills (diuretics).
• Certain medicines for high blood pressure.
• Nonsteroidal anti-inflammatory drugs (NSAIDs).

What are the signs or symptoms?

Symptoms of mild to moderate lithium toxicity are:

• Nausea and vomiting.
• Diarrhea.
• Drowsiness.
• Thirst.
• Muscle weakness.
• Slurred speech.
• Lack of coordination.
• Frequent urination.
• Being restless (agitation).

The symptoms of moderate to severe lithium toxicity are:

• Blurred vision.
• Giddiness.
• Ringing in the ears.
• Severe muscle spasms.
• Seizures.
• Abnormal heart rhythm.
• Loss of consciousness or coma.

How is this diagnosed?

This condition may be diagnosed based on:

• Your signs and symptoms.
• Your use of lithium. You will be asked about how much lithium you take, how long you have been taking it, and when you took your last dose.
• Blood tests. These are done to check the level of lithium in your blood.

How is this treated?

Treatment for this condition depends on how severe it is. It often involves special monitoring and hospitalization.

• For mild or moderate toxicity, your dosage of lithium may be reduced or stopped.
• For severe toxicity, lithium may be removed from your body. This is done in a hospital emergency department. It may involve:
  • Gastric lavage. A tube is placed through your nose or mouth into your stomach. The tube is used to remove lithium that has not yet been digested. It may also be used to put medicines directly into your stomach to help stop lithium from being absorbed.
  • Medicines that increase removal of lithium by your kidneys.
  • Use of an artificial kidney to clean your blood (dialysis). This is usually done only in the most severe cases.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Drink enough fluid to keep your urine pale yellow.
• If your toxicity was a result of an intentional overdose, work with a mental health care professional (psychiatrist or counselor).

How is this prevented?

Lithium toxicity is preventable. To keep it from recurring:

• Take medicines only as told by your health care provider.
• Drink enough fluid to keep your urine pale yellow.
• Talk with your health care provider before starting a low-salt (low-sodium) diet.
• Have your blood lithium levels checked regularly.
• Watch for signs and symptoms of lithium toxicity. If you have signs or symptoms, get treatment early. This can help keep severe symptoms from developing.
• Always ask about the risk of interactions when starting a new medicine.

Contact a health care provider if:

• You have signs or symptoms of mild or moderate lithium toxicity after you receive treatment, even if your blood lithium level is normal.

Get help right away if:

• Your symptoms get worse.
• You have signs or symptoms of severe lithium toxicity after you receive treatment.

Summary

• Lithium toxicity, which is also called lithium poisoning, is the condition of having too much lithium in your blood.
• This either results from taking too much lithium or from changes that cause the medicine to be eliminated from your body more slowly.
• Treatment depends on the severity of the condition but often involves special monitoring and hospitalization.