A Case of Lithium Toxicity in a Patient Treated with Maintenance Dose of Lithium / 대한정신약물학회지

ABSTRACT

Lithium is widely used in the treatment of various psychiatric disorders, including bipolar disorder. Lithium has been known to have a narrow therapeutic range inducing severe toxic effects with overdose. Many clinical guidelines recommended clinicians to check serum levels and renal panels regularly during lithium administration. In this case report, we report a case of 60 years old man with severe lithium toxicity, who was taking daily dose of lithium 900 mg through an year. The serum lithium level checked 4 months before admission was 0.4 mEq/L. He restarted his habitual drinking a few months before admission, and soon after acute confusional symptoms were occurred to bring him to emergency room of the Dongguk University International Hospital. During hospitalization the highest serum lithium level was found to be 3.55 mEq/L. He was treated with hemodialysis and recovered without any prominent sequela. Acute renal failure associated with dehydration, alcohol drinking, and nephrotoxic effects by lithium were thought to be risk factors of lithium toxicity.