Lithium overdose and delayed severe neurotoxicity:timing for renal replacement therapy and restarting of lithium

Abstract

This is a case report of a man in his 60s who presented to an English hospital following a significant lithium overdose. He was monitored for 24 hours, and then renal replacement therapy was initiated after assessment by the renal team. As soon as the lithium level returned to normal therapeutic levels (from 4.7 mEq/L to 0.67 mEq/L), lithium was restarted by the medical team. At this point, the patient developed new slurred speech and later catatonia. In this case report, we discuss the factors that could determine which patients are at risk of neurotoxicity following lithium overdose and the appropriate decision regarding when and how to consider initiation of renal replacement therapy and restarting of lithium.

Publication DOI: https://doi.org/10.1136/bcr-2017-222453
Divisions: College of Health & Life Sciences > Aston Medical School
Additional Information: Copyright © 2018 by the BMJ Publishing Group Ltd.
Uncontrolled Keywords: bipolar i disorder,poisoning,psychiatry (drugs and medicines),suicide (psychiatry),toxicology,Medicine(all)
Publication ISSN: 1757-790X
Last Modified: 19 Feb 2024 08:17
Date Deposited: 25 Sep 2018 14:32
Full Text Link: https://wlv.ope ... dle/2436/620769
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2017-10-25
Accepted Date: 2017-10-10
Authors: De Cates, Angharad N.
Morlet, Julien
Antoun Reyad, Ayman
Tadros, George (ORCID Profile 0000-0001-5820-7643)

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