Monday, June 04, 2012

Lithium overdose

Table of Contents

Alternative Names

Eskalith toxicity; Lithane toxicity; Lithobid toxicity; Lithonate toxicity; Lithotabs toxicity


Before Calling Emergency

Determine the following:

  • Patient's age, weight, and condition
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed
  • Whether the medication was prescribed for the patient

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number


What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. You may receive:

  • Activated charcoal, especially if other substances were also taken
  • Blood tests to measure lithium levels
  • Fluids through a vein (by IV)
  • Kidney dialysis
  • Medicines to control nausea
  • Tube through the mouth into the stomach to remove some of the pills before they are absorbed by the stomach (gastric lavage) -- only if you recently swallowed a large amount of lithium

Expectations (prognosis)

If you have acute lithium toxicity, how well you do depends on how much lithium you took and how quickly you get help. Those who do not develop nervous system symptoms usually have no long-term complications.

If serious nervous system symptoms occur, you may have permanent neurologic problems.

Chronic toxicity is sometimes difficult to diagnose until late in the course. This delay can lead to long-term problems. If dialysis is performed quickly, you may feel much better, but symptoms such as memory and mood problems may be permanent.

Acute on chronic overdose often has the worst outlook. Nervous system symptoms may not go away even after many rounds of dialysis.



Review Date: 01/21/2010
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)