The authors report a unique case that presented with hemodynamic abnormalities and severe bradycardia, necessitating the insertion of a temporary pacemaker, as well as metabolic disturbances, hematologic changes, and hepatic and renal dysfunction in an elderly individual owing to lithium intoxication. This case also demonstrates that these various serious side effects of lithium resolved with prompt recognition and discontinu ation of lithium. Lithium should be used with extreme caution and frequent monitoring especially in the elderly.
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References
1.
Simard M., Gumbiner B., Lee A., et al: Lithium carbonate intoxication: A case report and review of the literature. Arch Intern Med149:36-46, 1989.
2.
Schou M.: Lithium in the treatment of other psychiatric and nonpsychiatric disorders . Arch Gen Psychiatry36:856-859, 1979.
3.
Mitchell J., Mackenzie T.: Cardiac effects of lithium therapy in man: A review. J Clin Psychiatry43 :47-51, 1982.
4.
Palileo E., Coelho A., Westveer D., et al: Persistent sinus node dysfunction secondary to lithium therapy . Am Heart J106:1443-1444, 1983 .
5.
Tilkian T., Schroeder J., Kao J., et al: The cardiovascular effects of lithium in man. Am J Med61:665-670, 1989.
6.
Ong A., Handler C.: Sinus arrest and asystole due to severe lithium intoxication. Int J Cardiol30:364-366, 1991.
7.
Granoff A., Davis J.: Heart illness syndrome and lithium intoxication. J Clin Psychiatry39:103-107, 1978.
8.
Singer I., Rotenberg D.: Mechanisms of lithium action. N Engl J Med289:254-260, 1973.
9.
Price L., Heninger G.: Lithium in the treatment of mood disorders. N Engl J Med331:591-598, 1994.
10.
Viegut V., Jefferson J.: Lithium and the liver. Lithium1:9-13, 1990.
11.
Mallette L. , Eichhort E.: Effects of lithium carbonate on human calcium metabolism. Arch Intern Med146:770-776, 1986.
12.
Barr R., Galbraith P.: Lithium and hematopoiesis. Can Med Assoc J128:123-126, 1983.
13.
Stein R., Beaman C., Ali M., et al: Lithium carbonate attenuation of chemotherapy-induced neutropenia . N Engl J Med297:430-431, 1977.
14.
Collado S., Charron D., Degos L.: Double-blind, placebo-controlled lithium treatment in chemotherapy-induced aplasia for AML: Reduced antibiotic requirement. Med Oncol Tumor Pharmacother5:103-105, 1988.
15.
Roberts D., Berman S., Nakasatao S., et al: Effects of lithium carbonate on zidovudine-associated neutropenia in the acquired immunodeficiency syndrome. Am J Med85:428-431, 1988.
