Abstract
The literature concerning side effects of normal serum levels of lithium on various organ systems is reviewed. Suggestions for monitoring and managing these adverse effects are discussed. A table is presented that provides recommendations for evaluation prior to initiation and during follow-up of therapy.
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References
1.
Demers
RG
Heninger
G
. Electrographic changes during lithium treatment . Dis Nerv Syst
1970 ; 31 : 674 –9 .
2.
Demers
RG
Heninger
GR
. Electrocardiographic T-wave changes during lithium carbonate treatment . JAMA
1971 ; 218 : 381 –6 .
3.
Kochar
MS
Wang
RIH
D'Cunha
GF
. Electrocardiographic changes simulating hypokalemia during treatment with lithium carbonate . J Electrocardiol
1971 ; 4 : 371 –3 .
4.
Albrecht
JW
. Muller-Oerlinghavsen. Cardiovascular side-effects of lithium . In:
Johnson
FN
, ed. Handbook of lithium therapy . Lancaster, England : MTP Press Ltd. , 1980 : 323 –7 .
5.
Wilson
JR
Kraus
ES
Bailas
MM
Reversible sinus-node abnormalities due to lithium carbonate therapy . N Engl J Med
1976 ; 294 : 1223 –4 .
6.
Wellers
HJ
Cats
VM
Duren
DR
. Symptomatic sinus node abnormalities following lithium carbonate therapy . Am J Med
1975 ; 59 : 285 –7 .
7.
Eliasen
P
Anderson
M
. Sinoatrial block during lithium treatment . Eur J Cardiol
1975 ; 3 : 97 –8 .
8.
Roose
SP
Nunberger
JI
Dunner
DL
Cardiac sinus node dysfunction during lithium treatment . Am J Psychiatry
1979 ; 6 : 804 –6 .
9.
Tangedahl
TN
Gau
GT
. Myocardial irritability associated with lithium carbonate therapy . N Engl J Med
1972 ; 287 : 867 –8 .
10.
Rosenquist
RJ
Brauer
WW
Mork
JN
. Recurrent major ventricular arrhythmias . Minn Med
1971 ; 54 : 877 –80 .
11.
Jarrett
DJ
Serry
J
Burrows
GD
. Lithium-induced tremor . Med J Aust
1975 ; 62 : 21 .
12.
Kirk
L
Baastrup
PC
Schou
M
. Propranolol and lithium-induced tremor . Lancet
1972 ; 1 : 839 .
13.
Kirk
L
Baastrup
PC
Schou
M
. Propranolol treatment of lithium induced tremor (letter) . Lancet
1973 ; 2 : 1086 .
14.
Schou
M
Baastrup
PC
Gross
P
Pharmacological and clinical problems of lithium prophylaxis . Br J Psychiatry
1970 ; 116 : 615 –9 .
15.
Jus
A
Villeneuve
A
Gautier
J
Some remarks on the influence of lithium carbonate in patients with temporal epilepsy . Int J Clin Pharmacol
1973 ; 7 : 67 –79 .
16.
Erwin
CW
Gerber
CJ
Morrison
SD
Lithium carbonate and convulsive disorders . Arch Gen Psychiatry
1973 ; 28 : 646 –8 .
17.
Baldessarini
RJ
Stephens
JH
. Lithium carbonate for affective disorders, I: Clinical pharmacology and toxicology . Arch Gen Psychiatry
1970 ; 22 : 72 –7 .
18.
Demers
R
Lukish
R
Prichard
J
. Convulsion during lithium therapy . Lancet
1970 ; 2 : 315 –6 .
19.
Muniz
CE
Forman
AJ
Wilder
BJ
Lithium toxicity with low serum levels—report of a case . Clin Electroencephalogr
1976 ; 7 : 31 –4 .
20.
Salem
RB
Muniz
CE
Director
K
. Ataxia as the primary symptom of lithium toxicity . Drug Intell Clin Pharm
1980 ; 14 : 622 –3 .
21.
Kusumi
Y
. A cutaneous side-effect of lithium: Report of two cases . Dis Nerv Syst
1971 ; 32 : 853 –4 .
22.
Ruiz-Maldonado
R
Francisco
CD
Tamayo
L
. Lithium dermatitis . JAMA
1973 ; 224 : 1534 .
23.
Yoder
FW
. Acneiform eruption due to lithium carbonate . Arch Dermatol
1975 ; 111 : 396 –7 .
24.
Okrasinski
H
. Lithium acne . Dermatologica
1977 ; 154 : 251 –3 .
25.
Reiffers
J
Dick
P
. Cutaneous side-effects of treatment with lithium . Dermatologica
1977 ; 155 : 155 –63 .
26.
Aldoroty
N
LeVine
WR
. Dermatosis and lithium therapy . Am J Psychiatry
1980 ; 137 : 870 .
27.
Carter
TN
. The relationship of lithium carbonate to psoriasis . Psychosomatics
1972 ; 13 : 325 –7 .
28.
Skott
A
Mobacken
H
Starmark
JE
. Exacerbation of psoriasis during lithium treatment . Br J Dermatol
1977 ; 96 : 445 –8 .
29.
Skott
A
Magnusson
B
Mobacken
H
Starmark
J
. Lithium and psoriasis (letter) . Br J Psychiatry
1977 ; 131 : 223 .
30.
Lowe
NJ
Rigway
HB
. Generalized pustular psoriasis precipitated by lithium carbonate . Arch Dermatol
1978 ; 114 : 1788 –9 .
31.
Skoven
I
Thormann
J
. Lithium compound treatment and psoriasis . Arch Dermatol
1979 ; 115 : 1185 –7 .
32.
Evans
DL
Martin
W
. Lithium carbonate and psoriasis . Am J Psychiatry
1979 ; 136 : 1325 –7 .
33.
Callaway
CL
Hendrie
HC
Luby
ED
. Cutaneous conditions observed in patients during treatment with lithium . Am J Psychiatry
1968 ; 124 : 1124 –5 .
34.
Posey
RE
. Lithium carbonate dermatitis (letter) . JAMA
1972 ; 221 : 1517 .
35.
Meinhold
JM
West
D
Gurwich
E
Spunt
A
Koya
D
. Cutaneous reaction to lithium carbonate: A case report . J Clin Psychiatry
1980 ; 41 : 395 –6 .
36.
Vacaflor
L
Lehman
HE
Bar
TA
. Side effects and teratogenicity of lithium carbonate treatment . J Clin Pharmacol
1970 ; 10 : 387 –9 .
37.
Muniz
CE
Salem
RB
Director
KL
. Hair loss in a patient receiving lithium . Psychosomatics
1982 ; 213 : 312 –3 .
38.
Jefferson
JW
Greist
JH
Diamond
RD
Lithium and hair loss . Int Drug Ther Newslett
1979 ; 14 : 23 .
39.
Kuhnley
EJ
Granoff
AL
. Exfoliative dermatitis during lithium treatment . Am J Psychiatry
1978 ; 115 : 1185 –7 .
40.
Jeppsson
J
Sjögren
J
. The influence of food on side effects and absorption of lithium . Acta Psychiatr Scand
1975 ; 51 : 285 –8 .
41.
Lapierre
G
Stewart
RB
. Lithium carbonate and leukocytosis . Am J Hosp Pharm
1980 ; 37 : 1525 –8 .
42.
O'Connell
RA
. Leukocytosis during lithium carbonate treatment . Int Pharmacopsychiatry
1970 ; 4 : 30 –4 .
43.
Shopsin
B
Friedman
R
Gershon
S
. Lithium and leukocytosis . Clin Pharmacol Ther
1971 ; 12 : 923 –8 .
44.
Freyhan
FA
O'Connell
RA
Mayo
JA
. Treatment of mood disorders with lithium carbonate . Int Pharmacopsychiatry
1970 ; 5 : 137 –48 .
45.
Murphy
DL
Goodwin
FK
Bunney
WE
Jr.
Leukocytosis during lithium treatment . Am J Psychiatry
1971 ; 127 : 1559 –61 .
46.
Hammond
WP
IV
Applebaum
F
. Lithium and acute monocytic leukemia (letter) . N Engl J Med
1980 ; 302 : 808 .
47.
Nielsen
JL
. More on lithium and leukemia (letter) . N Engl J Med
1980 ; 303 : 283 –4 .
48.
Longo
DL
. More on lithium and leukemia (letter) . N Engl J Med
1980 ; 303 : 283 .
49.
Lyskowski
J
Nasrallah
HA
. Lithium therapy in the risks of leukemia (letter) . Br J Psychiatry
1981 ; 139 : 256 .
50.
Leber
P
. Lithium, leukocytosis, and leukemia: The probable influence of biologic plausibility on clinical concern . Psychopharmacol Bull
1981 ; 17 : 10 –3 .
51.
Lindstedt
G
Nilsson
LA
Walinder
J
On the prevalence, diagnosis and management of lithium induced hypothyroidism in psychiatric patients . Br J Psychiatry
1977 ; 130 : 452 –8 .
52.
Cho
JT
Bone
S
Dunner
DL
The effect of lithium treatment on thyroid function in patients with primary affective disorder . Am J Psychiatry
1979 ; 136 : 115 –6 .
53.
Emerson
CH
Dyson
WL
Utiger
RD
. Serum thyrotropin and thyroxine concentrations in patients receiving lithium carbonate . J Clin Endocrinol Metab
1973 ; 36 : 338 –46 .
54.
Rabin
PL
Evans
DC
. Exophthalmos and elevated thyroxine levels in association with lithium therapy . J Clin Psychiatry
1981 ; 10 : 398 –400 .
55.
Valenta
LJ
Elias
AN
Weber
DJ
. Hyperthyroidism and propylthiouracil-induced agranulocytosis during chronic lithium carbonate therapy . Am J Psychiatry
1981 ; 138 : 1605 –7 .
56.
Christensson
TA
. Lithium, hypercalcemia, and hyperthyroidism (letter) . Lancet
1976 ; 2 : 144 .
57.
Christiansen
C
Baastrup
PC
Lindgreen
P
Endocrine effects of lithium II. Primary hyperparathyroidism . Acta Endocrinol (Copenh) 1978 ; 88 : 528 –34 .
58.
Cervi-Skinner
SJ
. Lithium carbonate induced hypercalcemia . West J Med
1977 ; 127 : 527 –8 .
59.
Christiansen
C
Baastrup
PC
Transbol
I
. Development of “primary” hyperparathyroidism during lithium therapy: Longitudinal study . Neuropsychobiology
1980 ; 6 : 280 –3 .
60.
Graze
KK
. Hyperparathyroidism in association with lithium therapy . J Clin Psychiatry
1981 ; 1 : 38 –9 .
61.
Shen
F
Shennard
DJ
. Lithium-induced hyperparathyroidism: An alteration of the “set point.”
Ann Intern Med
1982 ; 96 : 63 –5 .
62.
Davis
BM
Pfefferbaum
A
Krutzik
S
Davis
KL
. Lithium's effect on parathyroid hormone . Am J Psychiatry
1981 ; 138 : 489 –92 .
63.
Carman
JS
Wyatt
RJ
. Calcium: Pace-setting the possible psychosis . Am J Psychiatry
1979 ; 136 : 1035 –9 .
64.
Dempsey
M
Dunner
DL
Fieve
RR
Treatment of excessive weight gain in patients taking lithium . Am J Psychiatry
1976 ; 133 : 1082 –4 .
65.
Hestbech
J
Hansen
HE
Amdisen
A
Chronic renal lesions following long-term treatment with lithium . Kidney Int
1977 ; 12 : 205 –13 .
66.
Golt
E
Igel
G
Fieve
R
Lithium-associated nephropathy (letter) . Am J Psychiatry
1979 ; 136 : 1098 –9 .
67.
Hallfren
R
Alm
PO
Hellsing
K
. Renal function in patients on lithium treatment . Br J Psychiatry
1979 ; 135 : 22 –7 .
68.
Vestergaard
P
Amdisen
A
Hansen
HE
Lithium treatment and kidney function . Acta Psychiatr Scand
1979 ; 60 : 504 –20 .
69.
Donker
AJM
Prins
S
Meyer
S
A renal function study in 30 patients on long-term lithium therapy . Clin Nephrol
1979 ; 12 : 254 –62 .
70.
Hullin
RP
Coley
VP
Birch
JJ
Renal function after long-term treatment of lithium . Br Med J
1979 ; 1 : 1457 –9 .
71.
Hansen
HE
Hestbech
J
Sorensen
JL
Chronic interstitial nephropathy in patients on long-term lithium treatment . Q J Med
1979 ; 192 : 577 –91 .
72.Biological therapies in psychiatry . Mass Gen Hosp Newslett
1981 ; 4 : 25 –6 .
73.
Gelenberg
AJ
Wojcik
JD
Coggins
CH
Renal function monitoring in patients receiving lithium carbonate . J Clin Psychiatry
1981 ; 42 : 428 –31 .
74.
Cockcroft
DW
Gault
MH
. Prediction of creatinine clearance from serum creatinine . Nephron
1976 ; 16 : 31 –41 .
75.
Wallin
L
Ailing
C
. Effect of sustained-release lithium tablets on renal function . Br Med J
1979 ; 2 : 1332 .
76.
Vestergaard
P
. Sustained-release lithium and renal function (letter) . Br Med J
1980 ; 280 : 113 .
