The case of a 58 year old woman on maintenance lithium therapy who developed an acute organic brain syndrome is reported. The patient subsequently showed evidence of persistent brain damage. It is suggested that lithium toxicity was precipitated by electrolyte disturbances possibly caused by self medication with a diuretic, where serum levels of lithium were an unreliable measure of impending toxicity.
References
1.
AnanthJ.RuskinR. (1974). Unusual reaction to lithium. Canadian Medical Association Journal111: 1049.
2.
AngstJ.WeisP.GrofP.BaastrupP. C.SchouM. (1970). Lithium prophylaxis in recurrent affective disorders. British Journal of Psychiatry116: 604.
3.
BaerL.GlassmanA.H.KassirS. (1973). Negative sodium balance in lithium carbonate toxicity. Archives of General Psychiatry29: 823.
4.
CadeJ. F. J. (1949). Lithium salts in the treatment of psychotic excitement. Medical Journal of Australia36: 349.
5.
von HartitzschB.HoenichN. A.LeighR. J.WilkinsonR.FrostT.H.WeddelA.PosenG. A. (1972). Permanent neurological sequelae despite haemodyalisis for lithium intoxication. British Medical Journal4: 757.
6.
Juul-JensenP.SchouM. (1973). Permanent brain damage after lithium intoxication. British Medical Journal4: 673.
7.
MaggsRonald, (1973). Lithium intoxication. British Medical Journal1: 416.
8.
MatthewH.LawsonA. A. H. (1975). The Treatment of Common Acute Poisoning.Churchill-Livingston, Edinburgh.
9.
MunizC.FormanA. J.WilderB. J.RamsayR. E. (1976). Lithium toxicity with low serum levels: report of a case. Clinical Electroencephalography1: 31.
10.
NoyesR.DempseyG.M. (1974). Lithium treatment of depression. Diseases of the Nervous System4: 573.
11.
PetersonV.HuidtS.ThomasenK.SchouM. (1974). Effect of prolonged thiazine treatment on renal lithium clearance. British Medical Journal3: 145.
SchouM.BaastrupP. C.GrofP.WeisP.AngstJ. (1970). Pharmacological and clinical problems of lithium prophylaxis. British Journal of Psychiatry116: 615.
14.
SchouM.AmisdenA.BaastrupP. C. (1971). The practical management of lithium treatment. British Journal of Hospital Medicine18: 53.
15.
ShopsinB.JohnsonG.GershonS. (1970). Neurotoxicity with lithium: differential drug responsiveness. International Pharmacopsychiatry5: 170.
16.
TakamashiR.SakumaA.ItohK.ItohH.KuriharhM.SaitoM.WantanabeM. (1975). Comparison of efficacy of lithium carbonate and chlopromazine in mania. Archives of General Psychiatry32: 1310.
17.
VerbovJ. L.PhillipsJ. D.FifeD. G. (1965). A case of lithium intoxication. Post Graduate Medicine41: 190.
