BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuLithium toxicityLithobid toxicityLithium is a prescription medicine used to treat bipolar disorder. This article focuses on lithium overdose, or toxicity.Bipolar disorderBipolar disorder is a mental condition in which a person has wide or extreme swings in their mood. Periods of feeling sad and depressed may alternat...Read Article Now Book Mark Article Acute toxicity occurs when you swallow too much of a lithium prescription at one time. Chronic toxicity occurs when you slowly take a little too much of a lithium prescription every day for a while. This is quite easy to do, because dehydration, other medicines, and other conditions can easily affect how your body handles lithium. These factors can make the lithium build up to harmful levels in your body without you intending this. Acute-on-chronic toxicity occurs when you normally take lithium every day, but one day you take an extra amount. This can be as little as a couple of pills or as much as a whole bottle.Lithium is a medicine with a narrow range of safety. Significant poisoning can result when the amount of lithium taken is more than this range.This article is for information only. DO NOT use it to treat or manage an actual overdose or toxicity. If you or someone you are with has an overdose or toxicity, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Lithium is a medicine that can be harmful in large amounts. Where Found Lithium is sold under various brand names, including:Carbolith LithobidNote: Lithium is also commonly found in batteries, lubricants, high performance metal alloys, and soldering supplies. This article focuses only on the medicine form of lithium. Small amounts of lithium are also found in certain spring waters. Symptoms Symptoms of the three types of lithium toxicity are described below.ACUTE TOXICITYCommon symptoms of taking too much lithium at one time include the following symptom groups.Stomach and intestinal symptoms:Nausea Vomiting Diarrhea DiarrheaDiarrhea is when you pass loose or watery stool.Read Article Now Book Mark Article Stomach painsStomach painsAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.Read Article Now Book Mark Article Neurologic symptoms (develop after the intestinal symptoms)Dizziness Weakness Coma (decreased level of consciousness, lack of responsiveness) ComaDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Hand tremors Hand tremorsA tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...Read Article Now Book Mark Article Lack of coordination of arms and legs Muscle twitches Seizures SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...Read Article Now Book Mark Article Slurred speech Slurred speechDysarthria is a condition in which you have difficulty saying words because of problems with the muscles that help you talk.Read Article Now Book Mark Article Uncontrollable eye movement Uncontrollable eye movementNystagmus is a term to describe uncontrollable movements of the eyes that may be:Side to side (horizontal nystagmus)Up and down (vertical nystagmus)R...Read Article Now Book Mark Article Changes in mental status or altered thinkingHeart problems may occur in rare cases:Slow heart rateCHRONIC TOXICITYThere will likely not be any stomach or intestinal symptoms. Symptoms that can occur include:Increased reflexes Slurred speech Uncontrolled shaking (tremors)In severe cases of chronic toxicity, there may also be nervous system and kidney problems, such as:Kidney failure Kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...Read Article Now Book Mark Article Drinking a lot of fluids Urinating more or less than normal Memory problems Movement disorders, muscle twitches, hand tremors Problems keeping salts in your body Psychosis (disturbed thought processes, unpredictable behavior) Coma (decreased level of consciousness, lack of responsiveness) Lack of coordination of arms and legs Seizures Slurred speechACUTE-ON-CHRONIC TOXICITYThere will often be a combination of the acute and chronic symptoms listed above, including both nervous system and intestinal symptoms. Before Calling Emergency Determine the following:Person's age, weight, and condition Name of the product (ingredients and strength, if known) Time it was swallowed Amount swallowed Whether the medicine was prescribed for the person Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.Poison control centerFor a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...Read Article Now Book Mark Article 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. What to Expect at the Emergency Room Take the container to the hospital with you, if possible.The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.Vital signsVital signs reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. Your health care provider m...Read Article Now Book Mark Article Tests that may be done include:Blood tests to measure lithium levels and other body chemicals, and urine tests to detect other drugs Electrocardiogram (ECG) ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.Read Article Now Book Mark Article Pregnancy test in younger women CT scan of the brain in some casesCT scan of the brainA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.Read Article Now Book Mark Article Treatment may include:Fluids through a vein (by IV) Medicines to treat symptoms Activated charcoal, if other substances were also taken Laxative Whole bowel irrigation with a special solution taken by mouth or through a tube through the nose into the stomach (to flush sustained-release lithium quickly through the stomach and intestines) Kidney dialysis (kidney machine) Outlook (Prognosis) If someone has acute lithium toxicity, how well they do depends on how much lithium they took and how quickly they get help. People who do not develop nervous system symptoms usually do not have long-term complications. If serious nervous system symptoms occur, these problems may be permanent.Chronic toxicity is sometimes hard to diagnose at first. This delay can lead to long-term problems. If dialysis is done quickly, the person may feel much better. But symptoms such as memory and mood problems may be permanent.Acute-on-chronic overdose often has a poor outlook. Nervous system symptoms may not go away, even after treatment with dialysis.Open ReferencesReferencesAronson JK. Lithium. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:597-660.Soderstrom J. Lithium. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 25.5.Theobald JL, Aks SE. Lithium. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 154.AllVideoImagesTogRelated Information Review Date: 11/2/2023 Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Lithium toxicityLithobid toxicityLithium is a prescription medicine used to treat bipolar disorder. This article focuses on lithium overdose, or toxicity.Bipolar disorderBipolar disorder is a mental condition in which a person has wide or extreme swings in their mood. Periods of feeling sad and depressed may alternat...Read Article Now Book Mark Article Acute toxicity occurs when you swallow too much of a lithium prescription at one time. Chronic toxicity occurs when you slowly take a little too much of a lithium prescription every day for a while. This is quite easy to do, because dehydration, other medicines, and other conditions can easily affect how your body handles lithium. These factors can make the lithium build up to harmful levels in your body without you intending this. Acute-on-chronic toxicity occurs when you normally take lithium every day, but one day you take an extra amount. This can be as little as a couple of pills or as much as a whole bottle.Lithium is a medicine with a narrow range of safety. Significant poisoning can result when the amount of lithium taken is more than this range.This article is for information only. DO NOT use it to treat or manage an actual overdose or toxicity. If you or someone you are with has an overdose or toxicity, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Lithium is a medicine that can be harmful in large amounts. Where Found Lithium is sold under various brand names, including:Carbolith LithobidNote: Lithium is also commonly found in batteries, lubricants, high performance metal alloys, and soldering supplies. This article focuses only on the medicine form of lithium. Small amounts of lithium are also found in certain spring waters. Symptoms Symptoms of the three types of lithium toxicity are described below.ACUTE TOXICITYCommon symptoms of taking too much lithium at one time include the following symptom groups.Stomach and intestinal symptoms:Nausea Vomiting Diarrhea DiarrheaDiarrhea is when you pass loose or watery stool.Read Article Now Book Mark Article Stomach painsStomach painsAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.Read Article Now Book Mark Article Neurologic symptoms (develop after the intestinal symptoms)Dizziness Weakness Coma (decreased level of consciousness, lack of responsiveness) ComaDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Hand tremors Hand tremorsA tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...Read Article Now Book Mark Article Lack of coordination of arms and legs Muscle twitches Seizures SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...Read Article Now Book Mark Article Slurred speech Slurred speechDysarthria is a condition in which you have difficulty saying words because of problems with the muscles that help you talk.Read Article Now Book Mark Article Uncontrollable eye movement Uncontrollable eye movementNystagmus is a term to describe uncontrollable movements of the eyes that may be:Side to side (horizontal nystagmus)Up and down (vertical nystagmus)R...Read Article Now Book Mark Article Changes in mental status or altered thinkingHeart problems may occur in rare cases:Slow heart rateCHRONIC TOXICITYThere will likely not be any stomach or intestinal symptoms. Symptoms that can occur include:Increased reflexes Slurred speech Uncontrolled shaking (tremors)In severe cases of chronic toxicity, there may also be nervous system and kidney problems, such as:Kidney failure Kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...Read Article Now Book Mark Article Drinking a lot of fluids Urinating more or less than normal Memory problems Movement disorders, muscle twitches, hand tremors Problems keeping salts in your body Psychosis (disturbed thought processes, unpredictable behavior) Coma (decreased level of consciousness, lack of responsiveness) Lack of coordination of arms and legs Seizures Slurred speechACUTE-ON-CHRONIC TOXICITYThere will often be a combination of the acute and chronic symptoms listed above, including both nervous system and intestinal symptoms. Before Calling Emergency Determine the following:Person's age, weight, and condition Name of the product (ingredients and strength, if known) Time it was swallowed Amount swallowed Whether the medicine was prescribed for the person Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.Poison control centerFor a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...Read Article Now Book Mark Article 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. What to Expect at the Emergency Room Take the container to the hospital with you, if possible.The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.Vital signsVital signs reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. Your health care provider m...Read Article Now Book Mark Article Tests that may be done include:Blood tests to measure lithium levels and other body chemicals, and urine tests to detect other drugs Electrocardiogram (ECG) ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.Read Article Now Book Mark Article Pregnancy test in younger women CT scan of the brain in some casesCT scan of the brainA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.Read Article Now Book Mark Article Treatment may include:Fluids through a vein (by IV) Medicines to treat symptoms Activated charcoal, if other substances were also taken Laxative Whole bowel irrigation with a special solution taken by mouth or through a tube through the nose into the stomach (to flush sustained-release lithium quickly through the stomach and intestines) Kidney dialysis (kidney machine) Outlook (Prognosis) If someone has acute lithium toxicity, how well they do depends on how much lithium they took and how quickly they get help. People who do not develop nervous system symptoms usually do not have long-term complications. If serious nervous system symptoms occur, these problems may be permanent.Chronic toxicity is sometimes hard to diagnose at first. This delay can lead to long-term problems. If dialysis is done quickly, the person may feel much better. But symptoms such as memory and mood problems may be permanent.Acute-on-chronic overdose often has a poor outlook. Nervous system symptoms may not go away, even after treatment with dialysis.Open ReferencesReferencesAronson JK. Lithium. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:597-660.Soderstrom J. Lithium. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 25.5.Theobald JL, Aks SE. Lithium. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 154.