Eskalith toxicity; Lithane toxicity; Lithobid toxicity; Lithonate toxicity; Lithotabs toxicity
Lithium is a prescription medicine used to treat bipolar disorder (formerly called manic depression). This article focuses on lithium overdose, or toxicity.
This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Lithium is a soft metal that can be harmful in large amounts.
Lithium is sold under various brand names, including:
Note: Lithium is also commonly found in batteries, lubricants, high performance metal alloys, and soldering supplies. This article focuses only on the medicine.
Symptoms of the 3 types of lithium toxicity are described below.
Common symptoms of taking too much lithium at one time include:
Depending on how much lithium was taken, a person may also have some of the following nervous system symptoms:
Heart problems may occur in rare cases.
There will likely not be any stomach or intestinal symptoms. Symptoms that can occur include:
In severe cases of chronic toxicity, there may also be nervous system and kidney problems, such as:
ACUTE ON CHRONIC TOXICITY
There will often be some stomach or intestinal symptoms and many of the severe nervous system symptoms listed above.
Determine the following:
Your local poison 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 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.
Take the container to the hospital with you, if possible.
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.
The person may receive:
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 the worst outlook. Nervous system symptoms may not go away, even after many dialysis treatments.
Hung O. Lithium. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 160.
Thundiyil JG, Olson KR. Lithium. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 30.
Zosel AE. General approach to the poisoned patient. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 143.
Last reviewed on: 10/13/2015
Reviewed by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.