In mild lithium toxicity, symptoms include weakness, worsening tremor, mild ataxia, poor concentration and diarrhea. With worsening toxicity, vomiting, the development of a gross tremor, slurred speech, confusion and lethargy emerge (Bauer and Gitlin 2016).
Moderate intoxication: confusion, agitation, delirium, tachycardia, and hypertonia (serum lithium concentration between 2.5-3.5 mEq/L)[33] [34]. Severe intoxication: Coma, seizures, hyperthermia, and hypotension (serum lithium concentration (more than 3.5 mEq/L)[33] [34].
Long term effects. The most concerning side effects of long term lithium use are hypothyroidism and kidney problems.
Lithium is a prescription medicine used to treat bipolar disorder. This article focuses on lithium overdose, or toxicity. 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.
Lithium has adverse effects on the kidneys, thyroid gland and parathyroid glands, necessitating monitoring of these organ functions through periodic blood tests.
Too little water (dehydration) can lead to high, or even toxic lithium levels So it's important to drink plenty of water while taking lithium. Diarrhea, vomiting, and excessive exercise or sweating can also dehydrate you. Let your healthcare provider know if you experience any of these events.
The most commonly prescribed drugs that have the potential to interact with lithium are ACE inhibitors, angiotensin II receptor antagonists (sartans), diuretics, and non-steroidal anti-inflammatory drugs (NSAIDs).
Lithium also stimulates proliferation of stem cells, including bone marrow and neural stem cells in the subventricular zone, striatum, and forebrain. The stimulation of endogenous neural stem cells may explain why lithium increases brain cell density and volume in patients with bipolar disorders.
It has long been known that lithium has toxic effects on the thyroid gland and the kidneys. The thyroid toxicity, caused primarily by lithium's interference with thyroid hormones' release from the gland (19) affects up to 19% of treated patients (20).
Initial general anti-poisoning measures, such as gastric lavage, may be helpful, but the ultimate success of treatment depends upon the elimination of lithium from the body. Hemodialysis, and, to a lesser extent, peritoneal dialysis, will both rapidly eliminate lithium from the body.
Short-term side effects can include nausea and diarrhoea, muscle weakness or a dazed feeling. A long-term side effect can be weight gain. Your lithium dose needs to be adjusted to suit you. Go for your blood tests to make sure you have the right amount in your system.
Acute toxicity often causes immediate gastrointestinal symptoms, while other symptoms tend to develop over several hours as lithium moves into tissues and cells without prior lithium stores.
The most common side effects of lithium are feeling or being sick, diarrhoea, a dry mouth and a metallic taste in the mouth. Your doctor will carry out regular blood tests to check how much lithium is in your blood. The results will be recorded in your lithium record book.
“Based on the research conducted on this issue, the average weight gain that people who take lithium experience is usually between 10 and 26 pounds,” says Faisal Tai, MD, a board-certified psychiatrist and CEO of PsychPlus, a mental health services provider in Houston.
► Exposure to Lithium can cause loss of appetite, nausea, vomiting, diarrhea and abdominal pain. ► Lithium can cause headache, muscle weakness, twitching, blurred vision, loss of coordination, tremors, confusion, seizures and coma.
Lithium has been associated with impaired memory, word finding difficulties, and impaired recall.
In addition to its effects on mood, lithium is known to alter neurocognition-improving some functions while impairing others. These opposing and complex actions likely occur both acutely and long term and are probably subject to changes in plasma levels.
Lithium in Food Products
The main sources of Li in the diet are cereals, potatoes, tomatoes, cabbage, and some mineral waters [44]. It may also be found in some spices such as nutmeg, coriander seeds, or cumin; however, their share in the total supply of this element is negligible in many geographic regions [49].
Avoid excessive intake of caffeinated beverages, such as coffee, tea, cola or energy drinks, since these may decrease levels of lithium and decrease effectiveness of the medication.
In humans, lithium alters sleep-wake rhythms, REM sleep latency, and temperature (89,90). It has been hypothesized that the phase-delaying effects of lithium synchronize sleep-wake rhythms to sustain SDT response (91).
When combined with lithium, NSAIDs can increase lithium levels in the blood resulting in an increased risk for serious adverse effects like confusion, tremor, slurred speech, and vomiting. Examples of non-prescription NSAIDs include: Ibuprofen (Advil® or Motrin®)
In order for lithium to work properly, it must be taken every day in regularly spaced doses as ordered by your doctor. This is necessary to keep a constant amount of lithium in your blood. To help keep the amount constant, do not miss any doses and do not stop taking the medicine even if you feel better.
Lithium is used to treat mania that is part of bipolar disorder (manic-depressive illness). It is also used on a daily basis to reduce the frequency and severity of manic episodes.
Take your lithium each night at the same time. You need to take it at night because blood tests need to be done during the day, 12 hours after a dose (see Section 4 'Blood tests after starting to take lithium').