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Pharmacy World and Science

, Volume 28, Issue 5, pp 274–277 | Cite as

A 4-year study of lithium intoxication reported to the Czech Toxicological Information Centre

  • Martina KřenováEmail author
  • Daniela Pelclová
Short Research Article

Abstract

Objective

To evaluate the frequency and severity of lithium intoxication in calls to the Czech Toxicological Information Centre (TIC).

Method

A 4-year retrospective study (2000–2003) of cases of lithium intoxication. Analysis of data from the database of the TIC and hospital discharge reports: sex, age, dose, blood level and biochemical markers of nephrotoxicity, symptoms, treatment and outcome of intoxication.

Results

The TIC received 70 calls concerning lithium intoxication, but only 27 discharge reports from hospitals were obtained and evaluated. Calls concerning women (16, median age 43.5 years) were more frequent than calls concerning men (11, median age 51.0 years). 16 patients had central nervous system or neurological symptoms. Signs of nephrotoxicity were present in 10 patients. Nine patients had cardiovascular symptoms. Possible interactions with other drugs during chronic overdoses were present in 14 patients. Six patients died due to lithium intoxication.

Conclusion

Lithium intoxication remains a serious problem in calls to the TIC. Severe symptoms mainly developed in older patients. Drugs significantly potentiating toxic reactions to lithium should be avoided.

Keywords

Czech Republic Drug-drug interaction Intoxication Lithium TDM Therapeutic drug monitoring 

Notes

Acknowledgements

This study was financially supported by Research Project No. MSM 0021620807 of the Ministry of Education of the Czech Republic. The authors thank professor Steve Diskin for linguistic assistance.

References

  1. 1.
    Lenox RH, McNamara RK, Papke RL, Manji HK. Neurobiology of lithium: an update. J Clin Psychiatr 1998; 58: 37–47.Google Scholar
  2. 2.
    Amdisen A. Clinical features and management of lithium poisoning. Med Toxicol 1988; 3: 18–32.Google Scholar
  3. 3.
    Finley PR, Warner MD, Peabody CA. Clinical relevance of drug interactions with lithium. Clin Pharmacokinet 1995; 29: 172–91.PubMedCrossRefGoogle Scholar
  4. 4.
    Simard M, Gumbiner B, Lee A, Lewis H, Norman D. Lithium carbonate intoxication. A case report and review of the literature. Arch Intern Med 1989; 149: 36–46.PubMedCrossRefGoogle Scholar
  5. 5.
    Timmer RT, Sands JM. Lithium intoxication. J Am Soc Nephrol 1999; 10: 666–74.PubMedGoogle Scholar
  6. 6.
    Okusa MD, Crystal LJT. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994; 97: 383–89.PubMedCrossRefGoogle Scholar
  7. 7.
    Fountoulakis KN, Vieta E, Sanches-Moreno J, Kaprinis SG, Goikolea JM. Treatment guidelines for bipolar disorder: a critical review. J Affect Disord 2005; 86(1): 1–10.PubMedCrossRefGoogle Scholar
  8. 8.
    Keck PE, McElroy SL, Strakowski SM. Anticonvulsants and antipsychotics in the treatment of bipolar disorder. J Clin Psychiatr 1998; 58: 37–47.Google Scholar
  9. 9.
    Češková E, Kašpárek T. Therapy of bipolar depression. Čes A Slov Psychiatr 2004; 100(4): 229–37.Google Scholar
  10. 10.
    Hansen HE, Amdisen A. Lithium intoxication (report of 23 cases and review of 100 cases from the literature). Q J Med 1978; 47: 123–44.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  1. 1.Toxicological Information Centre, Department of Occupational Medicine of the First Faculty of MedicineCharles University and General Teaching HospitalPrague 2Czech Republic

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