BACKGROUND: Lithium is a commonly prescribed pharmacological treatment for mood disorders. It is associated with a number of side effects and potentially serious toxicity. To date, there is little data from Irish samples on the subject of Lithium toxicity. AIM: To examine the incidence and clinical correlates of lithium toxicity in Cork, Ireland. RESULTS: Our study identified 130 cases of biochemical lithium toxicity over 5 years, with an incidence rate of approximately 5.4 cases per 100,000 per year. Mean toxic lithium level was 2.16 mmol/L ±SD 0.87 mmol/L. Of these, 36% cases were reviewed medically in the general hospital at the time of toxicity. A number of issues in relation to lithium toxicity were identified. Neurological symptoms were common, including tremor, confusion, ataxia, drowsiness. However, only 4.2% patients were reviewed by a neurologist while in hospital. Medications that interact with lithium were found in 50% cases, with significant polypharmacy in 15%. The psychiatric services were involved in patient care in 76% cases, and 85% patients presenting with toxicity were reviewed by a psychiatrist. Rates of admission to hospital and haemodialysis were 70 and 11%, respectively. CONCLUSION: Improvements in the standards of care in relation to lithium prescribing are required.
BACKGROUND:Lithium is a commonly prescribed pharmacological treatment for mood disorders. It is associated with a number of side effects and potentially serious toxicity. To date, there is little data from Irish samples on the subject of Lithiumtoxicity. AIM: To examine the incidence and clinical correlates of lithiumtoxicity in Cork, Ireland. RESULTS: Our study identified 130 cases of biochemical lithiumtoxicity over 5 years, with an incidence rate of approximately 5.4 cases per 100,000 per year. Mean toxic lithium level was 2.16 mmol/L ±SD 0.87 mmol/L. Of these, 36% cases were reviewed medically in the general hospital at the time of toxicity. A number of issues in relation to lithiumtoxicity were identified. Neurological symptoms were common, including tremor, confusion, ataxia, drowsiness. However, only 4.2% patients were reviewed by a neurologist while in hospital. Medications that interact with lithium were found in 50% cases, with significant polypharmacy in 15%. The psychiatric services were involved in patient care in 76% cases, and 85% patients presenting with toxicity were reviewed by a psychiatrist. Rates of admission to hospital and haemodialysis were 70 and 11%, respectively. CONCLUSION: Improvements in the standards of care in relation to lithium prescribing are required.
Authors: G J Moore; J M Bebchuk; K Hasanat; G Chen; N Seraji-Bozorgzad; I B Wilds; M W Faulk; S Koch; D A Glitz; L Jolkovsky; H K Manji Journal: Biol Psychiatry Date: 2000-07-01 Impact factor: 13.382
Authors: Robert M Post; Kirk D Denicoff; Gabriele S Leverich; Lori L Altshuler; Mark A Frye; Trisha M Suppes; A John Rush; Paul E Keck; Susan L McElroy; David A Luckenbaugh; Chad Pollio; Ralph Kupka; Willem A Nolen Journal: J Clin Psychiatry Date: 2003-06 Impact factor: 4.384
Authors: Victor M Castro; Ashlee M Roberson; Thomas H McCoy; Anna Wiste; Andrew Cagan; Jordan W Smoller; Jerrold F Rosenbaum; Michael Ostacher; Roy H Perlis Journal: Neuropsychopharmacology Date: 2015-08-21 Impact factor: 7.853