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 Marcia Purse

Lithium Toxicity - What You Need to Know

By September 4, 2012

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Lithium is considered by many to be a wonder drug for people with bipolar disorder, but too much of it can be poisonous. This can happen in a variety of ways. Some examples:
  • A family member might grab a patient's lithium pill bottle by mistake.
  • A child could get into the medication.
  • A patient might lose weight and thus need less lithium, so the current dose becomes too high.
  • Or a patient might take his pills, forget he took them so take them again, and do this a few times, spiking the level.
The window between the therapeutic dose of lithium and the toxic dose is almost vanishingly small. Differences in physiology may mean that what's the proper dose for one person is toxic for another.

If you or someone you care for - especially if there are children in the house - is taking lithium, it's essential to know not just the symptoms of lithium intoxication, but also what circumstances are most likely to lead to it.

Lithium poisoning is no joke. When it's properly and promptly treated, most people recover with no aftereffects. But if it's not treated, or if treatment is delayed too long, it can have permanent consequences or lead to death. Read this vital information on Lithium Toxicity.

Lithium prescription label

Photo: wonderferret / Flickr

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Comments
January 31, 2012 at 4:36 pm
(1) babs says:

I agree that people need to be informed about lithium toxicity. However the “vanishingly small” window has not changed in over 30 years. That window blood level is .8 to 1.2MEQ/L. The level needs to be checked twice a year. The thyroid needs to be checked as well.
The newer drugs that are used to treat depression and bipolar have worse side effects. There are no drugs totally free of side effects. Some have more than others. I have been on many, but have aways returned to lithium because it works for me and has the least amount of side effects. There needs to be even stronger warnings for mixing such drugs like Paxil, Seroquel, and Klonopin. These drugs cause SUDDEN CARDIAC DEATH. How is that for a side effect? Soldiers being treated for PTSD were given this coctail and 3 of them died in their 20s from sudden cardiac deaths. This happened in 2009. We can do better by informing the public of all the drugs that are causing deadly side effects. Can Lithium toxicity happen. Yes, but not in every case and if it is properly monitored, it can be corrected.
By the way Dr. Redfield stated that “LITHIUM IS THE GOLD STANDARD FOR TREATING BIPOLAR DISORDER. ” I was at that conference too. Dr. Redfield has been on lithium for over 20 years as have a lot of other people. The public needs to know that there are many many worse drugs to be on than lithium. Many of the newer drugs use inner city poor consumers or the military for their lab rats. Lithium has been around for a long time. It may not be sexy or exciting, but the side effects are much less. There are many more deaths now being attributed to the combination of Seroquel and Klonopin. That is a fact or side effect those drug companies would rather no one know. Yes, report aobut lithium toxicity and report ALL of the other toxic drugs out there. The public has a right to know.

January 31, 2012 at 6:18 pm
(2) Dor says:

I nearly died of lithium toxicity July of 09. In my case, alcohol and short gut also played a role in both nearly killing me and actually saving me.

I’m on a lot of different meds and dose low and several times a day. I have a highly responsible and ethical doctor who gives me a place in my treatment. If I need clarification — and even though I’m taking education in medicine, I don’t assume I am always certain — I call and ask. If I feel like in having a strange reaction off something, we talk about it and adjust as needed.

I guess … It’s hideously important to have competent and compassionate caretakers; it’s also important for patients to be partners in their treatment as much as they can … honest and carriers of impressions to help the doctors.

January 31, 2012 at 8:38 pm
(3) madnana says:

I am one of those people who will eventually be poisoned by anything. I took Depakote from 1998 to 2011 when my ammonia levels went through the ceiling. Because of fear of liver damage, my psychiatrist talked me into lithium. I was barfing my insides out, among other symptoms, by the fifth day. I’m taking zyprexa now and at 16 mg x day and at that level I sleep all the time so I’m back to 10 mg, cheerfully.
My point is that people should follow the directions of their pdocs but have their levels taken religiously and respect their own physical reactions.;

February 1, 2012 at 11:51 am
(4) Kristen says:

I know how dangerous lithium can be. Last September I was hospitalized with a 2.6 level, and had to have emergency dialysis. I had no idea I was toxic. I went into the hospital for another reason. I drastically cut my lithium dose, and am relatively stable. I fear the day my pdoc tells me no more lithium because I do not tolerate anti seizure or anti depressant meds. Lithium is the only thing that works for me. It is imperative that you be vigilant about keeping up with your blood levels, and knowing the signs of toxicity. I learned the hard way.

February 2, 2012 at 6:34 am
(5) Pete says:

Lithium brought me out of my psyhosis whn I was first diagnosed w/Bipolar. I did well on it! Seven years into taking it I developed hypo thyroidisim. I’ve been taking since syntroid since then. Three years ago I began to have too much protein in my urine. Twenty three years of Lithium caused me to develop mid kidney disease. I’ve been off of it for almost two years. Lucki;y it appears I probaly won’t have to undergo dialysis anytime in the near future. I’m being treated by a kidney specialist. Having done so well on Lithium for so long its been quite a loss. It did a wonderful job controlling the symptoms of the Bipolar. I’ve remained on Depakote. Last year I was put on tegretol which actually often lowers one’s Depakote level. Defeating the purpose of taking Depakote. I’m now in the process of being weened off of tegretol. I wish so much that I could go back on Lithium. I can’t though!! Its a great drug that’s helped a lot of people. It has too amny side effects though. In undergrad school I had a friend who was on Lithium. One night at a party she drank way too much. She ended up dying of Lithium toxicity. Alcohol and Lithium can indeed be deadly.

February 3, 2012 at 10:28 am
(6) Hannah says:

My doctor put me on lithium after trying 2 or 3 others that didn’t work.I was put on a “moderate” dose and within a few days I talked to my doctor and said that I didn’t think this was working but instead he increase my dose and then we’ll see.I was extremely lethargic,my stomach always hurt,especially after eating,I just felt like a walking zombie,even the people around me knew something was wrong.
So after about a week of this I called my doctor and said I had had enough and wasn’t taking it anymore and we would have to find something else.
But I know my body better than anyone else and was very firm with him.

February 17, 2012 at 11:29 pm
(7) Janell says:

I no longer have a thyroid because of lithium and not being checked. I no longer have anything I would call a quality life at all. If you are taking Lithium I would urge you to feel your neck daily. Daily. Then you will know if there is a change. I wish I had known that. Good luck.

February 18, 2012 at 10:34 am
(8) Marcia Purse / Bipolar Disorder Guide says:

Janell, please visit http://thyroid.about.com (About.com’s Thyroid site) for ways to improve your quality of life without a thyroid.

September 11, 2012 at 7:19 pm
(9) CReed says:

I agree with Babs (1) after the solid science of taking Lithium — prove it to yourself.

I attribute my working full time and steadily for 13 years and surviving the choreography and challenges of life — to a spiritual anchor, cognitive therapy, and time released Lithium. Yet, time and time again doctors seem biased against this medication. Has medication become an ego exercise and experimentation of the newer drugs the goal?

I do not mean always symptom free; I have my tangential moments. Of course, I vividly remember life without a sense of balance. I have that and have many activities to help myself.

November 21, 2012 at 2:10 pm
(10) Jamey r says:

NO ONE NEEDS LITHIUM, period…. You would be better off to stick a lithium battery in your bung hole …..there is zero pure control group that ther theology supports. You have a left side of the brain and right (bi) period…. Refer to def of polar. The body is self correcting… Period… You DONT need pills, you need unconditional love…. Which u already have its just buried….. Psychiatry has zero business model when truth is heard and listened to…. Good luck big pharmaceutical u will need it by the time I’m done correcting u….

December 8, 2012 at 2:32 pm
(11) Carla says:

Jamey r ; Are you a doctor???? You shouldn’t be telling people they don’t need medication; people die from this diease!.

December 26, 2012 at 6:23 pm
(12) Joan says:

My mum has been on lithium for the last 5 years after 22 ECTs. I have had the best 5 years with her ever. However she started having severe hand tremors where she could not hold a cup to drink, was not able to keep anything down, became confused and had a fall because her leg didn’t move when she expected it to.
She is now in hospital being treated for lithium toxicity. But only after having doctors out regularly to find the cause of these symptoms. We eventually found one who admitted her to hospital. One doctor wanted me to leave her without any food supplements or fluids til she saw a consultant in 2 weeks and no care package til then. If we weren’t there to fight for her she would have been left to die! If only I had known the symptoms of lithium toxicity I could have pushed harder for something to be done earlier. She has spent Christmas in hospital thanks to incompetent GPs.

February 11, 2013 at 8:17 pm
(13) ronda says:

I took lithium for 10 years and i started getting sick at mt stomach.so i was checked for ulsers and did not have none in 2011.i was losing 10 pds a month by the fall of 2011 i was getting weak and still sick.In febuary of 2012 i could feel my lower calf muscle moving and contracting uncontrollably and my spine hurt so bad and by this time all my muscles and bones are hurting so bad.my body would shake all over like i had parkins diease.Paraylises started i couldnt feel my legs and couldnt walk.but my muscles were jumping and contracting uncontrolablely.i was toxic for 20 months..almost died.i havent took lithium for 6 months now and my muscles are still doing that.CAN SOMEONE OUT THERE TELL ME IF THIS IS PERIMENT.IM SUFFERING.i also have thyroid problems and muscle spindles and ataxia and tinnitus in my ears.

February 11, 2013 at 8:24 pm
(14) ronda says:

to let everyone know.lithium serium can be very toxic without showing lithium toxicity on your blood work.everyone that is on this med please research the sideeffects and make sure you dont mix other meds with it.A youre not suppose to take it for a long perioud of time.cause over time it will build up in your bones and muscles.Lithium is suppose to be a last resort med.

March 31, 2013 at 1:57 am
(15) Christine says:

My 43-year-old son was very successful as an outpatient user of lithium for ~19 years until his assigned psychiatrist accepted another position. My son did not connect well with the new psychiatrist, who also suggested changing his medications. Because of all of the above, my son did not return to have his lithium levels checked. He was recently admitted to hospital with lithium levels of 4.7 and is struggling to rehabilitate from this unfortunate turn of events. Can anyone share about this level of toxicity as well as the role that could be taken on by a county mental health facility to protect patients from poisoning?

April 2, 2013 at 3:07 pm
(16) rebecca says:

ihave recently suffered from lithium toxicity. i didnt even know this existed.never advised from my doctor. although my case was mild , i am still suffering, i have a constant headache, muscle twitches, lack of appetite and general malaise. i would like to know the best way to flush this stuff out of my system. i basically feel like shit. help?

June 20, 2013 at 7:59 pm
(17) olive says:

I’m on lithium for a month now and i can’t sleep. I’ve tried all other meds for bi-polar disorder and suffer from their side effects. I think I’m going to try diet, exercise, and vitamins. My problems are situational which then play a role on my mental health. Learning to deal with problems is a better coping skill than taking pills. Some may have worse smptoms than i do so it may not be an option.

November 15, 2013 at 9:31 pm
(18) Jamie says:

I almost died in 1998 from lithium. I only took it for a few days and became so toxic that my liver started failing. I stopped the medication right away without consulting doctor after I collapsed in the bathroom. I knew something was wrong. Luckily the liver damage wasn’t severe and it healed on it’s own. It took 2 years to heal. I was up for a liver transplant if I didn’t improve in that time. Luckily I got well. I think if I hadn’t stop the lithium right away when I did, I probably wouldn’t be here right now. This is a bad medication for some people.

December 1, 2013 at 1:59 am
(19) joanna says:

I am praying my mom will be able to fully function, she has been in hosp for 5 days now from lithium poisning. She isnt eating drinking or seem to know anyone. Prior to admission she was bableing, and had symtoms of sundowners syndrom . I pray she comes oout of this….

December 2, 2013 at 1:08 pm
(20) Tina says:

My cousin was being treated inpatient for his bipolar disorder and was being treated with Lithium. He was then discharged and no lithium level was ever checked. Once he was released he had severe ataxia. Over the next 24 hours his symptoms became more severe. He could not urinate, he could not walk. He is a tall, sweet, strapping young man who could no longer care for himself. He was admitted with severe lithium toxicity. He is currently still in the hospital and is still unable to walk and can talk very little. If you are taking this medication, please be very verbal in your care and make sure your lithium levels are checked religiously.

January 18, 2014 at 4:43 am
(21) Sarah says:

My mom just o.d. on lithium, she took 90 pills, she told us and the doctor this information. They did all the procedure tests to check her levels, we were concerned that the doctors didn’t pump her stomach? I’ve never been through this before, I don’t know what they do for lithium. But she is on dialysis, and I’ve researched that the dialysis is usually how doctors try to get lithium out of a person’s system (because the kidney is the primary organ that lithium effects, I read that lithium is sorted out with kidneys.) I don’t exactly know how to put it.. but I also read that the lithium can be absorbed in the intestinal tract. My mom has been vomiting all day.. I know that much. I haven’t been able to talk to her or go visit she has been sleeping whenever she hasn’t been vomiting. I guess what my whole point is, I have never been through this with my mom before and I want to know if she’ll live? I am searching for answers. I know it’s probably pointless, I know for a fact everyone is different, and her body will respond to whatever it can take. But I don’t know much about lithium, and I want answers.. in case something does happen. Please, if anyone could help me out with some insight that would be much appreciated. Thank you.

February 26, 2014 at 7:40 am
(22) Jamie says:

I almost died from lithium in 1997. I became toxic and it damaged my liver. When I started getting symptoms of toxicity I immediately stopped taking it. If I had continued, my liver would have been so damaged I would have died. I remained ill from the liver damage for two years. I didn’t think I was going to make it but I pulled through. Because my liver wasn’t functioning properly during those two years, it started affecting my heart and my blood pressure became very unstable. People don’t realize the dangers of this drug. Yes, it does help some people but it can kill you too. Everybody is different. Just be cautious with it.

March 10, 2014 at 4:03 pm
(23) maura adams says:

I just want everyone to be aware that a kidney infection will cause your lithium levels to go sky high. If you suspect an infection get tested as soon as possible and if you have one stop the lithium at once and go to A and E only dont expect the doctors to know anything about this. In my case FIVE doctors missed it and nurses as well.. I want all doctors, nurses and everyone on lithium to link lithium and kidney infection together and know how deadly it can be.

March 29, 2014 at 3:46 pm
(24) Andrew Arrington says:

I have a new girlfriend whos been on lithium some 10 plus years. When stressed limictol. I took Depacoat for 2 years. Im a happy joyous and free Recovering Alcoholic. Too myself off the Depacoat and used and still use God and the 12 steps with some prayer and meditation. i spot it I got it. Once diagnosed bipolar. And by Gods grace I have been blessed with control today. My new girlfriend has 3 bachelor degrees from 3 colleges and a masters in Accounting. A few nervous breakdowns years ago. She lives in the Philippines. I agree Im not a doctor. Yet she has money issues. Cant afford the therapist and blood tests anymore. I worry she will get kidney disease and or like I developed bilateral kidney stones and a tumor on my renal artery the was removed in 2005. It was thank God stage 1 cancer contained. I don’t want her to have the same. I see her flip floppy decision making. But over all a very loving woman. Since I was only on Depacoat 2 years I had 2 years of withdrawal symptoms. Im guessing she would experience wors having been on lithium 10 plus years. Any way those are my experience strength and hopes. lastly I am now a health nut. Diet and exercise and one meeting a week. Thanx for letting me share

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