Lithium and Nsaids: Life Threatening Toxicity of Lithium Precipitated by a Common Over the Counter Medication

Lithium though a pivotal drug in treatment of several neuropsychiatric conditions,it needs to be maintained within a very narrow therapeutic range by frequent therapeutic drug level monitoring as excessive Lithium levels can cause toxicity with severe side effects involving multiple organ systems and can even be fatal. Lithium is also notorious for several drug-drug interaction with many frequently used medications, some of which are available as over the counter medications. Here we present a case of Lithium toxicity precipitated by its interaction with NSAIDS. It highlights the importance of careful prescribing of drugs and avoiding over the counter medication while on Lithium.