Lithium Intoxication

To the Editor:— I have recently observed that one of the table salt substitutes (westsal®, marketed by Westwood Pharmaceuticals, Division of Foster-Milburn Co., Buffalo, N. Y.) may cause toxic symptoms in patients following a 200 mg. low sodium diet. This salt substitute contains 25.00 per cent lithium chloride, 0.20 per cent citric acid and 0.01 per cent potassium iodide. I feel that it is important to bring this observation to the attention of the practitioner because these symptoms may simulate those which are already present or may occur, because of the very disease for which the low sodium diet is being given. The 2 patients whom I am reporting in some detail (Univ. Hosp. Bull., Ann Arbor15:9-10 [Feb.] 1949), after taking westsal® a few months, showed jerky tremor of the arms, unsteadiness in gait, generalized weakness, exhaustion and blurred vision. These symptoms were entirely new to the patients