A BSTRACT Lithium toxicity is a serious, potentially life-threatening condition, often resulting from inconsistent medication adherence, dehydration, or renal impairment. This case report presents a 56-year-old female with bipolar disorder and hypertension who developed severe lithium toxicity. Clinical presentation included generalized weakness, gastrointestinal symptoms, hypotension (blood pressure: 98/50–120/50 mmHg), oxygen desaturation (SpO 2 : 87%–90%), sinus bradycardia, and hyperreflexia. Laboratory findings confirmed a markedly elevated lithium level (>3.7 mEq/L). The patient had a history of irregular psychiatric medication use, clopidogrel, and intermittent antihypertensives. Management in the medical intensive care unit included intravenous hydration, antiemetics, gastric protection, atropine, and psychiatric support. A nephrology consultation was obtained due to potential renal involvement. Continuous monitoring of cardiac and renal function was maintained. This case report underscores the critical need for regular monitoring of lithium levels, renal function assessment, and psychiatric follow-up to prevent toxicity, especially in patients with poor medication adherence.
Asharaf et al. (Wed,) studied this question.