Citation

de Cates AN, Morlet J, Antoun Reyad A, Tadros G. BMJ Case Rep. 2017; 2017: bcr2017222453, bcr-2017-222453.

Copyright

(Copyright © 2017, BMJ Publishing Group)

DOI

10.1136/bcr-2017-222453

PMID

29070624

PMCID

PMC5665332

Abstract

This is a case report of a man in his 60s who presented to an English hospital following a significant lithium overdose. He was monitored for 24 hours, and then renal replacement therapy was initiated after assessment by the renal team. As soon as the lithium level returned to normal therapeutic levels (from 4.7 mEq/L to 0.67 mEq/L), lithium was restarted by the medical team. At this point, the patient developed new slurred speech and later catatonia. In this case report, we discuss the factors that could determine which patients are at risk of neurotoxicity following lithium overdose and the appropriate decision regarding when and how to consider initiation of renal replacement therapy and restarting of lithium.

Language: en

Keywords

Humans; Male; Middle Aged; Drug Overdose; Treatment Outcome; Suicidal Ideation; poisoning; Lithium; toxicology; Depressive Disorder; suicide (psychiatry); Neurotoxicity Syndromes; Renal Replacement Therapy; bipolar i disorder; psychiatry (drugs and medicines)