Presentation
At age 56, the patient presented with an acute encephalopathy caused by toxic lithium levels, which resolved only after lithium carbonate was discontinued. [ncbi.nlm.nih.gov]
Entire Body System
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Weight Gain
The five single most common adverse effects leading to lithium discontinuation were diarrhoea (13%), tremor (11%), polyuria/polydipsia/diabetes insipidus (9%), creatinine increase (9%) and weight gain (7%). [ncbi.nlm.nih.gov]
Increased thirst Increased urination Diarrhea Vomiting Weight gain Impaired memory Poor concentration Drowsiness Muscle weakness Hair loss Acne Decreased thyroid function (which can be treated with thyroid hormone) SOURCES: WebMD Medical Reference: "Bipolar [webmd.com]
A: Lithium did not appear to cause weight gain in clinical studies. Lamictal was shown to cause weight gain in 1 to 5% of patients taking the medication, but the information does not list the amount of weight gained. [everydayhealth.com]
This condition can cause symptoms that include: depression dry skin fatigue intolerance to cold trouble thinking quickly weight gain A person who is taking lithium will need to undergo regular tests to monitor their thyroid function. [medicalnewstoday.com]
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Fever
Tell your doctor if you have been sweating excessively, or if you are sick with fever, vomiting, or diarrhea. Avoid becoming overheated or dehydrated during exercise and in hot weather. [drugs.com]
Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. [mayoclinic.org]
[…] concentration Drowsiness Muscle weakness Hair loss Acne Decreased thyroid function (which can be treated with thyroid hormone) Notify your doctor if you suspect you may have persistent side effects from lithium or if you develop diarrhea, vomiting, fever [webmd.com]
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Fatigue
OBJECTIVE: The aim of this study was to test five types of implant restorations using titanium, zirconia and lithium disilicate abutments after being subjected to long-term fatigue loading. [ncbi.nlm.nih.gov]
Thyroid problems Share on Pinterest A person with hypothyroidism may experience fatigue, depression, and intolerance to cold. Hypothyroidism is another concern for those taking lithium. [medicalnewstoday.com]
Lithium can cause nausea, diarrhea, dizziness, muscle weakness, fatigue, and a dazed feeling. These unwanted side effects often improve with continued use. Fine tremor, frequent urination, and thirst can occur and may persist with continued use. [webmd.com]
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Goiter
These side effects are due to lithium's action on ion transport.[6] Hematologic: Leukocytosis and aplastic anemia Gastroenterologic: Diarrhea and nausea Endocrinal: Euthyroid goiter or hypothyroid goiter Other: Acne, rash, and weight gain. [ncbi.nlm.nih.gov]
Children born to women taking lithium during pregnancy have an increased risk of goiter and cardiac anomalies. If possible, lithium should be withheld during the first trimester. [medicinenet.com]
Thyroid Abnormalities : Euthyroid goiter and/or hypothyroidism (including myxedema) accompanied by lower T3 and T4. I131 uptake may be elevated. (See PRECAUTIONS .) Paradoxically, rare cases of hyperthyroidism have been reported. [rxlist.com]
Encephalopathic syndrome (brain disease) or Goiter or other thyroid problems or Nervous system problems—Use with caution. May make these conditions worse. Kidney disease—Use with caution. [mayoclinic.org]
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Myxedema
Thyroid Abnormalities : Euthyroid goiter and/or hypothyroidism (including myxedema) accompanied by lower T3 and T4. I131 uptake may be elevated. (See PRECAUTIONS .) Paradoxically, rare cases of hyperthyroidism have been reported. [rxlist.com]
Thyroid Abnormalities: Euthyroid goiter and/or hypothyroidism (including myxedema) accompanied by lower T3 and T4. Iodine 131 uptake may be elevated.. Paradoxically, rare cases of hyperthyroidism have been reported. [ndrugs.com]
Neurologic
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Confusion
Lithium Batteries Lithium batteries, not to be confused with Lithium Ion batteries, which are the rechargeable form of Lithium batteries. They are about the same as the alkaline batteries in almost every way. [batteryreview.org]
Toxicities included fatigue, somnolence, confusion or blunted affect in 50% of the patients. [ncbi.nlm.nih.gov]
It is not to be confused with Lithium-ion battery. Lithium 9 volt, AA, and AAA sizes. [en.wikipedia.org]
[…] tremor, lightheadedness, lack of coordination, and weakness; to moderate manifestations like giddiness, apathy, drowsiness, hyperreflexia, muscle twitching, ataxia, blurred vision, tinnitus, and slurred speech; severe manifestations such as clonus, confusion [reference.medscape.com]
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Tremor
Tremor is a common adverse effect associated with lithium at both therapeutic and toxic serum levels. [ncbi.nlm.nih.gov]
ANSWER Common side effects of lithium can include: Hand tremor (If tremors are particularly bothersome, dosages can sometimes be reduced or an additional medication can help.) [webmd.com]
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Seizure
This Phelan-McDermid syndrome (PMS), also presenting with symptoms from the autism spectrum and a higher risk of developing seizure disorders, may be caused by a deletion of chromosome 22q13 or by a mutation in the SHANK3 gene. [ncbi.nlm.nih.gov]
[…] right away if you have symptoms of lithium toxicity: muscle weakness, twitching, drowsiness, feeling light-headed, mood changes, blurred vision, ringing in your ears, irregular heartbeats, confusion, slurred speech, clumsiness. trouble breathing, or seizures [drugs.com]
Some of the combinations can lead to an increased risk of seizures, particularly in people with a history of a seizure disorder or who are already at risk for seizures. [everydayhealth.com]
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Ataxia
In spinocerebellar ataxia, introduction of lithium may be of benefits in terms of improvement of cerebellar symptoms. [ncbi.nlm.nih.gov]
Concurrent use of calcium channel blocking agents with lithium may increase the risk of neurotoxicity in the form of ataxia, tremors, nausea, vomiting, diarrhea, and/or tinnitus. Caution is recommended. [rxlist.com]
Ataxia as the Primary Symptom of Lithium Toxicity. Drug Intelligence & Clinical Pharmacy, Vol. 14, Issue. 9, p. 622. [dx.doi.org]
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Hyperactivity
Impulsive aggressive behavior associated with attention-deficit hyperactivity disorder (ADHD). Insufficient Evidence for Alcohol dependence. Blood cell disorders. Other conditions. [webmd.com]
Manic meaning hyperactive, exuberant and full of energy and depressive meaning down and lethargic. In order to control these episodes they take medication in the form of lithium. [micronit.com]
Typical symptoms of mania include pressure of speech, motor hyperactivity, reduced need for sleep, flight of ideas, grandiosity, elation, poor judgment, aggressiveness and possibly hostility. [rxlist.com]
Typical symptoms of a manic episode include excessive speech, hyperactivity, reduced need for sleep, flight of ideas, grandiosity, elation, poor judgment, aggressiveness, or hostility. [everydayhealth.com]
Urogenital
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Polyuria
The five single most common adverse effects leading to lithium discontinuation were diarrhoea (13%), tremor (11%), polyuria/polydipsia/diabetes insipidus (9%), creatinine increase (9%) and weight gain (7%). [ncbi.nlm.nih.gov]
When the kidneys are not able to control fluid balance you may notice: Greater than normal urine out-put (polyuria), along with greater than normal fluid intake (polydipsia) due to excessive thirst Getting up at night to urinate (nocturia) can be a sign [kidney.org]
Fine hand tremor, polyuria, and mild thirst may occur during initial therapy for the acute manic phase, and may persist throughout treatment. [rxlist.com]
Renal side effects of lithium Up to one-third of patients can develop nephrogenic diabetes insipidus, which presents as polyuria and polydipsia and is reversible on discontinuation of lithium. [dermnetnz.org]
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Kidney Failure
Lithium should not be used by patients who have or have had: acute myocardial infarction, acute kidney failure, or certain rare disorders of heart rhythm (notably, the Brugada syndrome of ventricular arrhythmia). [journalbipolardisorders.springeropen.com]
Workup
Serum
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Hyponatremia
Dehydration, severe or Heart or blood vessel disease or Hyponatremia (low sodium in the blood) or Kidney disease, severe or Muscle weakness, severe or Weakened physical condition—Should not be used in patients with these conditions. [mayoclinic.org]
Treatment
Thyroxine treatment was prescribed to 8 (32%) lithium-treated patients. [ncbi.nlm.nih.gov]
Prognosis
A long duration of neurotoxicity associated with lithium treatment does not necessarily indicate an irreversible prognosis. [ncbi.nlm.nih.gov]
[…] chronic [1] Causes Excessive intake, decreased excretion [1] Risk factors Dehydration, low sodium diet, kidney problems [1] Diagnostic method Based on symptoms and a lithium level [1] [2] Treatment Gastric lavage, whole bowel irrigation, hemodialysis [1] Prognosis [en.wikipedia.org]
Etiology
Articles were reviewed for etiology, location, severity and treatment. We also present a case of a burn to the upper thigh resulting from cellular phone battery malfunction. [ncbi.nlm.nih.gov]
Epidemiology
BACKGROUND: Several epidemiological studies have shown the inverse association of lithium levels in drinking water and suicide rates; however, it is necessary to perform a clinical study dealing with individual patients. [ncbi.nlm.nih.gov]
A recent review of epidemiological studies of lithium in drinking water reported that 9 out of 11 studies found an association between higher levels of lithium in local water and “beneficial clinical, behavioral, legal and medical outcomes.” [nytimes.com]
From Biological Activity and Epidemiological Observation to Food Fortification. Biological Trace Element Research, CrossRef Google Scholar Kavanagh, Laurence Keohane, Jerome Garcia Cabellos, Guiomar Lloyd, Andrew and Cleary, John 2018. [bjp.rcpsych.org]
Epidemiological research point to a possibility of diminished risk of dementia connected with lithium use, both in the general population and in patients with bipolar disorders. [frontiersin.org]
Cutaneous adverse eVects of lithium: epidemiology and management. Ann Med Intern 1984; 13:637–638. Drug eruptions caused by lithium salts. [zh.wikipedia.org]
Pathophysiology
The cytokine hypothesis of depression postulates that cytokines play a key role in the pathophysiology of depression. Concordantly, it has been shown that proinflammatory cytokine serum levels decrease during antidepressant treatment. [ncbi.nlm.nih.gov]
For a diagnosis, the syndrome requires the absence of prior symptoms and persistence of symptoms for greater than 2 months after cessation of lithium. [12] Pathophysiology [ edit ] Lithium is readily absorbed from the gastrointestinal tract. [13] It is [en.wikipedia.org]
In bipolar disorder, the thyroid function should be examined in the context of a role of the thyroid gland and the hypothalamic-pituitary-thyroid axis in the pathophysiology of this illness. [frontiersin.org]
Prevention
INTRODUCTION: Lithium is a medication used to treat bipolar disorder and may also prevent cognitive decline and suicide. [ncbi.nlm.nih.gov]