Lithium toxicity symptoms

Would you recognize lithium toxicity symptoms?

They are easy to identify, but fatal to ignore.

There is a world of difference between side effects and lithium toxicity - too much lithium in the blood can kill you.

Signs of overdose or poisoning are:

1. Persistent diarrhea.

2. Vomiting or severe nausea.

3. Coarse trembling of hands or legs.

4. Frequent muscle twitching such as pronounced jerking of arms or legs.

5. Blurred vision.

6. Marked dizziness.

7. Difficulty walking.

8. Slurred speech.

9. Irregular heart beat.

10. Swelling of the feet or lower legs.

Don't ignore any of these! See your doctor immediately - too much lithium can lead to coma, brain damage or death.

Even if your lithium levels are not toxic, serious side effects such as the above suggest that your dose may be too high or that lithium is not the right med for you.

With correct dosage, the side effects should be transient and/or mild. Anything that impairs your functioning or impacts significantly on your quality of life needs to be addressed with a skilled clinician who knows a lot about lithium and alternative bipolar medications such as Depakote or Lamictal. You can read more about lithium toxicity here, on this page about Eskalith side effects.

It gets complicated . . .

The lithium rash

See your doctor immediately if, while taking lithium, you develop a skin rash or itching.

Missed doses

Incorrect handling of missed doses is a very common way that people end up with too much lithium in their system.

If you miss a dose, NEVER DOUBLE UP in an effort to catch up. Taking an increased dose is a dangerous risk that may put too much lithium into your bloodstream at once.

Sometimes it is ok to take your meds a little bit later if you forget to take them on time - as long as you DON'T DOUBLE UP. However, everyone takes a different amount on a different schedule so get your doctor to give you precise guidelines.

Avoiding toxicity

1. ALWAYS take your blood tests exactly when your doctor advises.

2. PREPARE correctly for your blood tests. This means that for 4-5 days before testing don't forget any doses and don't take any extra doses. Also, your blood test should be done in the morning as close as possible to within 12 hours of your last dose.

3. Drink plenty of fluids each day, especially water, juice and milk. Avoid caffeinated drinks like coffee and some sodas because of their diuretic effect.

4. Do not go on any low salt diets.

5. Be careful about sweating too much or anything else that could promote dehydration.

Treating toxicity

However, if you detect lithium toxicity symptoms, drink lots of water and DO NOT TAKE ANY MORE LITHIUM. Go immediately to see your doctor or to a hospital emergency room.

If you do have lithium poisoning you will probably be admitted to hospital and cared for by a poisoning specialist.

Treatment will involve maintaining correct kidney functioning as much as possible by managing blood pressure, and replacing fluids and salt. Sometimes dialysis is necessary.

Want to read more? Check out this clear and concise summary from the World Health Organization (WHO).

Also helpful may be the excellent booklet, by James W. Jefferson & John H. Greist Lithium and Bipolar Disorder: A Guide, Lithium Information Center, Madison Institute of Medicine, 2004, available from Amazon for just $5.95.

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