Preventing lithium intoxication. Guide for physicians.

OBJECTIVE To raise awareness of risk factors for, and symptoms of, lithium intoxication. QUALITY OF EVIDENCE The literature was searched via MEDLINE from January 1970 to December 1999 using the MeSH headings Lithium, Lithium Carbonate, Drug Toxicity, and Aging. Articles were selected based on clinical relevance and design. Most were case reports, case series, or reviews. MAIN MESSAGE A case study illustrates both risk factors predisposing patients to lithium intoxication and the symptoms of lithium intoxication. Lithium intoxication can be avoided by conservative dosing, care in combining drug therapies, regular clinical observation, monitoring drug plasma concentrations, and educating patients and caregivers to recognize early signs of intoxication. CONCLUSION Knowing about lithium intoxication and how to avoid it is most important for family physicians who regularly treat patients receiving lithium.