LITHIUM POISONING IN THE TREATMENT OF BIPOLAR DISORDER CLINICAL AND MANAGEMENT

Abstract

The aim of this study was to analyze the clinical presentation of lithium intoxication in patients with bipolar disorder. An integrative review of the scientific literature was performed using the PubMed, BVS, and Capes Periodical Portal databases. Clinical studies, case reports, and management guidelines on lithium intoxication were included, covering patients with bipolar disorder at different stages of treatment. The main clinical findings of lithium intoxication ranged from gastrointestinal symptoms (nausea, vomiting, diarrhea) to severe neurological signs (tremors, ataxia, seizures, coma). Acute intoxication usually occurs in excessive doses, whereas chronic intoxication is associated with slow accumulation due to renal dysfunction or drug interactions (e.g., diuretics and NSAIDs). Initial management includes immediate discontinuation of lithium, intravenous hydration, and close monitoring of serum lithium levels, renal function, and electrolytes. Lithium intoxication is a medical emergency that requires rapid diagnosis and effective intervention to prevent irreversible damage. Patients with risk factors should be closely monitored, with dosage adjustments and guidance on adequate hydration and drug interactions. Although lithium remains a mainstay of treatment for bipolar disorder, its toxicity remains a significant concern.