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. 1975 Apr 5;112(7):868–870.

Fatal self-poisoning with lithium carbonate.

M R Achong, P G Fernandez, P J McLeod
PMCID: PMC1958962  PMID: 1122460

Abstract

In a fatal case of self-poisoning with lithium carbonate there was a progressive increase in serum lithium concentration for 48 hours after ingestion of the overdose. It is suggested that the continuous increase in serum lithium concentration reflects prolonged absorption of lithium from relatively insoluble aggregates of lithium carbonate in the gastrointestinal tract. In this case there was an interval of 45 hours between ingestion of the overdose and the onset of central nervous system depression. Simultaneous peritoneal dialysis and hemodialysis were effective in rapidly reducing the serum lithium concentration but there was little concomitant change in the patient's level of consciousness. The terminal event was a respiratory complication of the comatose state.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Almy G. L., Taylor M. A. Lithium retention in mania. Arch Gen Psychiatry. 1973 Aug;29(2):232–234. doi: 10.1001/archpsyc.1973.04200020062008. [DOI] [PubMed] [Google Scholar]
  2. Amdisen A., Skjoldborg H. Haemodialysis for lithium poisoning. Lancet. 1969 Jul 26;2(7613):213–213. doi: 10.1016/s0140-6736(69)91447-0. [DOI] [PubMed] [Google Scholar]
  3. Aoki F. Y., Ruedy J. Severe lithium intoxication: management without dialysis and report of a possible teratogenic effect of lithium. Can Med Assoc J. 1971 Oct 23;105(8):847–848. [PMC free article] [PubMed] [Google Scholar]
  4. Birch N. J. Lithium accumulation in bone after oral administration in rat and in man. Clin Sci Mol Med. 1974 Mar;46(3):409–413. doi: 10.1042/cs0460409. [DOI] [PubMed] [Google Scholar]
  5. Davis J. M., Bartlett E., Termini B. A. Overdosage of psychotropic drugs: a review. I. Major and minor tranquilizers. Dis Nerv Syst. 1968 Mar;29(3):157–164. [PubMed] [Google Scholar]
  6. Edwards K. D., McCredie M. Studies on the binding properties of acidic, basic and neutral drugs to anion and cation exchange resins and charcoal in vitro. Med J Aust. 1967 Mar 18;1(11):534–539. doi: 10.5694/j.1326-5377.1967.tb21444.x. [DOI] [PubMed] [Google Scholar]
  7. Fyrö B., Petterson U., Sedvall G. Pharmacokinetics of lithium in manic-depressive patients. Acta Psychiatr Scand. 1973;49(3):237–247. doi: 10.1111/j.1600-0447.1973.tb04417.x. [DOI] [PubMed] [Google Scholar]
  8. Gaind R., Saran B. M. Acute lithium poisoning. Postgrad Med J. 1970 Oct;46(540):629–631. [PMC free article] [PubMed] [Google Scholar]
  9. Hawkins J. B., Dorken P. R. Lithium. Lancet. 1969 Apr 19;1(7599):839–840. [PubMed] [Google Scholar]
  10. Herrero F. A. Lithium carbonate toxicity. JAMA. 1973 Nov 26;226(9):1109–1110. [PubMed] [Google Scholar]
  11. Hullin R. P., Swinscoe J. C., McDonald R., Dransfield G. A. Metabolic balance studies on the effect of lithium salts in manic-depressive psychosis. Br J Psychiatry. 1968 Dec;114(517):1561–1573. doi: 10.1192/bjp.114.517.1561. [DOI] [PubMed] [Google Scholar]
  12. Hurtig H. I., Dyson W. L. Letter: Lithium toxicity enhanced by diuresis. N Engl J Med. 1974 Mar 28;290(13):748–749. doi: 10.1056/nejm197403282901324. [DOI] [PubMed] [Google Scholar]
  13. Lavender S., Brown J. N., Berrill W. T. Acute renal failure and lithium intoxication. Postgrad Med J. 1973 Apr;49(570):277–279. doi: 10.1136/pgmj.49.570.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lee R. V., Jampol L. M., Brown W. V. Nephrogenic diabetes insipidus and lithium intoxication--complications of lithium carbonate therapy. N Engl J Med. 1971 Jan 14;284(2):93–94. doi: 10.1056/NEJM197101142840209. [DOI] [PubMed] [Google Scholar]
  15. Otto U., Paalzow L., Surén G. Lithium absorption from ordinary and from sustained-release tablets. Acta Pharm Suec. 1972 Dec;9(6):595–601. [PubMed] [Google Scholar]
  16. Saran B. M., Gaind R. Lithium. Clin Toxicol. 1973;6(2):257–269. doi: 10.3109/15563657308990524. [DOI] [PubMed] [Google Scholar]
  17. Schou M., Amdisen A., Trap-Jensen J. Lithium poisoning. Am J Psychiatry. 1968 Oct;125(4):520–527. doi: 10.1176/ajp.125.4.520. [DOI] [PubMed] [Google Scholar]
  18. Schou M., Baastrup P. C., Grof P., Weis P., Angst J. Pharmacological and clinical problems of lithium prophylaxis. Br J Psychiatry. 1970 Jun;116(535):615–619. doi: 10.1192/bjp.116.535.615. [DOI] [PubMed] [Google Scholar]
  19. Sletten I., Pichardo J., Korol B., Gershon S. The effect of chlorpromazine on lithium excretion in psychiatric subjects. Curr Ther Res Clin Exp. 1966 Sep;8(9):441–446. [PubMed] [Google Scholar]
  20. Sugita E. T., Stokes J. W., Frazer A., Grof P., Mendels J., Goldstein F. J., Niebergall P. J. Lithium carbonate absorption in humans. J Clin Pharmacol. 1973 Jul;13(7):264–270. doi: 10.1002/j.1552-4604.1973.tb00266.x. [DOI] [PubMed] [Google Scholar]
  21. Tangedahl T. N., Gau G. T. Myocardial irritability associated with lithium carbonate therapy. N Engl J Med. 1972 Oct 26;287(17):867–869. doi: 10.1056/NEJM197210262871709. [DOI] [PubMed] [Google Scholar]
  22. Thomsen K., Schou M. Renal lithium excretion in man. Am J Physiol. 1968 Oct;215(4):823–827. doi: 10.1152/ajplegacy.1968.215.4.823. [DOI] [PubMed] [Google Scholar]
  23. Vacaflor L., Lehmann H. E., Ban T. A. Side effects and teratogenicity of lithium carbonate treatment. J Clin Pharmacol J New Drugs. 1970 Nov-Dec;10(6):387–389. [PubMed] [Google Scholar]
  24. Von Hartitzsch B., Hoenich N. A., Leigh R. J., Wilkinson R., Frost T. H., Weddel A., Posen G. A. Permanent neurological sequelae despite haemodialysis for lithium intoxication. Br Med J. 1972 Dec 30;4(5843):757–759. doi: 10.1136/bmj.4.5843.757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Wilson J. H., Donker A. J., van der Hem G. K., Wientjes J. Peritoneal dialysis for lithium poisoning. Br Med J. 1971 Jun 26;2(5764):749–750. doi: 10.1136/bmj.2.5764.749. [DOI] [PMC free article] [PubMed] [Google Scholar]

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