UNTOWARD EFFECTS OF LITHIUM TREATMENT IN CHILDREN AGED 4 THROUGH 6 YEARS

Objective: To explore the relationship between lithium dose and serum lithium level on the occurrence of untoward or toxic effects of lithiu m in the treatment of 20 hospitalized aggressive and/or mood-disordere d children aged 4 through 6 years. Method: Clinical and research recor ds of 20 children treated with lithium according to an established inp atient protocol were reviewed. Side effects as reported by psychiatric staff were categorized by organ system affected and severity. Results : During the initial 2 weeks of lithium treatment, 60% of the children manifested one or more types of side effects, most commonly central n ervous system effects. Side effects were seen at doses of 25.6 to 52.1 mg/kg per day and at serum levels from 0.65 to 1.37 mEq/L. In general , adverse effects were associated with higher lithium doses and lithiu m levels and were most common during the first week of treatment. A po tential interaction between concurrent infection and more severe side effects was seen. Conclusions: Side effects occur frequently in childr en aged 6 years and younger during the initiation phase of lithium tre atment; are related to higher milligram per kilogram doses, higher ser um lithium levels, and phase of treatment; and may be related to concu rrent medical illness.