CLINICAL MANIFESTATIONS AND MANAGEMENT OF ACUTE LITHIUM INTOXICATION

Acute lithium intoxication is a frequent complication of chronic lithi um therapy for manic depressive disorders. Because of lithium's narrow therapeutic index and widespread use, lithium intoxication remains pr evalent in 1994. This review summarizes information on the renal handl ing of lithium and the physiologic basis for toxicity. Recent reports that describe previously unrecognized side effects of lithium intoxica tion are discussed. We also present management guidelines based upon o ur understanding of the renal handling of lithium. In this review we c ompare the effectiveness of lithium removal by various dialysis method s, including bicarbonate dialysis, peritoneal dialysis and continuous arteriovenous hemofiltration. Hemodialysis remains the cornerstone for the treatment of acute lithium toxicity.