Lithium salts overdose: risks of the slow release preparations.

Lithium carbonate has been an invaluable drug in the treatment of manic-dep ressive illness. At the present time slow-release forms are avaible for bet ter stability of circulating drug level with one daily take. However the be tter stability of lithiemia with these forms has to be balanced with a high er toxic risk in cases of lithium carbonate overdose because of continuous release. We report three cases of overdose with sustained-release lithium salts reac hing life threatening complications. Two hemodialysis sessions were necessa ry to control plasma lithium levels. In two cases, lithiemia rebond was obs erved after the first hemodialysis session, and was associated with severe neurological disorders. This publication pointed out the therapeutic rule of at least two hemodialy sis sessions in cases of severe slow release lithium carbonate salts intoxi cation.