Lithium toxicity—case study

A case of lithium toxicity is described. The patient presented with an altered mental status and decreased oral intake since last 2 days. On neurological assessment, patient was anxious, disoriented to time and place, resting tremors, tone and deep reflexes were increased. An initial diagnosis was made on the basis of presenting symptoms. However, upon detailed evaluation, patient’s previous medication history included lithium for manic depressive psychosis. The patient lithium levels were checked and found to be high. Patient was initially managed with hemodialysis. The patient neurological status started showing improvement and subsequent evaluated by psychiatrist. The patient was discontinued from lithium treatment and was started on alternative antipsychotics as per the psychiatrist with regular follow-up.