Jefferson Journal of Psychiatry


Abstract Lithium has been used in the treatment of bipolar affective disorder (BAD) for more than 50 years. Features of lithium toxicity include drowsiness, slurred speech, ataxia, psychomotor slowing, polyneuropathy, impaired memory, seizures, coma and death. Lithium neurotoxicity is usually reversible on cessation of its administration, and irreversible toxicity is uncommon. However, persistent neurological sequelae may follow lithium intoxication. There may be a contribution to neurotoxicity from the SIADH associated with lithium toxicity in addition to the direct effects of lithium itself. We describe a case of lithium toxicity with persistent delirium in a patient with a brief period of severe hypernatremia and persistent neurological signs for more than one month after the discontinuation of the medication.

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