Análisis de las intoxicaciones por litio ingresadas en un servicio de medicina interna

Abstract

Introduction:Lithiumsaltshavebeenmainlyusedinthetreatmentof bipolar disorder. Because of its narrow therapeutic range, and several well characterised adverse effects, serum lithium levels must be moni - tored regularly in patients given lithium treatment in order to prevent intoxication. Objetive: To describe the clinic and toxic characteristics in inpa - tientsatourClinicToxicologicUnit. Material and methods:Descriptiveandretrospectivestudyoflithium intoxications in 150 inpatients between 2003 and 2006. Patients were classified based on their neuropsychiathric symptom profile and serum lithiumlevels . Results: Sixteen of 150 inpatients had lithium intoxication: 58.3% women and 43.8% men; 49.19% ± 18.49% years old. Lithium was used as treatment of bipolar disorder in 87.5% of cases. The most frequent cause of intoxication was attempted suicide. Using neuropsychiatric parametres,intoxicationwasmoderatein50%ofcases,andmildin25% and severe or very severe in 25%. Using serum lithium levels, intoxica - tion was very severe in 31.35%, severe in 25%, and slight-moderate in 43.7%.Conservativemeasureswereusedasthemostfrequenttreatment (50%),andhaemodialfiltrationwasneededin37.5%.Meanstaywas4,8 days in acute intoxication, and 11.2 days in chronic. Sequelaes were foundintwopatients(ataxia).Deathwasnotpresent. Conclusions: Lithium intoxications can involve severe complica - tions, even death. Narrow control is encouraged in polymedicated and elderlypatients,andinconcommitanttreatmentwithantidepressantand neuroleptics.