Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th Edition. Shannon MW, Borron SW, Burns MJ, Haddad LM, Winchester-JF, eds., Philadelphia, PA: Saunders/Elsevier, 2007 May; :579-587
Lithium was discovered in 1818 and initially used for the treatment of gout, rheumatism, and renal calculi. In the early 1900s it was used as a salt substitute but was later abandoned because of toxic effects. It was also once present in the soft drink 7-Up. Although Aulde and Lange recognized in the 1880s that lithium could be used to treat depression, it was not until the 1950s that Cade and Schou established its use as a treatment for bipolar disorder. In 1970, the U.S. Food and Drug Administration (FDA) approved its use for the treatment of acute mania. Currently, lithium is used to treat a wide variety of disorders (Box 30-1) from bipolar affective disorder and alcoholism to prophylaxis for cluster headache. It remains the drug of choice for the treatment of recurrent bipolar illness. With increasing use of lithium comes an increased risk for toxic effects. It is estimated that up to 90% of patients taking lithium have at some time experienced signs and symptoms of toxicity. In 1991, the American Association of Poison Control Centers reported 4149 cases of lithium exposure, with 622 (15%) resulting in moderate to severe intoxication and 12 in death. In 2002, 4954 cases were reported (one third being unintentional exposures) with 1527 resulting in moderate to severe intoxication and 15 in death. Although death is rare, the risks for morbidity and prolonged hospitalization emphasize the importance of appropriate management.
Central-nervous-system; Chemical-analysis; Chemical-properties; Dose-response; Drugs; Drug-therapy; Lithium-compounds; Neurological-diseases; Neurological-reactions; Psychopharmacology; Psychophysiology; Psychotropic-drugs
Book or book chapter
Shannon-MW; Borron-SW; Burns-MJ; Haddad-LM; Winchester-JF
Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th Edition
University of California, Berkeley