Lithium 중독증상에 대한 고찰

A STUDY OF TOXIC SYMPTOMS DUE TO LITHIUM OVERDOSAGE

The author has tried to evaluate clinical correlation between toxic symptoms and serum level of lithium from an experience of mass intoxication. The intoxication was accidentally observed grom seven in-patients who had received lithium carbonate for the management of their manic symptoms. The accident occurred by measurement errer in capsuling of the lithium salt, resulting in doubling of its prescribed dosage. Moderate degree of toxic symptoms were noticed even at the serum level of 1.5mEq/L, severe degree symptoms such as confusion, muscle twitching and speech impairment at 1.5-3.0 mEq/L and far advanced degree symptoms with coma and generalized convulsion at 3 .5mEq/L and higher. For the safer and effective therapeutic use of lithium, the serum level should be maintained at 1.4 mEq/L and below. The toxic symptoms continued for over seven to ten days after dropping down of serum level to safe range Continuous observation and intensive care were should be recommended even after recovery of safe serum levelfor considerable period. Remedication of the lithium salt after disappearance of the toxic symptoms always resulted in reappearance of the symptoms even on the serum level under 1. OmEq/L. Remedication could be safely started at least two for our weeks after disappearance of the toxic symptoms. Poor food intake and previous cerebrovascular disorder were considered to be vulnarable to more severe intoxi cation, and the previous vascular disorder resulted in reappearance of the previous symptoms. The above findings were discussed in terms of possible correlation between clinical and laboratory data of the previous authors.