Citation

Hrdlicka M, Sevcik P, Horka E, Pejchl J. Cesk. Psychiatr. 1996; 92(5): 283-292.

Copyright

(Copyright © 1996, Avicenum)

DOI

unavailable

PMID

unavailable

Abstract

Intoxications are a relatively rare but serious complication of lithium therapy. The objective of the present work was to analyze lethal lithium intoxications and to attempt to characterize their course and common features. The group of four deaths from lithium intoxication in the South Moravian region in the course of 27 years of administration of the drug (1968-95) can be characterized by a common denominator of schizoaffective disorder and the use of lithium in a sustained release form (Contemnol R Slovakofarma). All three women in the group ingested large doses of lithium with suicidal intentions. These intoxications had always a multistage course. Serious symptoms developed as a rule only on the third day of intoxication, two of the three patients developed also an a confusional state which obscured the diagnosis. The only man in the group died while treated with therapeutic doses of lithium and the diagnosis of intoxication was made difficult by the concurrent diagnosis of a demyelinating disease of the type of multiple sclerosis. It is obvious that intoxications with large doses of sustained-release lithium preparations are difficult to control. The key problem is complete removal of tablets from the digestive tract. Classical gastric lavage proved insufficient in the authors' group. Therefore more radical elimination methods are discussed - intestinal lavage, gastroscopic removal of tablets under visual control and enterotomy.

Language: cs

Keywords

adult; human; suicide; Suicide; female; male; case report; lethality; lithium; Lithium; article; drug intoxication; confusion; schizoaffective psychosis; multiple sclerosis; sustained release preparation; Lithium intoxication; oral drug administration; Pharmacokinetics of lithium; Sustained-release preparations