The use of lithium salts in medicine and symptoms of the poisoning with them

O.M. Arustamian, V.S. Tkachishin, V.E. Kondratiuk


Lithium preparations are psychotropic medicines from the group of mood stabilizers. Their major importance is the treatment of affective disorders, primarily manic phases of bipolar disorder, as well as prevention of its exacerbations and therapy of severe and resistant depressions, they also can prevent suicide. Treatment of bipolar disorders with lithium drugs is based on their ability to inhibit selectively kinase-3-glycogen synthase by competition with magnesium ions. Lithium is an alkali metal, therefore in medicine it is used in the form of salts, mainly carbonate, as well as citrate, succinate, orotate, chloride and lithium sulphate. In addition to psychiatry, lithium and its compounds are used in the production of plastics, organic synthesis, glass blowing industry, pharmaceutical chemistry. Lithium poisoning is often of iatrogenic nature in psychiatric practice. Lithium affects the release of serotonin and receptor sensitivity, and modulates the action of norepinephrine. At present, it is believed that the mechanism of lithium action is associated with inositol depletion in the central nervous system. The neurological symptoms of lithium poisoning include: ataxia, impaired vision, memory loss, dizziness, loss of orientation, convulsive seizures, muscle twitching, stupor and coma. The longer the toxic level of lithium in the blood persists, the greater the likelihood of irreversible changes in the central nervous system. Patient with lithium intoxication must be hospitalized. First aid: sodium chloride and potassium chloride solution per os. It is necessary to measure the concentration of lithium in the blood plasma several times a day. To reduce the concentration of lithium rapidly, it is often effective to administer the physiological solution intravenously at a rate of 150–200 ml per hour. First of all, gastric and intestinal lavage should be done (especially with long-acting drug poisoning). Since gastric juice often has a high concentration of lithium, prolonged aspiration of the stomach is indicated. Pathogenetic treatment to be carried out in epileptic seizures, central nervous system depression, arterial hypotension and arrhythmias. The most effective method is hemodialysis. However, it should be noted that objectively positive changes in lithium therapy (if it is successful) far exceed the negative impact of possible side effects.


lithium salts; bipolar affective disorders; manic state; depression; lithium salt poisoning; lithium hydroxybuty­rate; psychiatry; acute and chronic intoxications


Джадд Л.Л. Терапевтическое использование психотропных средств // Браунвальд Е., Иссельбахер К.Дж., Петерсдорф Р.Г. Внутренние болезни. — М.: Медицина, 1997. — Т. 10. — C. 27-45.

Шейдер Р.Г. Маниакально-депрессивный психоз // Психиатрия / Под ред. Шейдера Р. (пер. с англ. Пащенкова М.В. при участии Вельтищева Д.Ю.; под ред. Алипова Н.Н.). — М.: Практика, 1998. — C. 11-45.

Фармакотерапия в неврологии и психиатрии: [Пер. с англ.] / Под ред. С.Д. Энна и Дж.Т. Койла. — М.: Медицинское информационное агентство, 2007. — 800 с.

Джекобсон Дж.Л., Джекобсон А.М. Секреты психиатрии. Пер. с англ. / Под общ. ред. акад. РАМН П.И. Сидорова. — 2-е изд. — М.: МЕДпресс-информ, 2007. — 576 с.

Подкорытов В.С., Чайка Ю.Ю. Депрессии. Современная терапия. — Харьков: Торнадо, 2003. — 352 с.

Морозова М.А. Новые подходы к лечению депрессий при аффективных расстройствах биполярного типа // Психиатрия и психофармакотерапия. — 2001. — Т. 3, № 1. — C. 2-15.

Малин Д.И. Лекарственные взаимодействия психотропных средств (Ч. II) // Психиатрия и психофармакотерапия. — 2001. — № 1. — С. 20-25.

Рустанович А.В., Шамрей В.К. Клиническая психиатрия в схемах, таблицах и рисунках. — Издание 3-е, перераб. и доп. — СПб.: ЭЛБИ-СПб, 2006. — 216 с.

Петрова Т.Р., Сибицкий В.В. и др. Опыт клинического применения лития оксибутирата у больных с нарушениями ритма сердца // Терапевтический архив. — 1987. — № 6. — С. 115-119.

Нуллер Ю.Л., Михаленко И.Н. Побочные действия препаратов лития // Аффективные психозы. — Л.: Медицина, 1988. — 264 с.

Клинические рекомендации по терапии маниакальных и смешанных состояний при биполярном расстройстве (проект) // Современная терапия психических расстройств. — 2007. — Т. 4. — С. 33-46.

Ильин Н.В. и др. Коррекция нейтропении карбонатом лития при лучевом лечении больных гранулематозом // Тер. арх. — 1986. — № 9. — С. 65-67.

Geddes J.R., Burgess S., Hawton K. et al. Long-term lithium therapy for bipolar disorder: Systematic review and meta-analysis of randomized controlled trials // The American Journal of Psychiatry. — 2004. — 161(2). — P. 217-222.

Bauer M. et al. Double-Blind, Placebo-Controlled Trial of the Use of Lithium to Augment Antidepressant Medication in Continuation Treatment of Unipolar Major Depression // Am. J. Psychiatry. — 2000. — 157. — P. 429-435.

Bauer M., Döpfmer S. Lithium Augmentation in Treatment-Resistant Depression: Meta-Analysis of Placebo-Controlled Studies // Journal of Clinical Psychopharmacology. — 1999. — 18(5). — P. 123-213.

Malhi G.S., Tanious M. Optimal Frequency of Lithium Administration in the Treatment of Bipolar Disorder // CNS Drugs. — April 2011. — 25(4). — P. 289-298.

Nieper H.A. The clinical applications of lithium orotate. A two years study // Agressologie. — 1973. — 14(6). — P. 47-81.

Kamienski C.W. (сonsultant), McDonald D.P., Stark M.W., Papcun J.R. Lithium and Lithium Compounds // Kirk-Othmer Encyclopedia of Chemical Technology. — V. 15. — P. 139-140.

Doongaji D.R., Jathar V.S., Satoskar R.S. Manic depressive psychosis in India and the possible role of lithium as a natural prophylactic. I Hypothesis // Journal of Postgraduate Medicine. — 1980. — 26(1). — P. 34-38.

Gielen M., Tiekink ERT. The history of lithium therapeutics // Metallotherapeutic Drugs and Metal-Based Diagnostic Agents: The Use of Metals in Medicine. — John Wiley & Sons, 2005. — P. 3-4.

Shosuke Watanabe, Hiroshi Ishino, Saburo Otsuki. Lithium Ion and Affective Psychoses // Psychiatry and Clinical Neurosciences. — 1974. — 28(4). — P. 267-305.

Marmol F. Lithium: bipolar disorder and neurodegenerative diseases Possible cellular mechanisms of the therapeutic effects of lithium // Prog. Neuropsychopharmacol. Biol. Psychiatry. — 2008. — 32(8). — P. 61-71.

Mitchell P.B., Hadzi-Pavlovic D. Lithium treatment for bipolar disorder (PDF) // Bulletin of the World Health Organization. — 2000. — 78(4). — P. 15-72.

Baum A.E. et al. A genome-wide association study implicates diacylglycerol kinase eta (DGKH) and several other genes in the etiology of bipolar disorder (Genome-wide association study of bipolar disorder) // Mol. Psychiatry. — 2008. — 13. — P. 197-207.

Ryves W.J. et al. Glycogen Synthase Kinase-3 Inhibition by Lithium and Beryllium Suggests the Presence of Two Magnesium Binding Sites // Biochem. Biophys. Res. Comm. — 2002. — V. 290, № 3. — P. 967-972.

Freland L., Beaulieu J.M.M. Inhibition of GSK3 by lithium, from single molecules to signaling networks // Frontiers in molecular neuroscience. — 2012. — V. 5. — P. 14-19.

Richter D.L. et al. Differential sensitivity of fungi to lit­hium chloride in culture media // Mycological Research. — 2008. — 112(6). — P. 717-724.

Drone B. et al. Lithium gluconate in the treatment of seborrhoeic dermatitis: a multicenter, randomised, double-blind study versus placebo // Eur. J. Dermatol. — 2002. — 12(6). — P. 49-52.



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