We just went through the most horrifying experience with lithium toxicity. My husband (and I) has been on lithium for several years with no problems until two weeks ago.

The first sign of problems was that he started developing tremors. He has a complicated medical profile, so the tremors at first weren't terribly worrisome, but after a few days they became so pronounced that he was losing the ability to do anything fine motor. About that same time, I started noticing, for lack of a better description, that he just didn't seem with it. I called his pdoc who sent us immediately to the ER for blood work. His lithium level was 3 times what it should have been, a 3.3. His kidneys were shutting down. They immediately called in a nephrologist and they started dialysis.

He was admitted to the hospital's progressive care unit -- a step down from ICU. The lithium level went down quickly and the kidneys seemed to recover nicely, but he then went into psychosis. For 3 days, his entire experience while conscious was constant hallucinations and delusions. He ripped out his IV's and monitors several different times. They finally kept him sedated to ride out the psychosis because consciousness was utterly terrifying for him.

They are unsure what caused the toxicity. He did not overdose. He had recently had levels checked. One theory is that it was a med interaction. Another is that one of his heart meds caused the kidney issues which caused the toxicity. It really is hard to know whether the lithium caused the kidney problems or kidney problems caused the toxicity. They assume the psychosis was the result of all meds being pulled off his system so abruptly through dialysis.

After about 5 days in the PCU, he started coming around. He started realizing he had been hallucinating and delusional, and the tremors finally went away. He came home after 8 days in the hospital. He is doing well now. Obviously he is no longer on lithium and they've made some other med adjustments.

Scary experience. I was on lithium myself when this all started, but I have taken myself off for now. This scared the crap out of me.

[Trippin2.0]

Omw Chris! How horrifying!!!!

I'm glad your hubby's feeling better, and don't blame you for being scared of the med yourself, I had my own bad experiences with it, but not toxicity...

So sorry you guys had to go through that.

Yup. Pdoc and I are going to have a long talk about lithium before I'll ever consider going back on. This was frightening.

Yes, I had temporary kidney damage from the use of lithium. Fortunately, my kidneys
calmed down about a month after the lithium was removed, but there is still medium damage.

Lithium causes closure of the tiny arteries of the kidneys and there's nothing nephrologists can do about that. Your husband is very, very fortunate. I will never take lithium again with the approval of my nephrologist. My endocrinologist told me that lithium is one of the most toxic
medications on the market.

I don't speak about this often, but you did ask.

I had been of lithium for awhile but went back on with reservations in April. It has always worked well for me and I've never had problems with it, but I have always been wary of long-term damage from lithium. Watching my husband go through this and come so close to death taking it as prescribed with all precautions has pretty much sealed my unwillingness to continue with lithium ever again.

Originally Posted by 1914sierra

I had been of lithium for awhile but went back on with reservations in April. It has always worked well for me and I've never had problems with it, but I have always been wary of long-term damage from lithium. Watching my husband go through this and come so close to death taking it as prescribed with all precautions has pretty much sealed my unwillingness to continue with lithium ever again.

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That may be a very smart move, in my view, for your future years.

I liked Lamictal and could take 15 mg of that and be just fine. You might
wish to check into that. (All medications are going to leave an acidic residue
or ash). Lamictal could cause acne, and I developed that on one side, so
I had to drop it; otherwise, it was the best medication I ever took for
Bipolar, Type II.

If either you or your husband has a sensitivity to caffeine you should stop
using it. It makes bipolar illness worse. So will alcohol. (This from my psychiatrist.)

Good wishes and I hope your husband continues to improve.

I've been on lamictal before. It comes in 25mg increments, so I'm not sure how you take 15mg. I had to take 375mg to hit a therapeutic dose. It's an option. Neither my husband or I consume caffeine or alcohol.

[cool09]

Therapeutic level and toxic level of lithium are very close so it's hard to find relief and not experience side effects. You have to experiment with the dose. I hit the therapeutic dose once (1800 mg) and my muscles felt like rubber and wouldn't work and had to back the dose down. Other than that it hasn't done a thing for me since 2003.

Originally Posted by 1914sierra

I've been on lamictal before. It comes in 25mg increments, so I'm not sure how you take 15mg. I had to take 375mg to hit a therapeutic dose. It's an option. Neither my husband or I consume caffeine or alcohol.

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Just split a 25 mg tablet into about 15% of the pill.