Saline infusion and amiloride in the management of lithium toxicity

This paper describes the case of a 74 year old patient who became lithium toxic after 15 years of lithium therapy. We discuss the clinical presentation of the case and some of the possible causes of the sudden development of his toxicity. Although haemodialysis is the treatment of choice for severe lithium toxicity it is not always available. In this paper we propose that the combination of saline diuresis and Amiloride may provide a suitable alternative in the management of lithium toxicity.