Lithium Intoxication After Sleeve Gastrectomy: A Case Report and Differential Diagnosis

Area of Science:

• Pharmacology
• Bariatric Surgery
• Clinical Toxicology

Background:

• Bariatric surgery is increasingly common for obesity treatment globally.
• Sleeve gastrectomy can significantly alter the bioavailability of medications.
• Patients with psychiatric conditions require careful medication management post-surgery.

Observation:

• A 51-year-old female developed lithium toxicity 37 days after sleeve gastrectomy.
• Initial symptoms included gastrointestinal issues, misdiagnosed as gastroenteritis.
• Neurological symptoms emerged, leading to a lithium toxicity diagnosis.

Findings:

• The patient experienced lithium toxicity due to altered drug bioavailability post-sleeve gastrectomy.
• Elevated mood was observed during lithium toxicity treatment.
• This case highlights the pharmacokinetic challenges of lithium after bariatric procedures.

Implications:

• Emphasizes the critical need for vigilant post-bariatric surgery follow-up for patients on psychiatric medications, particularly lithium.
• Highlights the importance of proactive medication management and clinical symptom monitoring in this population.
• Suggests a need for revised guidelines on lithium dosing and monitoring after bariatric interventions.