Intoxication in manic patients following chaotic self-administration of lithium

Intoxication is a serious complication of lithium therapy. Suicides attempted by depressive patients or excessive serum levels due to reduced renal elimination are typical causes of these intoxications. So far, lithium intoxications following excessive intake by patients with manic disorders have not been reported. We present 4 case histories of manic patients in whom the diagnosis of lithium intoxication was delayed, even though their affective disorders and medication were known. Lithium should be determined immediately on a routine basis in all patients who, on the basis of their history, are known to receive or who, considering the underlying mental illness, possibly receive lithium therapy.