Adverse Effects of Lithium Therapy

Neurological and Cardiovascular Effects

• Neurotoxicity can manifest as peripheral neuritis, optic neuritis, anxiety, depression, and psychosis, according to the American Thoracic Society 1
• QT prolongation has been reported with lithium use, as noted by the European Society of Cardiology 2

Toxicity Concerns and Risk Factors

• Early signs of toxicity include tremor, nausea, diarrhea, polyuria-polydipsia, as recommended by clinical guidelines from the American Medical Association 3
• Renal impairment increases the risk of toxicity, as reported by the National Kidney Foundation 4

Special Considerations and Monitoring Requirements

• Baseline testing should include complete blood count, thyroid function tests, renal function tests, serum calcium, and urinalysis, as recommended by the American College of Physicians 3
• Ongoing monitoring should include renal function tests, thyroid function tests, and urinalysis every 3-6 months, and serum calcium annually, according to the American Academy of Family Physicians 3

Long-Term Risks of Low-Dose Lithium Therapy

Monitoring Requirements

• The American Thoracic Society recommends ongoing monitoring, including liver function tests 1 month after starting treatment and then every 6 months, and ECG 1 month after starting treatment to check for QT prolongation 5