Lithium Therapy and Magnesium Levels

Clinical Implications

The American Heart Association suggests that magnesium has been associated with benefit in treating torsades de pointes and ventricular arrhythmias, and in patients with heart failure, hypomagnesemia is associated with more frequent ventricular arrhythmias, and magnesium supplementation can significantly reduce premature ventricular contractions 1
Monitoring magnesium levels is important in cancer patients and other clinical populations, as stated by the European Society for Medical Oncology 2

The European Society for Clinical Nutrition defines normal serum magnesium levels as ≥0.70 mmol/l, with hypomagnesemia classified as mild: between 0.76 and 0.64 mmol/l, moderate: between 0.63 and 0.40 mmol/l, and severe: <0.40 mmol/l 3
Particular attention should be paid to patients with cardiac conditions, as magnesium plays an important role in cardiac electrophysiology, according to the American College of Cardiology 1
Patients with kidney disease require special attention, as both lithium and altered magnesium levels can impact renal function, as noted by the National Institute of Diabetes and Digestive and Kidney Diseases 3