Diuretic-induced lithium toxicity presenting as mania.
A bipolar patient receiving lithium therapy developed a toxic state with a serum lithium level of 3.9 within 2 weeks of beginning hydrochlorthiazide treatment for hypertension. The initial changes in mental status suggested that the patient might be beginning another manic episode. Symptoms resolved following hemodialysis.
D001714:Bipolar Disorder / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007700:Kinetics; D008094:Lithium / Q000097:blood / Q000378:metabolism / Q000506:poisoning*; D016651:Lithium Carbonate; D008875:Middle Aged; D006435:Renal Dialysis
D006852:Hydrochlorothiazide; D016651:Lithium Carbonate; D008094:Lithium