[Aetiologies of lithium overdose: 10-year experience of Marseille poison centre].
OBJECTIVE
Lithium is used for control of bipolar disorders. In order to precise the different circumstances at the origin of poisonings, the authors present the cases of lithium intoxication observed in the Marseille poison centre between January 1991 and December 2000.


METHODS
Retrospective study.


METHODS
Three hundred and four cases were observed during the studied period (1 patient a case), concerning 6 different circumstances. For 3 of them, the symptoms were mild: accidental ingestion with children (13 cases); mistakes on the quantities of ingested tablets (43 cases); elevation of lithium blood level due to diuretic therapy (8 cases). For 2 other circumstances, the clinical signs were more severe: treated patients who developed renal failure (15 cases, 6 patients managed in intensive care unit [ICU], 1 death) or dehydration (35 cases, 8 patients treated in ICU and 1 death). Finally, the most severe cases were collected with suicide attempts. Fifty-six percent of the patients were managed in ICU, 5% needed haemodialysis, 10% had cardiac (repolarization disturbances) or neurological (seizures) complications, 2% died.


CONCLUSIONS
The severity of lithium poisonings depends of the circumstances. Ingestion of high quantities of sustained released tablets is the most dangerous situation. Accidental ingestion, even with children, must be considered as less severe situations.
de Haro
L
L
Centre antipoison, hôpital Salvator, 249, boulevard Sainte-Marguerite, 13009 Marseille, France. deharo.1@jean-roche.univ-mrs.fr
Roelandt
J
J
Pommier
P
P
Prost
N
N
Arditti
J
J
Hayek-Lanthois
M
M
Valli
M
M
D000059:Accidents; D058186:Acute Kidney Injury / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003681:Dehydration / Q000139:chemically induced; D003692:Delayed-Action Preparations / Q000506:poisoning; D004232:Diuretics / Q000627:therapeutic use; D062787:Drug Overdose / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005602:France; D006801:Humans; D008094:Lithium / Q000097:blood / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers; D006435:Renal Dialysis; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced; D013406:Suicide, Attempted
D003692:Delayed-Action Preparations; D004232:Diuretics; D008094:Lithium