Clinicoepidemiological Pattern of Lithium Poisoning: Comparison of Two Decades in Tehran, Iran

Background: Lithium has been identified as a substance of significant toxicological concern, with the potential to inflict permanent damage to the central nervous system (CNS). This study examined cases of lithium poisoning over a period of ten years and compared them with cases from the previous decade. Methods: This cross-sectional and retrospective study was conducted on patients with lithium poisoning. The study population comprised ۴۹۱ patients. Information regarding the patients was retrieved from the hospital archives using a checklist. Subsequent to discharge, patients were monitored for post-operative outcomes. Subsequent to the completion of the study, a comparison was made between the results obtained and those from the previous decade.Results: Among the ۴۹۱ patients (mean age ۳۳.۶±۱۵.۱ years, ۶۵% female) included in the study, ۷۵.۶% exhibited reduced systolic blood pressure. Lithium levels exhibited a substantial decrease following dialysis (p=۰.۰۱۶). The mortality rate was documented to be ۱.۶%. During subsequent follow-up, ۰.۴% of the subjects resumed lithium treatment, ۱.۸% attempted suicide, and ۱۵.۲% consulted a psychiatrist. It is noteworthy that cases of poisoning have increased fourfold over the past decade (P<۰.۰۰۱). Patients who consumed more than ۴۰ grams of the drug demonstrated a substantial decrease in the primary outcome (P=۰.۰۲۱). The proportion of hospitalizations lasting over two days decreased from ۵۰% to ۲۰.۴% (P<۰.۰۰۰۱).Conclusion: The identification of lithium toxicity cases is facilitated by epidemiological data, thereby enabling a targeted management approach. A multifaceted approach is imperative to minimize toxicity risks. This approach should include the implementation of restricted re-prescription for suicidal use, stringent pharmacy controls, comprehensive family education on interactions, and regular renal monitoring.

کلیدواژه ها:

Toxicity ، Lithium ، Epidemiological Study ، Poisoning ، Decade