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 491 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 491 patients (mean age 33.6±15.1 years, 65% female) included in the study, 75.6% exhibited reduced systolic blood pressure. lithium levels exhibited a substantial decrease following dialysis (p=0.016). the mortality rate was documented to be 1.6%. during subsequent follow-up, 0.4% of the subjects resumed lithium treatment, 1.8% attempted suicide, and 15.2% consulted a psychiatrist. it is noteworthy that cases of poisoning have increased fourfold over the past decade (p<0.001). patients who consumed more than 40 grams of the drug demonstrated a substantial decrease in the primary outcome (p=0.021). the proportion of hospitalizations lasting over two days decreased from 50% to 20.4% (p<0.0001).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.