Lithium 중독의 위험 요인에 대한 후향적 고찰

Abstract

After lithium being approved for the treatment of bipolar affective disorder in 1970, it has been used for many psychiatric symptoms. But lithium has a very narrow therapeutic index which can sometimes be fatal to patients. In this study, retrospective analysis was done to 72 psychiatric patients who had taken lithium and completed serum lithium level test, complete blood cell count, liver function test, thyroid function test and serum renal function test. We compared the difference of lithium intoxication risk factors between lithium intoxication and non-intoxication group. And we also studied the difference of risk factors of lithium intoxication in relation to the treatment of hemodialysis. Current findings are as follows：1) Serum lithium levels, presence of renal problems and Gadallah’s toxicity symptom stages were significantly higher in lithium intoxication group than in non-intoxication group. 2) Serum lithium levels and Gadallah’s toxicity symptom stages were significantly higher in hemodialysis group than in nonhemodialysis group. 3) Serum lithium levels had negative correlations with serum sodium level and positive correlations with toxicity symptom stages. These results suggest that renal problems were related to lithium intoxication and the higher serum lithium levels and intoxication symptom stage were, the more physicians chose the method of hemodialysis. And we also found that Gadallah’s toxicity symptom criteria might be very useful for the assessment of the side effects of lithium and helpful to prevent possible lithium intoxication. Further studies for verification of these facts will be necessary in the future.