Table 5.

Treatment of lithium poisoning

Protect oral airway if consciousness is impaired
Intravenous normal saline if volume depleted
Whole bowel irrigation with polyethylene glycol
Sodium polystyrene sulfonate
  • lithium level >6 mEq/L: any patient

  • lithium level >4 mEq/L: any patient on chronic lithium therapy

  • lithium level between 2.5 and 4 mEq/L: any patient with severe neurologic symptoms, renal insufficiency, or unstable hemodynamically or neurologically

  • lithium level <2.5 mEq/L: hemodialysis indicated only for patients with end-stage renal disease or patients whose lithium levels increase after admission or who fail to reach a lithium level below 1 mEq/L in 30 h

Data from references 2,3,4.