![]() Lithium should generally be avoided in patients with Brugada Syndrome or those suspected of having Brugada Syndrome. Brugada Syndrome is a disorder characterized by abnormal electrocardiographic (ECG) findings and a risk of sudden death. There have been postmarketing reports of a possible association between treatment with lithium and the unmasking of Brugada Syndrome. If symptoms occur, decrease dosage or discontinue lithium treatment. Monitor for signs and symptoms of lithium toxicity. Changes in electrolyte concentrations (especially sodium and potassium).Concomitant administration of drugs which increase lithium serum concentrations by pharmacokinetic interactions or drugs affecting kidney function (see PRECAUTIONS-Drug Interactions).Recent onset of concurrent febrile illness.The risk of lithium toxicity is increased by: No specific antidote for lithium poisoning is known (see OVERDOSAGE). Gastrointestinal manifestations include nausea, vomiting, diarrhea, and bloating. Respiratory manifestations include dyspnea, aspiration pneumonia, and respiratory failure. Renal manifestations include urine concentrating defect, nephrogenic diabetes insipidus, and renal failure. ![]() Cardiac manifestations involve electrocardiographic changes, such as prolonged QT interval, ST and T-wave changes and myocarditis. In rare cases, neurological sequelae may persist despite discontinuing lithium treatment and may be associated with cerebellar atrophy. Neurological signs of lithium toxicity range from mild neurological adverse reactions such as fine tremor, lightheadedness, lack of coordination, and weakness to moderate manifestations like giddiness, apathy, drowsiness, hyperreflexia, muscle twitching, ataxia, blurred vision, tinnitus, and slurred speech and severe manifestations such as clonus, confusion, seizure, coma, and death. Lithium may take up to 24 hours to distribute into brain tissue, so occurrence of acute toxicity symptoms may be delayed. Some patients abnormally sensitive to lithium may exhibit toxic signs at serum concentrations that are considered within the therapeutic range (see BOXED WARNING and DOSAGE AND ADMINISTRATION). The toxic concentrations for lithium (≥1.5 mEq/L) are close to the therapeutic range (0.8 to 1.2 mEq/L).
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