From the FDA Drug Label
The toxic levels for lithium are close to the therapeutic levels. ... Toxic symptoms are listed in detail under ADVERSE REACTIONS. In severe cases of lithium poisoning, the first and foremost goal of treatment consists of elimination of this ion from the patient Treatment is essentially the same as that used in barbiturate poisoning: 1) gastric lavage, 2) correction of fluid and electrolyte imbalance and 3) regulation of kidney functioning.
The FDA drug label does not answer the question.
From the Research
Lithium overdose is unlikely to cause permanent hepatic damage, as the liver is not the primary site of toxicity, and most studies focus on the central nervous system and kidneys as the main affected organs. The provided evidence does not directly support the notion that lithium overdose commonly results in permanent liver damage. While lithium can affect various organs, its primary toxicity is observed in the central nervous system and kidneys 1.
Key Points to Consider
- Lithium's narrow therapeutic index and the influence of kidney function increase the risk of toxicity, but the liver is not typically highlighted as a primary concern in overdose scenarios 1.
- The mechanism of lithium toxicity involves disruption of cellular processes, but the focus is usually on the central nervous system and kidneys rather than the liver 2.
- Treatment for lithium overdose typically involves discontinuation of lithium, supportive care, and sometimes hemodialysis to rapidly remove the drug from circulation, with an emphasis on managing central nervous system and kidney effects rather than liver damage 3.
- There is limited direct evidence in the provided studies to suggest that lithium overdose frequently leads to permanent hepatic damage, with most discussions centered around acute and chronic toxicity effects on the brain and kidneys 4, 2, 1.
Clinical Recommendations
- If lithium overdose is suspected, immediate medical attention is crucial, focusing on supportive care and potential hemodialysis based on the severity of the overdose and the patient's clinical presentation 3.
- Monitoring of liver function tests may be part of the overall assessment but is not the primary concern in managing lithium toxicity 1.
- The decision to use hemodialysis or other treatments should be based on the patient's overall clinical condition, including factors such as serum lithium levels, symptoms, and kidney function, rather than a specific concern for liver damage 2, 3.