Department of Psychiatry, Cork University Hospital, Cork, Ireland.
Ir J Med Sci. 2011 Sep;180(3):661-5. doi: 10.1007/s11845-011-0712-6. Epub 2011 Apr 23.
Lithium is a commonly prescribed pharmacological treatment for mood disorders. It is associated with a number of side effects and potentially serious toxicity. To date, there is little data from Irish samples on the subject of Lithium toxicity.
To examine the incidence and clinical correlates of lithium toxicity in Cork, Ireland.
Our study identified 130 cases of biochemical lithium toxicity over 5 years, with an incidence rate of approximately 5.4 cases per 100,000 per year. Mean toxic lithium level was 2.16 mmol/L ±SD 0.87 mmol/L. Of these, 36% cases were reviewed medically in the general hospital at the time of toxicity. A number of issues in relation to lithium toxicity were identified. Neurological symptoms were common, including tremor, confusion, ataxia, drowsiness. However, only 4.2% patients were reviewed by a neurologist while in hospital. Medications that interact with lithium were found in 50% cases, with significant polypharmacy in 15%. The psychiatric services were involved in patient care in 76% cases, and 85% patients presenting with toxicity were reviewed by a psychiatrist. Rates of admission to hospital and haemodialysis were 70 and 11%, respectively.
Improvements in the standards of care in relation to lithium prescribing are required.
锂是一种常用于治疗情绪障碍的药理学药物。它与许多副作用和潜在的严重毒性有关。迄今为止，关于爱尔兰样本的锂毒性数据很少。
检查爱尔兰科克锂毒性的发生率和临床相关性。
我们的研究在 5 年内确定了 130 例生化锂毒性病例，发病率约为每年每 100,000 人 5.4 例。平均毒性锂水平为 2.16mmol/L±SD0.87mmol/L。其中，36%的病例在毒性发生时在综合医院接受了医学审查。确定了与锂毒性有关的一些问题。神经症状很常见，包括震颤、意识混乱、共济失调、嗜睡。然而，只有 4.2%的住院患者接受了神经科医生的检查。在 50%的病例中发现了与锂相互作用的药物，15%的病例存在明显的多药治疗。精神科服务在 76%的病例中参与了患者的护理，85%的毒性患者接受了精神科医生的检查。住院和血液透析的比例分别为 70%和 11%。
需要改进与锂处方相关的护理标准。
