A Retrospective Chart Review of Lithium Side Effects in a Geriatric Outpatient Population.

The charts of 114 elderly outpatients with mood disorders treated with lithium were reviewed to determine the incidence of side effects. Patients had been treated with lithium for an average of 7.5 years, with an average serum lithium level of 0.5. Overall, 61.4% of patients experienced side effects from lithium at some point in their treatment, but only 0.11 side effects occurred per patient per year. Two (1.8%) patients had to discontinue lithium because of side effects and four (3-5%) required hospitalization. Delirium was the most common side effect noted (19.3%). Side effects occurred both at low ("subtherapeutic") and higher serum lithium levels. Variables significantly associated with experiencing side effects included male sex and higher serum lithium level. Hypothyroidism was significantly associated with longer length of time in years treated with lithium.