REBEL Core Cast 93.0 – Lithium Toxicity

Take Home Points

  • Lithium toxicity comes in a three flavors: acute, chronic and acute on chronic. Each form will have a different presentation as well as management.
  • Lithium levels are often unreliable in terms of guiding management and must be taken in context with symptoms and time of ingestion (in acute overdose).
  • IV fluids are a cornerstone of management as increasing intravascular volume and increasing renal elimination are critical.
  • Hemodialysis is indicated for a lithium level > 5 mEq/L or a level > 4 mEq/L in a patient with renal failure. However, dialysis decisions should be made in conjunction with a toxicologist.

REBEL Core Cast 93.0 – Lithium Toxicity

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)

Cite this article as: Anand Swaminathan, "REBEL Core Cast 93.0 – Lithium Toxicity", REBEL EM blog, January 11, 2023. Available at:

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