Abstract

For over 100 years, lithium salts have been used in the treatment of various disorders including rheumatism, gout, hyperthyroidism. diabetes mellitus and as a salt substitute in patients with congestive heart failure. These uses, however, proved unrewarding and were associated with significant toxic effects. Therapeutic efficacy of lithium salts in the treatment of manic-depressive psychosis recently has been appreciated. Lithium has a narrow therapeutic range and multiple side effects may develop when the serum concentration reaches or exceeds upper therapeutic levels (2.0 to 2.5 mEq/liter).1 Toxic serum levels of lithium can prove fatal. Therapeutic serum lithium levels do not appear to have significant cardiotoxic effects, but at toxic levels serious cardiac disorders and arrhythmias may develop which require particular attention.