A Rare Case of Lithium Toxicity Inducing Complete Heart Block and Nephrogenic Diabetes Insipidus

Lithium is a commonly utilized mood stabilizer for the treatment of bipolar disorder. Although it is efficacious, elevated levels may lead to neurologic, cardiac, nephrogenic, and gastrointestinal side effects. Management of severe lithium toxicity has been an evolving topic of debate in terms of its clinical management. We report a case of a 23-year-old female who presented to the emergency department with severe lithium toxicity, who needed intensive intervention and a critical level of care. This case provides an example of how utilizing standardized care algorithms may provide great benefit to clinicians managing lithium toxicity in emergencies and critical care setting. Current guidelines for lithium toxicity are categorized into three major classifications; 1. Acute overdose in lithium naïve patient, 2. Acute overdose in a patient on chronic therapy (acute on chronic), 3. Chronic over-medication or drug accumulation.