Risk factors for chronic lithium accumulation

Risk factors for chronic lithium accumulation and subsequent toxicity include:

  • impaired kidney function
  • dehydration
  • age more than 50 years
  • previous lithium toxicity
  • drug interactions (eg angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, nonsteroidal anti-inflammatory drugs, loop and thiazide diuretics)
  • lithium-induced nephrogenic diabetes insipidus
  • intercurrent illness
  • thyroid dysfunction.