Observation and patient disposition after chronic lithium accumulation

Admit patients for observation and management if they have chronic lithium toxicity and evidence of neurotoxicity (eg coma, seizures).

On discharge, lithium therapy does not have to be restarted immediately. Consider ceasing therapy or dose reduction, as there is a high risk of recurrence of toxicity from chronic accumulation.

Patients can have significant cognitive impairment for several days following exposure. Advise patients not to drive or operate machinery for at least 3 days after discharge.