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September 1984

Lithium Salt Intoxication and Neurologic Sequelae

Author Affiliations

Lithium Information Center Department of Psychiatry University of Wisconsin Center for Health Sciences 600 Highland Ave Madison, WI 53792

Arch Neurol. 1984;41(9):915-916. doi:10.1001/archneur.1984.04050200017006

To the Editor.  —In the recent article by Donaldson and Cuningham,1 "Persisting Neurologic Sequelae of Lithium Carbonate Therapy," all patients had maximum plasma lithium ion levels above the accepted ranges of 0.8 to 1.4 mEq/L for acute episodes and 0.6 to 1.0 mEq/L for maintenance therapy.2 Consequently, a more appropriate title would have been "Persisting Neurologic Sequelae of Lithium Carbonate Intoxication." Subsequent reporting of this article by the news media led a number of patients to express concern that their carefully monitored lithium carbonate treatment was likely to result in brain damage. The authors explored a number of explanations for the persistence of symptoms without mentioning the duration of elevated serum lithium ion levels, which is well recognized as a critical variable that affects the severity of intoxication and quite probably the outcome of an episode of lithium carbonate poisoning.3-6We agree with the authors' concluding statement about the necessity

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