Author/Editor		Sinkovič, Andreja; Vrbnjak, Matej; Svenšek, Franc; Kirbiš, Simona
Title		Lithium and venlafaxine poisoning - a case report
Type		članek
Vol. and No.		Letnik 8, št. 5
Publication year		2013
Volume		str. 591-596
ISSN		1644-3640 - Central European journal of medicine
Language		eng
Abstract		In treatment of manic-depressive conditions long-term lithium therapy may be combined with an effective and relatively safe antidepressant venlafaxine. Combined overdose may increase the risk of early toxicity of both drugs and of delayed lithium intoxication, responding to symptomatic and renal replacement therapy. We present a patient with combined lithium and venlafaxine self-poisoning with nothing but delayed signs of lithium intoxication with the emphasis on early and late treatment. 41-year old woman attempted suicide by large amount of lithium and venlafaxine. On admission she was asymptomatic, but with increased serum lithium over 5mmol/L. After gastric lavage, active charcoal and laxative administration she was receiving IV fluids. After a delay of 63 hours she deteriorated acutely by disorientation, confusion, fasciculation and tremor and was readmitted to Intensive care unit. In spite serum lithium decreased to 2mmol/L clinical signs were attributed to delayed lithium intoxication. After symptomatic and renal replacement therapy the patients condition improved after few days. We conclude that decontamination procedures are effective in particular for venlafaxine poisoning. If increased serum lithium levels are noted renal replacement therapy may be started even in asymptomatic patients as delayed lithium intoxication is most likely after few days.
Keywords		zastrupitev litij venlafaksin ledvično nadomestno zdravljenje prikaz primera