Lithium toxicity following bariatric surgery

Suzanna Connick Jamison; Kelley Aheron

doi:10.1177/2050313X20953000

Lithium toxicity following bariatric surgery

SAGE Open Med Case Rep. 2020 Sep 10:8:2050313X20953000. doi: 10.1177/2050313X20953000. eCollection 2020.

Authors

Suzanna Connick Jamison^{1

2

3}, Kelley Aheron^{1

4}

Affiliations

¹ Carilion Clinic, Roanoke, VA, USA.
² Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
³ 804 Medical Brigade, Devens, MA, USA.
⁴ Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA.

Abstract

A patient with morbid obesity and several psychiatric comorbidities underwent laparoscopic sleeve gastrectomy and experienced success with weight loss. However, she experienced lightheadedness, nausea, and a fall and was admitted to the hospital for encephalopathy due to lithium toxicity. The pharmacokinetics of lithium is altered following bariatric surgery. Due to these factors, adjustments were made to the patient's lithium therapy, her levels were subsequently reduced into the therapeutic range, and she continued with no further issues. Mechanisms of lithium toxicity following bariatric surgery and a monitoring protocol to prevent toxicity are discussed.

Keywords: Psychopharmacology; bariatric surgery; lithium; mental health/psychiatry.

Publication types

Case Reports