Lithium carbonate is a highly effective and commonly prescribed treatment for bipolar illness, but its use-owing to a narrow therapeutic index-risks iatrogenic (and sometimes irreversible) neurotoxicity. We present a case of "acute-on-chronic" lithium neurotoxicity and use it to highlight the clinical features, pathophysiol-ogy, and treatment of lithium-induced neurotoxicity. In addition, current guidelines for the management of lithium toxicity are examined critically and future directions are presented.
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