Deep Vein Thrombosis after Lithium Toxicity: A Report of Two Cases and Literature Review

Abstract

Lithium administration can reportedly cause toxicity, including lithium-associated thrombosis; however, not all reported cases of this adverse effect have been attributable to lithium overdoses. We report here two cases of deep vein thrombosis that occurred in association with lithium toxicity. Lithium overdose was deemed to be the cause in only one of these cases; a patient in whom deep vein thrombosis occurred 11 days after identification of lithium toxicity. In the other patient, the deep vein thrombosis occurred 15 days after diagnosis of lithium toxicity; this patient was not considered to have been overdosed. Both patients had other risk factors in addition to receiving lithium. We recommend monitoring D-dimer concentrations to facilitate early detection of deep vein thrombosis in patients with lithium toxicity.

Lithium and risk of cardiovascular disease, dementia and venous thromboembolism

“…[29][30][31] The use of antidepressants has been suggested to be causal for venous thrombosis in this context, 32 and antipsychotics have also been linked to higher risk of VTE. 27,31 There are a few case reports on VTE in lithium-treated patients associated with lithium toxicity, 33,34 and case reports of lithium-induced nephrogenic diabetes insipidus contributing to the development of dural sinus 35 and superior sagittal sinus thrombosis, 36 respectively. Excess mortality from pulmonary embolism in lithium-treated patients has been previously described.…”