Clinical features

• Coarse tremor
• Central nervous system disturbance, which may include seizures, impaired coordination, and dysarthria
• Cardiac arrhythmias
• Visual disturbance

Clinical features at therapeutic dose

• Fine tremor
• Dry mouth
• Gastrointestinal disturbance
• Increased thirst
• Increased urination
• Drowsiness
• Thyroid dysfunction

Investigations

• Serum lithium levels: this is the gold standard for diagnosing lithium toxicity
• Electrolyte levels: to assess for any electrolyte imbalance
• Thyroid function tests: given the potential for thyroid dysfunction
• Renal function tests: given lithium's potential to cause renal impairment.
• ECG: to assess for arrhythmias

Management