Mood Emot 2023 Jul; 21(2): 28-30   https://doi.org/10.35986/me.2023.21.2.28
Lithium Toxicity during Hypertension Treatment Using Angiotensin II Receptor Blocker in a Patient with Bipolar Disorder
Su-Woo Lee , MD, Chan-Mo Yang , MD, Sang-Yeol Lee , MD, PhD, Seung-Ho Jang , MD
Departement of Psychiatry, Wonkwang University School of Medicine, Iksan, Korea
Correspondence to: Seung-Ho Jang, MD
Department of Psychiatry, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea
TEL +82-63-859-1044 FAX +82-63-857-1043 E-mail psychicjang@gmail.com ORCID https://orcid.org/0000-0002-3479-0552
Received: July 8, 2023; Accepted: July 9, 2023; Published online: July 31, 2023.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Herein, we present a case of lithium intoxication in a patient with bipolar disorder who was concurrently using an angiotensin II receptor blocker (ARB). Lithium, commonly prescribed for mental illnesses, possess a narrow therapeutic range (0.6-1.2 mmol/L) and can be influenced by medications that alter renal function. Interactions with other drugs, such as ARBs and chlorothiazide, can exacerbate lithium toxicity by influencing the sodium channel. This may lead to increased lithium reabsorption followed by toxicity and dehydration. This study highlights the importance of closely monitoring patients on lithium when co-administering medications that can impact lithium metabolism.
Keywords: Lithium; Antihypertensive agents; Angiotensin receptor antagonists

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