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Open Medicine

formerly Central European Journal of Medicine

Editor-in-Chief: Darzynkiewicz, Zbigniew

IMPACT FACTOR 2018: 1.221

CiteScore 2018: 1.01

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ICV 2017: 152.94

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Volume 8, Issue 5


Volume 10 (2015)

Lithium and venlafaxine poisoning — a case report

Andreja Sinkovič
  • Department of medical intensive care, University clinical centre Maribor, Ljubljanska 5, SI-2000, Maribor, Slovenia
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/ Matej Vrbnjak
  • Department of medical intensive care, University clinical centre Maribor, Ljubljanska 5, SI-2000, Maribor, Slovenia
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/ Franci Svensek
  • Department of medical intensive care, University clinical centre Maribor, Ljubljanska 5, SI-2000, Maribor, Slovenia
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/ Simona Kirbis
  • Department of medical intensive care, University clinical centre Maribor, Ljubljanska 5, SI-2000, Maribor, Slovenia
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Published Online: 2013-09-18 | DOI: https://doi.org/10.2478/s11536-013-0191-4


In treatment of manic-depressive conditions long-term lithium therapy may be combined with an effective and relatively safe antidepressant venlafaxine. Combined overdose may increase the risk of early toxicity of both drugs and of delayed lithium intoxication, responding to symptomatic and renal replacement therapy. We present a patient with combined lithium and venlafaxine self-poisoning with nothing but delayed signs of lithium intoxication with the emphasis on early and late treatment. 41-year old woman attempted suicide by large amount of lithium and venlafaxine. On admission she was asymptomatic, but with increased serum lithium over 5mmol/L. After gastric lavage, active charcoal and laxative administration she was receiving IV fluids. After a delay of 63 hours she deteriorated acutely by disorientation, confusion, fasciculation and tremor and was readmitted to Intensive care unit. In spite serum lithium decreased to 2mmol/L clinical signs were attributed to delayed lithium intoxication. After symptomatic and renal replacement therapy the patient’s condition improved after few days. We conclude that decontamination procedures are effective in particular for venlafaxine poisoning. If increased serum lithium levels are noted renal replacement therapy may be started even in asymptomatic patients as delayed lithium intoxication is most likely after few days.

Keywords: Lithium; Poisoning; Venlafaxine; Renal replacement therapy

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About the article

Published Online: 2013-09-18

Published in Print: 2013-10-01

Citation Information: Open Medicine, Volume 8, Issue 5, Pages 591–596, ISSN (Online) 2391-5463, DOI: https://doi.org/10.2478/s11536-013-0191-4.

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© 2013 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

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