CARDIOVASCULAR EFFECTS OF LITHIUM IN MAN - REVIEW OF LITERATURE

The medical literature since 1900 was reviewed to determine the nature of cardiovascular effects of Li. In therapeutic doses, Li produces reversible T wave flattening and inversion in the ECG; rarely, it may cause sinus node dysfunction or ventricular arrhythmias. Patients with Li toxicity almost always present with neurologic signs and symptoms. Hypotension and cardiovascular collapse, alleged cardiotoxic manifestations of Li, invariably follow days of coma. Given the possible cardiotoxic effect of other psychopharmacologic agents and the hazards of withholding effect therapy in mania, Li may be used safely in patients with cardiac disease if the dose is adjusted to the rate of Li excretion and if serum Li levels are followed carefully. When used in patients with cardiac arrhythmias, frequent ECG monitoring is advised.