Lithium Carbonate-Induced Nephrogenic Diabetes Insipidus and Glucose Intolerance

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Abstract
The use of lithium carbonate in manic-depressive disorders appears to be of definite therapeutic value.1-3 Because of potential toxic reactions, frequent measurements to assure that lithium plasma levels remain between 1.5 and 2.0 mEq/liter are required. Common side effects of lithium carbonate treatment are abnormal electrolyte metabolism and changes in renal function.4-7 Recently, a syndrome of nephrogenic diabetes insipidus has been described in some patients receiving lithium carbonate therapy.8-11 The present report is that of a man in whom nephrogenic diabetes insipidus resulted from lithium carbonate treatment. In addition, despite absence of previous evidence of diabetes mellitus, glucose intolerance developed. Patient Summary A 52-year-old white man suffering from chronic schizophrenia had been treated with lithium carbonate since 1967 because of episodic mania resistant to phenothiazine therapy. The severity of his psychotic disorder fluctuated while receiving lithium carbonate doses ranging from 2.4 to 3.4 gm daily. Monthly determinations

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