THE efficacy of lithium in the treatment of affective disorders and particularly the manic phase of manic-depressive psychosis is widely accepted.1 It has been suggested that no serious toxicity would result if the serum levels of lithium were monitored and the dosage adjusted to avoid serum levels above 1.5 to 2.0 mEq per liter.1, 2 Animal experiments in the dog and rat3 4 5 and our experience indicate that this may not be true. Case Report A 54-year-old woman was admitted to the hospital on June 19, 1969, in diabetic ketoacidosis. She had a 25-year history of manic-depressive psychosis. She had been treated.
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