Reversible Lithium Toxicity Misdiagnosed as Dementia in an Elderly Patient: A Case Report and Follow-Up to Previous Work on Lithium Sensitivity in Aging
Bibliographic record
Abstract
Lithium is a widely used mood stabilizer but requires careful management in the elderly due to altered pharmacokinetics and pharmacodynamics. This case report describes a dramatic reversal of apparent end-stage dementia in an 85-year-old woman after recognition and correction of chronic lithium toxicity. The case is of interest because over a two-year period of the case, the average lithium level, creatinine level, and eGFR remained the same, yet the lithium became toxic. It demonstrates that even though the eGFR remains constant, the dose of lithium may need to be reduced with aging to keep the lithium level therapeutic. It reinforces and expands upon previous findings that therapeutic serum lithium levels can become toxic with aging due to physiological changes, particularly in renal function and neural sensitivity. The woman is in stage four of chronic kidney disease, which means there is a very small therapeutic region for the lithium. The paper also describes how a second, unusual form of dementia, caused by lithium toxicity, was diagnosed and treated.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".