{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:44:17Z","timestamp":1791924257210,"version":"4.3.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100007281","name":"National Drug and Alcohol Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To determine: (1) the characteristics, clinical presentation and circumstances of death for deaths related to lithium toxicity in Australia, 2000\u20132024; (2) the toxicology of cases; and (3) the major autopsy findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective study of all cases of death aged \u2a7e15 years associated with lithium toxicity in Australia, 2000\u20132024, retrieved from the National Coronial Information System.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 93 cases, with a mean age of 48.7 years (range, 18\u201389), 12% being aged under 30 years and 51% being male. A diagnosis of bipolar disorder was documented in 52%, with 28% having a documented psychotic disorder. The circumstances of death were unintentional toxicity (58%), intentional toxicity (23%) and undetermined intent (19%). The median blood lithium concentration was 0.68 mmol\/L (range, 0.01\u201317.3). Concentrations were higher for ante-mortem versus post-mortem samples (2.3 vs 0.5 mmol\/L), intentional overdose versus unintentional (2.2 vs 0.5 mmol\/L) and cases in which lithium was the sole drug detected versus multiple drugs (2.1 vs 0.6 mmol\/L). Other drugs were present in the majority (87%), most commonly antipsychotics (67%) and antidepressants (57%). Cardiomegaly was diagnosed in 22% and nephro\/arteriosclerosis in 26%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Toxicity remains a rare event compared to exposure to lithium, with intentional cases comprising a fifth of the series. Deaths were not the sole preserve of the middle-aged or elderly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00048674251336037","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T06:14:09Z","timestamp":1745820849000},"page":"622-628","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of deaths related to lithium toxicity in Australia, 2000\u20132024"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-7055","authenticated-orcid":false,"given":"Shane","family":"Darke","sequence":"first","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Duflou","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia"},{"name":"Sydney Medical School, The University of Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessy","family":"Lim","sequence":"additional","affiliation":[{"name":"School of Pharmacy, The University of Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alys","family":"Havard","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia"},{"name":"Medicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5946-2144","authenticated-orcid":false,"given":"Julia","family":"Lappin","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia"},{"name":"Discipline of Psychiatry, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"e_1_3_3_2_1","volume-title":"Pharmaceutical Benefits Scheme Schedule Items","author":"Australian Government","year":"2024","unstructured":"Australian Government (2024) Pharmaceutical Benefits Scheme Schedule Items. 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