Lactulose-associated lithium toxicity a case series

Andrew Bregman, Kathy Fritz, Glen Xiong

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Lactulose is commonly used for constipation and hepatic encephalopathy. Its adverse effects of dehydration and serum electrolyte imbalances are widely known. Objective: This study aimed to describe a case series of 3 patients receiving lactulose who developed lithium toxicity. Methods: The authors described a case series of 3 patients admitted to a large county psychiatric hospital who developed lithium toxicity while taking lactulose for constipation or hyperammonemia. Results: In all 3 cases of lithium toxicity, the patients were prescribed with lithium for acute mania and lactulose for constipation or hyperammonemia. One case required the patient to be transferred to a local emergency department for further treatment. Conclusions: This case series shows the interaction between lithium and lactulose. It is postulated that lactulose's effects of volume depletion can lead to poor renal excretion of lithium.

Original languageEnglish (US)
Pages (from-to)742-743
Number of pages2
JournalJournal of Clinical Psychopharmacology
Issue number6
StatePublished - Dec 1 2014


  • Drug interaction
  • Lactulose
  • Lithium toxicity

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)


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