Obesity Surgery

, Volume 29, Issue 2, pp 735–738 | Cite as

Lithium Toxicity with Severe Bradycardia Post Sleeve Gastrectomy: a Case Report and Review of the Literature

  • Arik DahanEmail author
  • Daniel Porat
  • Carmil Azran
  • Yoni Mualem
  • Nasser Sakran
  • Subhi Abu-Abeid
Brief Communication


Lithium is one of the major treatment options in bipolar disorder. Bariatric surgery can significantly modify the oral bioavailability of drugs, and lithium is no exception; although in most cases drug absorption seems to decrease, in the case of lithium, toxicity is the risk. In this article, we describe a 61-year-old male patient presented with lithium toxicity, including newly diagnosed severe bradycardia requiring a permanent pacemaker, after undergoing sleeve gastrectomy. We discuss the mechanisms behind this case, provide potential solutions for clinicians treating bariatric patients with lithium, and review previous reports of lithium toxicity post bariatric surgery. Awareness of changes in drug absorption, particularly lithium, following bariatric surgery, is prudent and essential for optimal patient care. Close clinical and drug levels monitoring is strongly advised.


Lithium toxicity Sleeve gastrectomy Bipolar disorder Bradycardia Drug absorption Bariatric surgery 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent Statement

Informed consent was obtained from all individual participants included in the study.

Studies with Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Clinical Pharmacology, School of Pharmacy, Faculty of Health SciencesBen-Gurion University of the NegevBeer-ShevaIsrael
  2. 2.Clinical Pharmacy, Herzliya Medical CenterHerzliyaIsrael
  3. 3.Department of Surgery A, Emek Medical CenterAfulaIsrael
  4. 4.Bariatric Surgery Unit, General Surgery Division, The Tel-Aviv Sourasky Medical CenterTel-AvivIsrael

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