Lithium

Fine postural bilateral tremor (lithium), coarse withdrawal tremor (alcohol), variable anxiety-related

UrgentReview due

At a glance

Core tests: 1
Related differentials: 5

Safety snapshot

Watch forLithium toxicitywithdrawal seizuresthyrotoxicosis

Check this recordThe generated review for this record carried material from akathisia, drug-induced parkinsonism and tardive syndromes, so it is withheld rather than shown. The related diagnoses listed are the extrapyramidal family rather than causes of tremor. The assessment steps are locally authored. The safety snapshot and investigations are retained from the same export and were not part of the contaminated text. There is no linked original for this record, so check its source and review status and treat it as unreviewed reference before acting on it.

Do now

1Characterise the tremor: a fine postural tremor fits lithium at therapeutic level, while a coarse tremor with ataxia suggests toxicity
2Take a lithium level with U&E, eGFR, calcium and thyroid function, and note the time since the last dose
3Ask about dehydration, vomiting, diarrhoea, a new NSAID, ACE inhibitor or diuretic, and any recent dose change
4Ask about alcohol intake and the time of the last drink, since withdrawal tremor is coarse and carries its own risks
5Escalate for neurological signs with any raised level, taking the threshold from the local lithium protocol, since toxicity can progress despite a stopped dose

Locally authored, reviewed by PsychSift on 27 September 2026

Clinical review

The generated review for this record is not shown

Its sections were found to describe a different diagnosis, so they are withheld rather than printed under a warning. The assessment steps above are locally authored. The safety snapshot and investigations are retained from the source export and were not part of the contaminated text. There is no linked original to open here, so treat this as unreviewed reference and check its source and review status before acting on it.

Do now

1Characterise the tremor: a fine postural tremor fits lithium at therapeutic level, while a coarse tremor with ataxia suggests toxicity
2Take a lithium level with U&E, eGFR, calcium and thyroid function, and note the time since the last dose
3Ask about dehydration, vomiting, diarrhoea, a new NSAID, ACE inhibitor or diuretic, and any recent dose change
4Ask about alcohol intake and the time of the last drink, since withdrawal tremor is coarse and carries its own risks
5Escalate for neurological signs with any raised level, taking the threshold from the local lithium protocol, since toxicity can progress despite a stopped dose

Locally authored, reviewed by PsychSift on 27 September 2026

First-line tests

Applies to the presentation group — not specific to Lithium

Thyroid function tests

Watch for

Lithium toxicity
withdrawal seizures
thyrotoxicosis

Also consider

Source and review

Review due· Unverified

v10 · exported 2026-07-11

Clinical reference — not validated decision support. Review before use.