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Lithium is an effective therapeutic agent for the manic phase of manic depressive disease. The average daily dosage for acute manic states is 300 to 3,600 mg. of lithium carbonate. Careful monitoring of serum level and clinical signs of lithium intoxication are indicated because lithium intoxication is being encountered more frequently, as the drug is administered more often, even when the serum levels are within the acceptable range of safety. Overdosage of lithium can cause serious intoxication and several fatalities have been reported. There is on specific antidode, and treatment has been limited to supportive measures and attempts to increase the removal of lithium from the body. Saline infusion with or without forced diuresis and alkalinization of the urine is usually sufficient. In the following case, severe lithium intoxication with acute renal failure was treated with hemodialysis and the patient was completely recovery.