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Lithium is widely used in the treatment of bipolar disorder. Here we describe the syndrome of irreversible lithium-effectuated neurotoxicity in a patient within therapeutic doses and levels, which persisted after discontinuation of Lithium. A 50-year-old gentleman with Bipolar disorder presented with symptoms of Mania following drug default. Lithium was initiated as a mood stabilizer. On day 4, the patient developed abdominal pain, itching, and sore throat. On day 5, lithium levels were 0.9 mEq/L. Subsequently, the patient was noted to