According to the World Health Organization, every year, 700.000 people die from suicide.1Suicide accounts for 1.4% of the total number of deaths in Europe.2 In 2019, the rates of suicidedeaths in the USA and Turkey were 13.9 and 4.12 per 100,000 people, respectively.3,4 The useof 20%-lipid emulsion therapy (LET) to treat patients with intoxicated is a frequently usedmodality. In the present case report, we shared our experiences with managinghypertriglyceridemia developed after 20%-LET.A 27-year-old patient with the diagnosis of bipolar affective disorder and Asperger's syndromewas admitted to the emergency department with the complaint of confusion after taking ahandful of olanzapine (20 mg), lithium (300 mg), lamotrigine (200 mg), and bupropion (300mg). He was letargic. The Glasgow coma scale was E3V2M5. The patient with no need for anyoxygen support had normal vital parameters (Heart rate:129/min, SpO2:97%, tensionarterial:166/92 mmHg, respiratory rate:24/min). No significant pathology was detected in thepatient's arterial blood gas analysis and laboratory data (Table 1). Gastric lavage and activatedcharcoal application were performed. Then he was transferred to the intensive care unit (ICU).After ICU admission, a 2-hour hemodialysis session and 20%-LET with a bolus of 1.5 mL/kgand maintenance of 0.25 mL/kg/min doses were applicated for drug elimination.5 After thesetherapies, the patient's consciousness was improved. The toxic lithium level returned to normal,but biochemistry tests performed after 20%-LET were reported as lipemic serum. Also, a highHb level (24.0 g/dL) was observed in hemogram parameters, which could be explained byincorrect measurement. Triglyceride was detected as 4887 mg/dL. The endocrinologydepartment consulted the patient to clarify the need for plasmapheresis, but daily lipid paneltesting was recommended. Additionally, we measured the amylase and lipase level daily due tothe increased risk of pancreatitis. The patient's high levels of blood lipids dramatically resolvedin the consequent days. Additionally, the abnormal hemogram parameters observed after 20%-LET returned to the normal level. The patient was transferred to the psychiatry ward on thefourth day of ICU admission. Written informed consent was obtain from the patient to presentthis case report.The 20%-LET is frequently used to treat intoxications, but it may cause acute increases in thelipid profile. Therefore, measuring blood lipid levels after 20%-LET and administering lowerdoses and longer infusion durations in the risky group may reduce the risk of complications. </p
