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Background: Lithium poisoning is currently managed using a combination of supportive care and urgent haemodialysis in severe cases. The use of kayexalate as an adsorbent has been found to be effective in some studies, however, there are reports of complications such as hypokalaemia and intestinal necrosis. Bentonite is a known adsorbent that has been used in the management of paraquat poisonings. The purpose of this study was to determine the ability of bentonite to adsorb lithium. Methods: 4.5 g of lithium carbonate was dissolved in 1.5 litres of deionized water to form the stock solution. 50 mL aliquots of this stock solution were added to 50 mL of either distilled deionized water (pH 7) or simulated gastric fluid (pH 1.2). Bentonite of either 0.75, 1.5, or 4.5 g was then added to simulate 5: 1, 10:1, and 30: 1 ratio of adsorbent to drug. Controls were made with no bentonite added. The resulting mixture was placed on a shaker for 5 minutes before being filtered. The filtrate was diluted and batch analyzed for lithium using atomic absorption spectrophotometry. Results: Bentonite decreased concentration of lithium recovered from the filtrate by 20.5% in deionized water compared to 48.1% in simulated gastric fluid at a bentonite lithium ratio of 30:1 (p value 0.0001). Conclusion: This study shows that bentonite is an effective adsorbent for lithium. The effect is enhanced in simulated gastric fluid. In vivo studies are being planned for clinical correlation., Ponampalam R, Otten E. Singapore General Hospital, Department of Emergency Medicine, Singapore; University of Cincinnati, Department of Emergency Medicine, Cincinnati, [...]