Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-11T09:49:44.515Z Has data issue: false hasContentIssue false
  • English
  • Français

Recovery from lithium neurotoxicity. A case study

Published online by Cambridge University Press:  18 September 2015

J.D. van Scheyen
Get access Rights & Permissions [Opens in a new window]

Summary

The author describes the development of a neurotoxicity syndrome in a 68 year old women treated for 1½ years with lithium for recurrent depressions. The syndrome developed after 10 mgr. haloperidol per day was added, during a manic episode, for 10 days. The lithium levels were 0.71 ± 0.19 MEq/L. After 19 days all medications were discontinued. The neurotoxicity consisted succes-sivily of confusion, somnolence, agitation, extrapyramidal symptoms, cerebellair ataxia and EEG abnormalities. After 10 weeks memory impairmments were still present. At four months, memory function was restored. After five months, the patient was discharged without residual symptoms. The patient reported amnesia for the first six weeks of the syndrome. The author points out that while patients may develop tolerance to lithium maintenance after several years, they still may develop a neurotoxicity syndrome when haloperidol is added to treat a manic episode.

Keywords

lithiumneurotoxicityhaloperidolmanialithiumneurotoxiciteithaloperidolmanìe
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 2 , Issue 2 , June 1990 , pp. 26 - 29
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Literatuur

1.Cohen, WJ, Cohen, NH. Lithiumcarbonate, haloperidol and irreversible brain damage. JAMA 1974; 230:1283-7.CrossRefGoogle Scholar
2.Loudon, JB, Waring, H. Toxic reactions to lithium and haloperidol. Lancet 1976;2:1088.CrossRefGoogle ScholarPubMed
3.Spring, CK. Neurotoxicity with combined use of lithium and thioridazine. J Clin Psychiat 1979; 40:135-8.Google ScholarPubMed
4.Pühringer, W, Kocher, R, Gastpar, M. Zur Frage der Inkompaidilität einer Lithium-Neuroleptica Kombinationstherapie. Nerverarzt 1979;50:124-7.Google Scholar
5.Donaldson, IM, Cunningham, J. Persisting neurological sequelae of lithium carbonate therapy. Arch Neurol 1983; 40:747-51.CrossRefGoogle ScholarPubMed
6.Schou, M. Longlasting neurological sequelae after lithium iitoxication. Acta Psychiat Scand 1984;70:594–602CrossRefGoogle Scholar
7.Van de Broek, WW, van Hülst, AM, Klompenhouwer, JL, Mofeman, P. Blijvende neurologische schade bij therapeutische lithium ooncen-tratiesinhetplasma. Ned T Geneesk 1988; 132:2063-6.Google Scholar
8.Prakash, R, Kelwala, S, Ban, TA. Neurotoxicity with combined administration of lithium and a neuroleptic. Compr Psychiat 1981; 23: 567-71.CrossRefGoogle Scholar
9.Thomas, CJ. Brain damage with lithium-haloperidol. Br J Psychiat 1979;13:552.CrossRefGoogle Scholar
10.Lindeboom, J, Wijngaard, D van de, Jonker, C. Een neuropsychologische procedure voor démentie onderzoek. Tijdschr Psychiat 1979; 212:241-52.Google Scholar
11.Rifkin, A, Quitkin, F, Klein, DF. Organic brain syndrome during lithium carbonate treatment. Compr Psychiat 1973; 14:251-54.CrossRefGoogle ScholarPubMed
12.Strayhorn, JM, Nash, JL. Severe neurotoxicity despite “therapeutic” serum lithium levels. Dis Nerv Syst 1977; 38:107-11.Google ScholarPubMed
13.Kemperman, CJF, van Gent, EM, de Rooy, JAM, Notermans, SLH. Neurotoxiciteit van lithium bij een normale lithiumspiegel. Ned Tijdschr Geneeskd 1988; 132:2066-9.Google Scholar
14.West, AP, Meitzer, HY. Paradoxical lithium neurotoxicity: a review of five cases and a hypothesis about risk for neurotoxicity. Am J Psychiat 1979; 136:963-6.Google Scholar
15.Samsone, MEG, Ziegler, DK. Lithium toxicity: a review of neurological complications. Clin Neuropharmacol 1985; 8:242-8.CrossRefGoogle Scholar
16.Gallager, DW, Pert, A, Bunney, WE. Haloperidol induced presynaptic dopamine supersensitivity is blocked by chronic lithium. Nature 1987;273:309-12.CrossRefGoogle Scholar
17.Shopsin, B, Johnson, G, Gershon, S. Neurotoxicity with lithium: differential drug reponsiviness. Int Pharmacopsychiat 1970; 5:170-82.CrossRefGoogle Scholar
18.Keliam, AMP. The neuroleptic malignant syndrome, a survey of the world literature. Br J Psychiat 1987; 150:752-9.CrossRefGoogle Scholar
19.Scheyen, JD van. Over de waarde van langdurig voortgezette lithium profylaxe, effectiviteit en het probleem van de “lithium resistentie”. Tijdschr Psychiat 1988; 30:273-80.Google Scholar