Reactions 1680, p207 - 2 Dec 2017
Neurotoxicity: 2 case reports
A 54-year-old man and a 76-year-old man developed lithium
neurotoxicity [routes and time to reactions onsets not stated].
A 76-year-old man, who had bipolar I disorder, started
receiving therapy with lithium 300mg twice daily. He was
hospitalised with a diagnosis of mixed manic-depressive
disorder. At the time of admission, he was confused and
experienced balancing difficulty. A total work up of delirium
showed no clear cause. Following a neurological consultation,
diagnosis of delirium was agreed upon, and lithium
neurotoxicity was suggested despite of normal lithium
therapeutic level of 0.71 (lithium therapeutic range: 0.6-1.2).
Later on, his delirium improved and eventually resolved after
A 54-year-old man, who had schizophrenia, started
receiving therapy with lithium 300mg twice daily and
clozapine. Later, he presented with recurrent falls related to
postural instability. His lithium level was 0.6 (lithium
therapeutic range: 0.6-1.2). Diagnosis of lithium neurotoxicity
was made with lithium being within therapeutic levels. His
motor difficulties recovered after discontinuation of lithium
Author comment: "Because lithium neurotoxicity may
occur with therapeutic serum levels, and may occasionally be
irreversible, lithium should be discontinued until it is clear
that it is not contributing to the neurological dysfunction."
"We present two cases of lithium neurotoxicity within
therapeutic lithium levels."
Moustafa Y, et al. Lithium-induced neurotoxicity at therapeutic levels: Illustrative
cases and literature review. CNS Spectrums 22: 104-105, No. 1, Feb 2017.
Available from: URL: http://doi.org/10.1017/S1092852916000900 [abstract] -
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved