Reactions 1680, p209 - 2 Dec 2017 Lithium thoxicity: case report A 74-year-old woman developed lithium toxicity following concomitant administration of lithium and moxifloxacin. The woman, who had a history of the bipolar affective disorder, was started on lithium 600 mg/day (300mg in the morning and 300mg at night) [route not stated], along with haloperidol and risperidone, in 2010. Her lithium concentration ranged from 0.60 0.80 mmol/L. She presented to the emergency department with myoclonic jerks of the upper extremities, slurred speech, exhaustion and severe tremor in both hands, on 15 January 2016. Of note, her symptoms began a day after she started taking moxifloxacin 400 mg/day for bronchitis [route not stated]. Subsequent physical examination and other laboratory tests in the emergency department were unremarkable. Her lithium level was noted at 1.7 mEq/L. Her electrocardiography and cranial magnetic resonance imaging were normal. Hypoxia, hypoglycaemia, hypothermia or hyperthermia, electrolyte disorders, central nervous system infection, head trauma, intracranial bleeding and neuroleptic malignant syndrome were ruled out. Thereafter, she was diagnosed with the mild- moderate toxicity of lithium. Lithium and moxifloxacin were discontinued and fluid resuscitation with saline solution was employed. The lithium level was measured at 0.9 mEq/L, after 12 hours, and tremors and myoclonic jerks subsided. In the following week, the remaining symptoms resolved. Author comment: "Result of the Naranjo Adverse Drug Reaction Probability Scale in this case, indicated a ’probable’ (score, 6) interaction between lithium and moxifloxacin." "[S]he was diagnosed with mild-moderate toxicity of lithium." Kayipmaz S, et al. Lithium intoxication: A possible interaction with moxifloxacin. Clinical Psychopharmacology and Neuroscience 15: 407-409, No. 4, 2017. Available from: URL: http://doi.org/10.9758/cpn.2017.15.4.407 - Turkey 803284887 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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