Lithium-induced delirium with therapeutic serum lithium levels: a case report.
Lithium-induced delirium occurring in geriatric patients with serum lithium levels that are within the "therapeutic" range (less than 1.5 mEq/L) has been described in the literature. We present a case that illustrates three major issues regarding this syndrome: (1) differentiating lithium-induced delirium from a recurrence of a chronic psychiatric disorder; (2) the use of the electroencephalogram in supporting this diagnosis; and (3) factors that may increase a patient's vulnerability to delirium while on lithium. A brief review of the most relevant literature is then presented. We conclude that lithium-induced neurotoxicity should be suspected in any patient receiving lithium who develops delirium, regardless of the serum level, and that immediate discontinuation of the medication be considered.
Brown
A S
AS
Department of Psychiatry, University of Pittsburgh School of Medicine, PA.
Rosen
J
J
D003693:Delirium / Q000097:blood / Q000139:chemically induced*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy* / Q000523:psychology
D016651:Lithium Carbonate