title: Diltiazem-induced psychosis and a possible diltiazem-lithium interaction.
abstract: Calcium channel blockers are being used increasingly for a variety of cardiovascular problems. Diltiazem hydrochloride, a benzothiazepine derivative, has been reported to have a low incidence of adverse side effects. We report a case of acute psychosis associated with the use of diltiazem in a patient receiving lithium carbonate therapy. Both diltiazem hydrochloride and lithium carbonate have calcium antagonist effects in the central nervous system, and we review their mechanisms of action. A possible synergistic drug interaction between diltiazem and lithium is reported.
authors.affiliation: Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo.
authors.forename: E F
authors.initials: EF
authors.lastname: Binder
authors.forename: L
authors.initials: L
authors.lastname: Cayabyab
authors.forename: D J
authors.initials: DJ
authors.lastname: Ritchie
authors.forename: S J
authors.initials: SJ
authors.lastname: Birge
mesh_terms: D000368:Aged; D004110:Diltiazem / Q000009:adverse effects* / Q000494:pharmacology; D004357:Drug Synergism; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008094:Lithium / Q000494:pharmacology*; D016651:Lithium Carbonate; D019964:Mood Disorders / Q000188:drug therapy; D011605:Psychoses, Substance-Induced / Q000209:etiology*
chemical_list: D016651:Lithium Carbonate; D008094:Lithium; D004110:Diltiazem