Multifocal neurological impairment caused by infection-induced rise in blood lithium and amitriptyline.
We present the case of a thirty-eight-year-old woman who developed a febrile illness which was associated with a rise of blood lithium and amitriptyline, and subsequently suffered permanent neurological impairment, implicating CNS dysfunction at several levels. Medical, laboratory, radiological and neuropsychological findings are described, and the attribution of the syndrome is discussed. It is crucial to emphasize that the authors are not challenging the frequently useful combination of lithium and antidepressants. Rather, we urge psychiatrists to be vigilant when such patients develop febrile illnesses.
D000328:Adult; D000639:Amitriptyline / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004927:Escherichia coli Infections / Q000150:complications*; D005260:Female; D006801:Humans; D008094:Lithium / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D012306:Risk; D018805:Sepsis / Q000150:complications*; D019966:Substance-Related Disorders / Q000097:blood*; D014552:Urinary Tract Infections / Q000150:complications*
D000639:Amitriptyline; D008094:Lithium