Persistent cerebellar deterioration in a patient with lobar pneumonia under lithium, carbamazepine, and trifluperidol treatment.
We report on a patient with schizoaffective disorder who was on combination therapy of lithium, carbamazepine, and the neuroleptic trifluperidol. He experienced a lobar pneumonia and developed an acute and persistent cerebellar deterioration which was most likely due to lithium toxicity, while the serum lithium level was within the therapeutic range. The combination of lithium, carbamazepine, and neuroleptics is common, and is generally considered to be safe. The reported case suggests that this regimen might increase the risk of intoxication with potentially disabling side-effects.
Bischof
F
F
Department of Immunology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands.
Melms
A
A
Fetter
M
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects*; D002526:Cerebellar Diseases / Q000209:etiology*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D008094:Lithium / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D011618:Psychotic Disorders / Q000188:drug therapy*; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy; D016896:Treatment Outcome; D014272:Trifluperidol / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D014150:Antipsychotic Agents; D002220:Carbamazepine; D008094:Lithium; D014272:Trifluperidol