title: Lithium intoxication associated with intramuscular ziprasidone in schizoaffective patients.
abstract: Antipsychotic agents have been used for the treatment of mood disorders in schizophrenic and schizoaffective patients. It has also been suggested that combinations of lithium and antipsychotics may be more effective than either class alone in treatment of schizoaffective patients. Lithium is known to interact with a variety of medications, including conventional and atypical antipsychotics. Although these combinations are generally well tolerated, they may sometimes lead to various adverse side effects. The authors report two schizoaffective patients with manic psychotic state and psychomotor agitation treated with lithium. Both patients developed symptoms of lithium intoxication after intramuscular ziprasidone treatment. To the best of their knowledge, this is the first description of such an adverse effect of this new atypical neuroleptic drug. They assume that lithium intoxication in the two presented cases was associated with the fast increase of ziprasidone serum level after its parenteral application, possibly affecting lithium excretion and thereby leading to lithium intoxication.
authors.affiliation: Division of Psychiatry, Ministry of Health Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, 84170 Israel.
authors.forename: Chanoch
authors.initials: C
authors.lastname: Miodownik
authors.forename: Michael
authors.initials: M
authors.lastname: Hausmann
authors.forename: Katherina
authors.initials: K
authors.lastname: Frolova
authors.forename: Vladimir
authors.initials: V
authors.lastname: Lerner
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000097:blood; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy; D010054:Brief Psychiatric Rating Scale; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D008094:Lithium / Q000009:adverse effects* / Q000097:blood; D008297:Male; D010879:Piperazines / Q000009:adverse effects* / Q000097:blood; D011596:Psychomotor Disorders / Q000150:complications / Q000188:drug therapy; D011618:Psychotic Disorders / Q000097:blood / Q000150:complications / Q000188:drug therapy; D013844:Thiazoles / Q000009:adverse effects* / Q000097:blood
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone; D008094:Lithium