title: Extrapyramidal syndrome related to lithium-carbamazepine combination therapy at therapeutic serum levels.
abstract: Neurological disturbances due to lithium-carbamazepine combination therapy are infrequent, and only a few cases have been reported so far. We describe a most unusual case of a patient with a history of bipolar disorder who developed ataxic gait, imbalance, and intention tremor after lithium-and-carbamazepine combination treatment with therapeutic serum levels of both drugs; he recovered completely when carbamazepine was discontinued. We also review the literature about this infrequent relationship, discuss on its proposed origin, and underline its importance as a potential adverse effect in elderly patients, yet with therapeutic or even subtherapeutic serum levels.
authors.affiliation: Department of Neurology and Neurosurgery, University Clinic of Navarra, Pamplona, Spain. jpalmaca@unav.es
authors.forename: Jose-Alberto
authors.initials: JA
authors.lastname: Palma
authors.forename: Roberto
authors.initials: R
authors.lastname: Fernandez-Torron
authors.forename: Jaime
authors.initials: J
authors.lastname: Gallego Perez-Larraya
mesh_terms: D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D004359:Drug Therapy, Combination / Q000009:adverse effects*; D004409:Dyskinesia, Drug-Induced / Q000150:complications*; D006801:Humans; D018020:Lithium Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D018692:Antimanic Agents; D018020:Lithium Compounds; D002220:Carbamazepine