It is well known that chronic treatment with lithium gives cytoprotection from ischemia and neurodegeneration. Despite the clinical relevance, the potential effects of acute lithium treatment just before and during early stages of ischemia are not well known. Brain impedance was measured in an experimental global ischemia model, to determine these potential effects and their time course,as measured in minutes. Thiobarbital anesthetized (60 mg·kg(-1), intraperitoneal injection) male Sprague-Dawley rats were infused intravenously (i.v.) with isovolumetric amounts of ringer (n = 10 rats) or lithium (Li(2)CO(3); 10; 30; 100 mg·kg(-1); n = 6 rats per dose tested). Cortico-subcortical impedance was recorded before (20 min) and after (20 min) the infusion, and during global cerebral ischemia (20 min) induced by cardiopulmonary arrest due to the administration of D-tubocurarine. Lithium did not change tissue impedance in normoxid animals. In the ringer-infused group, global cerebral ischemia first (9 min) shows a fast voltage decay rate (-7.08%·min(-1)), followed by a slow one (-0.94%·min(-1)) for the last 11 min of the recording. Lithium, at any dose tested, induced a strong reduction in voltage decay for both fast (-3.7%·min(-1)) and slow (-5.2%·min(-1)) phases, although the reduction was more intense in the first phase (>58%, Mann-Whitney Z = 2.02; P < 0.043). The reduction was more effective at 10 mg (Li₂CO₃)·kg(-1) than at 30 or 100 mg·kg(-1). The time course of brain edema was defined by curve fitting for ringer- (time constant λ = 512.9 s) or lithium-infused animals (λ = 302.0 s). These results suggest that acute lithium infusion 20 min prior to global ischemia, strongly reduces cerebral impedance by reducing the decay rate and the duration of the fast decay phase, and increasing time constant decay during ischemia.

Male patient 24 years old with a pituitary microadenoma and mental and behavioural disorders due to multiple drug use and use of other psychoactive substances (cocaine, cannabis and alcohol) were treated with haloperidol (dopamine receptor blocker) 10 mg daily. In the last control, the patient presented mammary hypertrophy; laboratory testing and brain magnetic resonance imaging (MRI) was performed, reporting the presence of a pituitary microadenoma syndrome with hormonal alteration (Prolactin levels 28.4 ng/ml). Haloperidol, carbamazepine and levomepromazine were then discontinued. He was started on aripiprazole 15 mg po daily for 4 days; the dosage was then increased to 30 mg po daily, with Valproic Acid 500 mg po tid. After 3 weeks on aripiprazole, the mammary hypertrophy that had increased in the patient had resolved. After 10 weeks follow up of prolactin revealed a normal level, at 4.33 ng/ml. Insomnia, aggressiveness, irritability, visual, tactile and auditory hallucinations remained absent after treatment with aripiprazole which is not a first line drug in multiple drug use patient with psychosis. We also consider the correlation of drug use in patient with psychosis, haloperidol treatment, pituitary microadenoma syndrome, hyperprolactinemia, and dopamine D2-receptor partial agonist aripiprazole treatment. This article also summarizes some relevant patents.

No abstract

No abstract

No abstract