Lithium intoxication–induced dysgeusia accompanied by glossalgia in a patient receiving lithium carbonate: a case report

Abstract

Background Lithium carbonate is widely used as a first-line therapeutic agent for the depressive and manic phases of bipolar disorder. Although limb tremors and hypothyroidism are well-known side effects of lithium carbonate, other rare adverse reactions can also occur. Case presentation A 53-year-old Japanese woman diagnosed with lithium intoxication developed dysgeusia and glossalgia during treatment with lithium carbonate. She also showed symptoms of a swaying gait, finger tremors, and dysarthria. All of these symptoms subsided when her blood lithium concentration was reduced to a level below that which induces intoxication. Conclusions We present a rare case of lithium carbonate–induced dysgeusia accompanied by glossalgia. Early detection of these symptoms is important in clinical settings because they can be overlooked until patients lose their appetite, which severely impairs their quality of life.

Lithium-Induced Dysgeusia and Hyposmia: A Case Report and a Literature Review

“…A switch to VPA, quetiapine, or lamotrigine as a second-line therapy is recommended when patients cannot tolerate lithium adverse effects. Aripiprazole, olanzapine, or risperidone can be alternatives 6 . In our particular case, we did switch to VPA and the patient was already on quetiapine.…”

“…In 2011, Terao et al 5 described a case of dysgeusia secondary to lithium therapy associated with loss of appetite and body weight even with therapeutic blood levels of lithium. More recently, Hanyu et al 6 described a case of lithium intoxication-induced dysgeusia accompanied by glossalgia after 2 years of lithium therapy (800 mg/d). The patient recovered 4 days after discontinuation 6 …”

“…More recently, Hanyu et al 6 described a case of lithium intoxication-induced dysgeusia accompanied by glossalgia after 2 years of lithium therapy (800 mg/d). The patient recovered 4 days after discontinuation 6 …”

“…In 3 large studies of lithium adverse effects, no alteration in smell or taste was described 8 . However, they may occur more often than expected 6 . The low report could be because of various factors: patients can assume that the smell and taste impairment are not related to the treatment, and therefore, they tend to not mention them to their physicians; physicians may overlook them or consider psychogenic 6 ; some studies may use questionnaires in which alterations of taste or smell are not included; and patients might not complain about it spontaneously 8 .…”

The development and validation of a prediction model of lithium carbonate blood concentration by artificial neural network: a retrospective study

“…Since the therapeutic dose of Li carbonate is close to the toxic dose, the effective safety window of treatment is narrow, and Li poisoning is prone to occur. Some articles have pointed out that the safe range of Li carbonate blood concentration should be maintained at 0.60-1.20 mmol/L, and when the concentration is ≥1.50 mmol/L, the incidence of serious adverse reactions will increase significantly (7,8), including kidney failure, seizures, coma, and even death (9). Therefore, it is recommended to monitor the blood concentration of Li carbonate in each patient (10)(11)(12).…”