Lithium Neurotoxicity in Schizophrenie and
Schizoaffective Patients

Ap, West

doi:10.1159/000468562

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…For example, West identified journal articles and reviewed the evidence on lithium neurotoxicity in patients with schizophrenia and schizoaffective disorder. 11 He made mention of three researchers who reported varying frequencies of a lithium-induced confusional state: Johnson found it very common (>10% of n = 7), Prien found it common (1-10% of n = 36), and Zall found it rare (<0.01% of n =10) for patients treated with lithium to experience such a state. 12,13,14 Additional studies attempted to explain the mechanism of a lithium-induced confusional state.…”

Section: Resultsmentioning

confidence: 99%

“…In a 1982 literature review, West reported variations in the frequency of a lithium-induced confusional state in patient. 11 He attributed these variations to individual differences in absorption and excretion of lithium, and acute exacerbations of illness. However, other patient characteristics (i.e., sex, age, and concomitant medical illnesses and medications) must be considered.…”

Section: Discussionmentioning

confidence: 99%

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Lithium carbonate-induced confusional state in patients with bipolar disorder: identification of case reports and review of the evidence

Lyons,

Gossell-Williams

2024

Caribb Med J

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Objective: Lithium carbonate is a mood stabilizer used in the treatment of bipolar disorder. However, its narrow therapeutic index (normal = 0.6-1.2 mmol/L) predisposes patients to toxic effects. This study aimed to identify case reports and review the evidence on the frequency, mechanism, risk factors and guidelines associated with a lithium-induced confusional state in patients with bipolar disorder. Methods: All Databases from the National Center for Biotechnology Information (NCBI) were used to search for lithium AND “confusional state” AND “case report” published in English between 2015 and 2020. This search engine was also used to search for lithium AND “confusional state” AND frequency OR mechanism OR “risk factor” OR guideline published in English. Results: Case reports showed (1) all patients were treated with lithium for bipolar disorder and hospitalized for a confusional state, (2) most patients took concomitant therapies and recovered after lithium withdrawal, (3) some patients were female and old-aged (65+ years old), and (4) no ethnicities, causality assessments and dose patterns were reported. Other scientific literature showed (1) frequencies of a lithium-induced confusional state varied from very common (>10%) to rare (<0.01%), (2) inhibition of inositol phosphate-phosphatase (IMPase) and glycogen synthase kinase-3 (GSK3) might result in a lithium-induced confusional state, (3) ageing, diseases and concomitant therapies increased the risk of a lithium-induced confusional state, and (4) patients should complete lab tests and diagnostic procedures to monitor and/or prevent a lithium-induced confusional state. Conclusion: Case reports and other scientific literature elucidated the relationship between lithium and a confusional state.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lithium carbonate-induced confusional state in patients with bipolar disorder: identification of case reports and review of the evidence

Lyons,

Gossell-Williams

2024

Caribb Med J

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“…Various hypotheses have been proposed to explain this phenomenon; for instance, ECT may increase the permeability of the blood-brain barrier (BBB), thereby increasing cerebral blood flow [ 22 ]. This dysfunction may cause a sudden increase in lithium ions entering the brain or a redistribution of concentrations within cerebral tissue compartments, resulting in peak levels observed in white matter [ 23 ]. Age-related factors can influence BBB permeability fluctuations as well as chemical means [ 24 ] in human subjects.…”

Section: Discussionmentioning

confidence: 99%

Delirium with Concurrent Use of Lithium and ECT and the Safety Implications: Case Reports and Review of the Literature

Ali,

Malathesh,

Chatterjee

et al. 2023

Case Reports in Psychiatry

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Using electroconvulsive treatment and lithium together to treat acute manic episodes is common, but the effects of combining these therapies vary according to the literature. Some studies have found severe adverse side effects, while others have found the combination of both medications safe and helpful. To investigate potential adverse side effects, this study reports on two cases where bipolar affective disorder patients developed delirium after receiving electroconvulsive therapy and lithium concurrently. The delirium was attributed only to the combined administration of these medicines after ruling out other potential causes. Additionally, alterations in blood-brain barrier permeability, such as those caused by electroconvulsive therapy and age, increased the likelihood of delirium. As a result, caution should be taken when using this combination of medicines, especially in those predisposed to delirium. This study established links between these medications and adverse effects, such as delirium. Further research is necessary to determine the efficacy and risks of combining these medications, establish causality, and develop prevention strategies.

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Neuropsychiatric manifestations of alkali metal deficiency and excess

Yung

1984

Pharmacology Biochemistry and Behavior

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Lithium Neurotoxicity in Schizophrenie and Schizoaffective Patients

Cited by 6 publications

References 19 publications

Lithium carbonate-induced confusional state in patients with bipolar disorder: identification of case reports and review of the evidence

Lithium carbonate-induced confusional state in patients with bipolar disorder: identification of case reports and review of the evidence

Delirium with Concurrent Use of Lithium and ECT and the Safety Implications: Case Reports and Review of the Literature

Neuropsychiatric manifestations of alkali metal deficiency and excess

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