Lityumun nörolojik yan etkileri

Year 2013, , 119 - 27, 01.03.2013

Selçuk Özdin Gökhan Sarısoy

https://doi.org/10.5455/jmood.20130521121833

Abstract

Lityum 1940’lı yılların sonuna doğru Avustralya’lı bilim adamı John Cade’in çalışmaları sonucunda iki uçlu mizaç bozukluğunda yaygın olarak kullanılmaya başlanmıştır. Terapötik aralığının dar olması kullanımını kısıtlasa da iki uçlu bozukluk tedavisinde en önemli ilaçlardan biridir. Terapötik aralığının dar olmasından dolayı lityum zehirlenmesine sık rastlanır. Lityum kullanımı ile mide-barsak, kalp-damar, dermatolojik, endokrinolojik ve sinir sistemlerini ilgilendiren birçok yan etki gelişebilmektedir. Gerek zehirlenmede gerekse normal serum düzeylerinde sinir sistemi ile ilgili yan etkilere sıklıkla rastlanmaktadır. Sinir sistemi ile ilgili yan etkiler lityum tedavisinin nadir olmayan, ancak en az tanınan yan etkilerindendir. Merkezi sinir sistemi ile ilgili yan etkiler hastanın ilaca uyumu konusunda önemli bir sorun teşkil etmektedir. Bu derlemenin amacı lityum kullanımı ya da zehirlenmesine bağlı ortaya çıkan sık ve az görülen nörolojik yan etkilerin gözden geçirilmesidir.

Keywords

lityum, nörolojik, yan etki

Neurological side effects of lithium

Abstract

Lithium began being widely used in bipolar disorder thanks to the work of the Australian scientist John Cade in the late 1940s. Although its narrow therapeutic range restricts its use, it is one of the most important drugs in the treatment of bipolar disorder. Intoxication is frequently encountered due to its narrow therapeutic range. Various side-effects involving the gastrointestinal, cardiovascular, dermatological, endocrinological and neurological systems may develop with lithium use. Neurological side-effects are frequently observed in both intoxication and at normal serum levels. Neurological side-effects are one of the common but little known consequences of lithium therapy. Neurological side-effects represent a major problem in terms of patients’ drug compliance. The purpose of this study was to review common and rare neurological side-effects associated with lithium use or intoxication.

Keywords

lithium, neurological, side-effect

References

• Nguyen L. Lithium II:Irreversible neurotoxicity after lithium intoxication. J Emerg Nurs 2008;34:378-9.
• Timmer RT, Sands JM. Lithium Intoxication. J Am Soc Nephrol 1999;10:666-74.
• Giuliani E, Iseppi D, Orlandi MC, Alfonso A, Barbieri A. Prolonged neurological burden in severe lithium intoxication. Minerva Anestesiol 2010;76:463-5.
• Prettyman R. Lithium neurotoxicity at subtherapeutic serum levels. Br J Psychiatry 1994;164:123.
• Tuğlu C, Erdoğan E, Abay A. Delirium and extrapyramidal symptoms due to a lithium-olanzapine combination therapy. J Korean Med Sci 2005;20:691-4.
• Harvey NS. Lithium intoxication. BMJ 1991;302:1537.
• West AP, Meltzer HY. Paradoxical lithium neurotoxicity. A report of five cases and a hypothesis about risk of neurotoxicity. Am J Psychiatry 1979;136:963-6.
• Friedman E, Gershon S. Effect of lithium on brain dopamine. Nature 1973;243:520-1.
• Kemperman CJF, Gerdes JH, Rooij JD, Vencken LM. Reversible lithium neurotoxicity at normal serum level may refer to intracranial pathology. J Neurol Neurosurg Psychiatry 1989;52: 679Jaeger A. Lithium. Medicine 2012;40:131-2.
• Finley PR, Warner MD, Peabody CA. Clinical relevance of drug interactions with lithium. Clin Pharmacokinet 1995;29:172-91.
• Smith D, Keane P, Donovan J, Malone K, McKenna TJ. Lithium encephalopathy. J R Soc Med 2003;96:590-1.
• Kesebir S, Akdeniz F, Vahip S. Lityum Zehirlenmesine Bağlı Koreatetoz: Bir Olgu ve Literatürün Gözden Geçirilmesi. Turk Psikiyatri Derg 2001;12:315-9.
• Sadosty AT, Groleau GA, Atcherson MM. The use of lithium levels in the emergency department. J Emerg Med 1999;17:887-91.
• Morgan JC, Sethi KD. Drug-induced tremors. Lancet Neurol 2005; 4:866-76.
• Mahasuar R, Kuruvilla A, Jacob KS. Palatal tremor after lithium and carbamazepine use: A case report. J Med Case Rep 2010;11:176.
• Adityanjee. The syndrome of irreversible lithium effectuated neurotoxicity. Pharmacopsychiatry 1989;22:81-3.
• Kesebir S, Üstündağ MF, Kavzoğlu SÖ. Lityum zehirlenmesi. Psikiyatride Güncel Yaklaşımlar 2011;3:426-45.
• Adityanjee, Munshi KR, Thampy A. The syndrome of irreversible lithium-effectuated neurotoxicity. Clin Neuropharmacol 2005;28:38-49.
• Porto FHG, Leite MAA, Fontenelle LF, Marrocos RP, Szczerback NF, Freitas MRG. The syndrome of irreversible lithium-effectuated neurotoxicity (SILENT): One-year follow-up of a single case. J Neurol Sci 2009;277:172-3.
• Sastre JS, Menendez SF, Rodriguez E. Irreversible lithium-induced neurotoxicity syndrome. Eur Neuropsychopharmacol 2012;22:282.
• Mani J, Tandel SV, Shah PU, Karnad DR. Prolonged neurological sequelae after combination treatment with lithium and antipsychotic drugs. J Neurol Neurosurg Psychiatry 1996;60:350-1.
• Sellers J, Tyrer P, Whiteley A, Banks DC, Barer DH. Neurotoxic effects of lithium with delayed rise in serum lithium levels. Br J Psychiatry 1982;140:623-5.
• Singh SV. Lithium carbonate/fluphenazine deconoate producing irreversible brain damage. Lancet 1982;2:278.
• Goldwater L, Pollock M. Neurological sequelae after lithium intoxication. N Z Med J 1976;84:356-8.
• Speirs J, Hisrsch S. Severe lithium toxicity with normal serum concentration. BMJ 1978;1:815-6.
• Jensen PJ, Schou M. Permanent brain damage after lithium intoxication. BMJ 1973;4:673.
• Von-Hartizsch B, Hoenich NA, Zleigh RJ, Wilkinson R, Frost TH, Weddel A et al. Permanent neurological sequelae despite hemodialysis for lithium intoxication. BMJ 1972;4:757.
• Handy MS, Dove AF, Arblaster PG. Mazindol-induced lithium toxicity. BMJ 1980;1:685.
• Loudon JB, Waring H. Toxic reactions to lithium and haloperidol. Lancet 1976;2:1088.
• Normann C, Brandt C, Berger M, Walden J. Delirium and persistent dyskinesia induced by lithium neuroleptic interaction. Pharmacopsychiatry 1998;31:201-4.
• Kores B, Lader MH. Irreversible lithium neurotoxicity: An overview. Clin Neuropharmacol 1997;20:283-99.
• Amdisen A. Clinical features and management of lithium poisoning. Med Toxicol Adverse Drug Exp 1988;3:18-32.
• Cerqueira ACR, Reis MCD, Novis FD, Bezerra JMF, Magalhaes GC, Rozenthal M, Nardi AE. Cerebellar degeneration secondary to acute lithium carbonate intoxication. Arq Neuropsiquiatr 2008;66:578-80.
• Adityanjee. Maintenance lithium. Lancet 1987;1:866-7.
• Schou M. Long-lasting neurological sequelae after lithium intoxication. Acta Psychiatr Scand 1984;70:594-602.
• Ikeda Y, Kameyama M, Narita K, Takei Y, Suda M, Aoyama Y, Yuuki N, Sakurai N, Fukuda M, Mikuni M, Amanuma M. Total and regional brain volume reductions due to the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT): A voxelbased morphometric study. Prog Neuropsychopharmacol Biol Psychiatry 2010;34:244-6.
• Brown AS, Rosen J. Lithium-induced delirium with therapeutic serum lithium levels: A case report. J Geriatr Psychiatry Neurol 1992;5:53-5.
• Lin CE, Mao WC. Mania complicated with delirium following cessation of long-term lithium therapy. Gen Hosp Psychiatry 2010;32:102-4.
• Duggal HS, Singh I. Lithium-induced hypercalcemia and hyperparathyroidism presenting with delirium. Prog Neuropsychopharmacol Biol Psychiatry 2008;32:903-4.
• Chen B, Cardasis W. Delirium induced by lithium and risperidone combination. Am J Psychiatry 1996;153:1233-4.
• Spring GK. Delirium Associated With Lithium and Thioridazine. Am J Psychiatry 1983;140: 1257.
• Miodownik C, Alkatnany A, Frolova K, Lerner V. Delirium Associated With Lithium-Quetiapine Combination. Clin Neuropharmacol 2008;31:176-9.
• Omata N, Murata T, Omori M, Wada Y. A patient with lithium intoxication developing at therapeutic serum lithium levels and persistent delirium after discontinuation of its administration. Gen Hosp Psychiatry 2003;25:53-5.
• Patten SB, Williams JV, Petcu R, Oldfield R. Delirium in psychiatric inpatients: A case-control study. Can J Psychiatry 2001;46:162-6.
• Hoenig J, Chaulk R. Delirium associated with lithium therapy and electroconvulsive therapy. Can Med Assoc J. 1977;116:837-8.
• Faaij RA, Ziere G, Zietse R, Van der Cammen TJ. Delirium due to a drug-drug interaction of lithium and an NSAID. J Nutr Health Aging 2009; 13: 275-6.
• Ehle G, Uebelhack R. Dangerous side effects of lithium therapy. Psychiatr Neurol Med Psychol Beih 1977;22-23:177-82.
• Shulman KI, Sykora K, Gill S, Mamdani M, Bronskill S, Wodchis WP, Anderson G, Rochon P. Incidence of delirium in older adults newly prescribed lithium or valproate:A population-based cohort study. J Clin Psychiatry 2005;66:424-7.
• Nagamine M, Yoshino A, Ishii M, Ogawa T, Kurauchi S, Yoshida T, Shigemura J, Kodera T, Tanaka Y, Nomura S. Lithium-induced Hashimoto’s encephalopathy: A case report. Bipol Disord 2008;10: 846Swartz CM, Dolinar LJ. Encephalopathy associated with rapid decrease of high levels of lithium. Ann Clin Psychiatry 1995;7:207-9.
• Boora K, Xu J, Hyatt J. Encephalopathy with combined lithiumrisperidone administration. Acta Psychiatr Scand 2008;117:394-6.
• Swartz CM. Olanzapine-lithium encephalopathy. Psycosomatics 2001;42: 370.
• Gille M, Ghariani S, Pieret F, Delbecq J, Depre A, Saussu F, de Barsy T. Acute encephalomyopathy and persistent cerebellar syndrome after lithium salt and haloperidol poisoning. Rev Neurol 1997;153:268-70.
• Sandyk R, Hurwitz MD. Toxic irreversible encephalopathy induced by lithium carbonate and haloperidol. A report of 2 cases. S Afr Med J 1983;64: 875-6.
• Fetzer J, Kader G, Danahy S. Lithium encephalopathy: A clinical, psychiatric, and EEG evaluation. Am J Psychiatry 1981;138: 1622-3.
• Cantor CH. Encephalopathy with lithium and thioridazine in combination. Med J Aust 1986;144: 164-5.
• Engel J, Berggren U. Effects of lithium on behaviour and central monoamines. Acta Psychiatr Scand Suppl 1980;280: 133-43.
• Palma JA, Torron RF, Larraya JGP. Extrapyramidal syndrome related to lithium-carbamazepine combination therapy at therapeutic serum levels. Clin Neuropharm 2010;33: 102-3.
• Shen HC, Li JY, Lo YK. Lithium intoxication-induced acute parkinsonism complicated with hyperparathyroidism and nephrogenic diabetes insipidus: Report of a case. Acta Neurol Taiwan 2007;16: 231-3.
• Dallocchio C, Mazzarello P. A case of Parkinsonism due to lithium intoxication: Treatment with Pramipexole. J Clin Neurosci 2002;9: 310Asnis GM, Asnis D, Dunner DL, Fieve RR. Cogwheel rigidity during chronic lithium therapy. Am J Psychiatry 1979;136:1225-6.
• Bell AJ, Cole A, Eccleston D, Ferrier IN. Lithium neurotoxicity at normal therapeutic levels. Br J Psychiatry 1993;162: 689-92.
• Kelwala S, Pomara N, Stanley M, Sitaram N, Gershon S. Lithiuminduced accentuation of extrapiramidal symptoms in individuals with Alzheimer’s disease. J Clin Psychiatry 1984;45: 342-4.
• Gelenberg AJ, Jefferson JW. Lithium tremor. J Clin Psychiatry 1995;56:283-7.
• Shopsin B, Gershon S. Cogwheel rigidity related to lithium maintenance. Am J Psychiatry 1975;132:536-8.
• Abrams AA, Braff DL. Lithium induced cogwheel rigidity: treatment with amantadine. Pharmakopsychiatr Neuropsychopharmakol 1980;13:240-2.
• Dinan TG, Kohen D. Tardive dyskinesia in bipolar affective disorder: Relationship to lithium therapy. Br J Psychiatry 1989;155: 55Axelsson R, Nilsson A. On the pathogenesis of abnormal involuntary movements in lithium-treated patients with major affective disorder. Eur Arch Psychiatry Clin Neurosci 1991;241:1-7.
• Muthane UB, Prasad BNK, Vasanth A, Satishchandra P. Tardive Parkinsonism, orofacial dyskinesia and akathisia following brief exposure to lithium carbonate. J Neurol Sci 2000;176:78-9.
• Beitman BD. Tardive dyskinesia reinduced by lithium carbonate. Am J Psychiatry 1978;135:1229-30.
• Serinken M, Türkçüer İ, Erdur B. Dizartri ile başvuran ve serebrovasküler olay sanılan bir lityum toksisitesi olgusu. Akademik Acil Tıp Dergisi 2008;7: 38-9.
• Tiryaki A, Özkorumak E, Ak İ. Kronik lityum zehirlenmesine bağlı koreatetoz. Psikiyatride Derlemeler, Olgular ve Varsayımlar 2008;2:21-5.
• Podskalny GD, Factor SA. Chorea Caused by Lithium Intoxication: A Case Report and Literature Review. Mov Disord 1996;11:733-7.
• Bartha L, Marksteiner J, Bauer G, Benke T. Persistent cognitive deficits associated with lithium intoxication: A neuropsychological case descripriton. Cortex 2002;38:743-52.
• Donaldson JO, Hale MS, Klau M. A case of reversible pure-word deafness during lithium toxicity. Am J Psychiatry 1981;183:242-3.
• Gordon PH, Hirsch LJ, Balmaceda C. Transient aphasia associated with lithium intoxication. J Clin Psychopharmacol 1997;17:55-6.
• Worrall E, Gillham R. Lithium induced constructional dyspraxia. BMJ 1983;286:189.
• Brumm VL, Van Gorp WG, Wirshing W. Chronic neuropsychological sequelae in a case of severe lithium intoxication. Neuropsychiatry Neuropsychol Behav Neurol 1998;11:245-9.
• Işıkay CT, Yiğit A, Çelik T. Creutzfeldt-Jakob-like EEG changes in a case of fatal lithium toxicity. J Neurol Sci 2011;29:604-8.
• Finelli PF. Drug-induced creutzfeldt-jakob like syndrome. J Psychiatr Neurosci 1992;17: 103-5.
• Casanova B, de Entrambasaguas M, Perla C, Gomez-Siurana E, Beneto A, Burguera JA. Lithium-induced Creutzfeldt-Jakob syndrome. Clin Neuropharmacol 1996;19: 356-9.
• Kikyo H, Furukawa T. Creutzfeldt-Jakob-like syndrome induced by lithium, levomepromazine, and phenobarbitone. J Neurol Neurosurg Psychiatry 1999;66: 802-3.
• McPherson A. Convulsive seizures and electroencephalogram changes in three patients during Levodopa therapy. Neurology 1970;20:41-5.
• Broussolle E, Setiey A, Moene Y, Trielett M, Chazot G. Reversible Creutzfeldt-Jakob like syndrome induced by lithium plus levodopa treatment. J Neurol Neurosurg Psychiatry 1989;52: 686-7.
• Suda M, Kubota F,Aihara Y, Hiraoka T, Aoyama Y, Hattori S, Fukuda M, Mikuni M. A case of lithium intoxication with periodic sharp waves. Pharmacopsychiatry 2009;42:122-3.
• Warabi YS, Idezuka S, Yamazaki M, Onishi Y. Triphasic waves detected during recovery from lithium intoxication. Intern Med 2003;42:908-9.
• Slama M, Masmoudi K, Blanchard N, Andrejak M. A possible case of lithium intoxication mimicking creutzfeld-jakob syndrome. Pharmacopsychiatry 2000;33:145-6.
• Kelly SJ, O’Donnell T, Fleming JC, Einhaus S. Pseudotumor cerebri associated with lithium use in an 11-year-old boy. J AAPOS 2009;13:204-6.
• Jonnalagadda J, Saito E, Kafantaris V. Lithium, minocycline andpseudotumor cerebri. J Am Acad Child Adolesc Psychiatry 2005;44:209.
• Hexom B, Barthel RP. Lithium and pseudotumor cerebri. J Am Acad Child Adolesc Psychiatry 2004;43:247-8.
• Köybaşı GP, Gülpek D. Lityum kullanımına bağlı gelişen psödotümör serebri: Bir olgu sunumu. Anadolu Psikiyatri Dergisi 2012;13:85-7.
• Bigal ME, Bordini CA, Speciali JG. Daily headache as a manifestation of lithium intoxication. Neurology 2001;57:1733-4.
• Wasoy M, Bakshi R, Kojan S, Bobustuc G, Dubey N. Superior sagittal sinus thrombosis due to lithium: Local urokinase thrombolysis treatment. Neurology 2000;54:532-3.
• Kamijo Y, Soma K, Hamanaka S, Nagai T, Kurihara K. Dural sinus thrombosis with severe hypernatremia developing in a patient on long-term lithium therapy.J Toxicol Clin Toxicol 2003;41:359-62.
• Gulack BC, Puri NV, Kim WJ. Stutter exacerbated by lithium in a pediatric patient with bipolar disorder. Ann Pharmacother 2011;45:57.
• Sabillo S, Samala RV, Ciocon JO. A stuttering discovery of lithium toxicity. J Am Med Dir Assoc. 2012;13:660-1.
• Netski AL, Piasecki M. Lithium-induced exacerbation of stutter. Ann Pharmacother 2001;35:961.
• Neil JF, Himmelhoch JM, Licata SM. Emergence of myasthenia gravis during treatment with lithium carbonate. Arch Gen Psychiatry 1976;33:1090-2.
• Lipton ID: Myasthenia gravis unmasked by lithium carbonate. J Clin Psychopharmacol 1987;7:57.
• Alevizos B, Gatzonis S, Anagnostara Ch. Myasthenia Gravis Disclosed by Lithium Carbonate. J Neuropsychiatry Clin Neurosci 2006;18:427-9.
• Hız F, Karagöl T, Eyiipgil T, Çınar M, Kökeş Ü, Hasan B. Kronik lityum kullananımına bağlı yorgunluk ve bilateral ptoz olgusu. Türk Nöroloji Dergisi 2008;14:117-20.
• Argyriou AA, Drakoulogona O, Karanasios P, Kouliasa L, Leonidou L, Giannakopoulou F, Goudas P, Makris N. Lithium-induced fatal neuroleptic malignant syndrome in a patient not being concomitantly treated with commonly offending agents. J Pain Symptom Manage 2012;44:e4-e6.
• Herken H, Kaya N, Aşkın R, Kucur R. Nöroleptik malign sendrom: 5 olgu. Klinik Psikiyatri Dergisi 1998;2:120-4.
• Edokpolo O, Fyyaz M. Lithium toxicity and neurologic effects: Probable neuroleptic malignant syndrome resulting from lithium toxicity. Case Rep Psychiatry 2012 (in press).
• Borovicka MC, Bond LC, Gaughan KM. Ziprasidone- and lithiuminduced neuroleptic malignant syndrome. Ann Pharmacother 2006;40:139-42.
• Bourgeois JA, Kahn DR. Neuroleptic malignant syndrome following administration of risperidone and lithium. J Clin Psychopharmacol 2003;23:315-7.
• Kösehasanoğulları SG, Akdede B, Akan M, Tunca Z. Neuroleptic malignant syndrome caused by combination of risperidone and lithium in a patient with multiple medical comorbidities. Prog Neuropsychopharmacol Biol Psychiatry 2007;31:1147-8.
• Ünaldı M, Sayhan MB, Söğüt Ö, Demirhan R, Güzel B. Neuroleptic malignant syndrome after the addition of lithium to risperidone treatment: A case report and review of the literature. Hong Kong Journal of Emergency Medicine. 2010;17:289-92.
• Tharoor H, Deora S, Chauhan A, Sharma PSVN. Lithiumneuroleptic combination leading to permanent neurological sequelae? German journal of psychiatry 2007;10:18-20.
• Ali S, Pearlman RL, Upadhyay A, Patel P. Neuroleptic malignant syndrome with aripiprazole and lithium: A case report. J Clin Psychopharmacol 2006;26:434-6.
• Zaluska M, Janota B, Kszczotek M, Brykalski J. Lithium intoxication and neuroleptic malignant syndrome induced with aripiprazole. Case presentation. Eurepean Psychiatry 2012;27(Suppl.1):P-1125.
• Berry N,Pradhan S, Sagar R, Gupta SK. Neuroleptic malignant syndrome in an adolescent receiving olanzapine-lithium combination therapy. Pharmacother 2003;23:255-9.
• Assion HJ, Heinemann F, Laux G. Lithium and neuroleptic malignant syndrome. Eur Neuropsychopharmacol 1997;7:284.
• Johnston SRD, Burn DJ, Brook DJ. Peripheral neuropathy associated with lithium toxicity. J Neurol Neurosurg Psychiatry 1991;54:1019-20.
• Pamphlett RS, Mackenzie RA. Severe peripheral neuropathy due to lithium intoxication. J Neurol Neurosurg Psychiatry 1982;45:656.
• Merwick A, Cooke J, Neligan A, McNamara B, Sweeney BJ. Acute neuropathy in setting of diarrhoeal illness and hyponatraemia due to lithium toxicity. Clin Neurol Neurosurg 2011;113:923-4.
• Chan CH, Leung AKH, Cheung YF, Chan PYC, Yeung KWA, Lai KY. A rare neurological complication due to lithium poisoning. Hong Kong Journal of Emergency Medicine 2012;18:343-5.
• Khan AU, Chang FL, Howsepian A. Central pontine myelinolysis related to lithium toxicity. Gen Hosp Psychiatry 1997;19:150-2.
• Bejot Y, Depierre P, Osseby GV, Troisgros O, Moreau T, Giroud M. Central pontine and extra-pontine myelinolysis: A complication of lithium toxicity in a pregnant woman. Clin Neurol Neurosurg 2008;110:852-4. 1 Halmagyi CM, Lessell I, Curthous IS, Lessell S, Hoyt WF. Lithium induced downbeat nystagmus. Am J Ophthalmol 1989;107:664-70. 1 Monteiro ML, Sampaio CM. Lithium induced downbeat nystagmus in a patient with Arnold-Chiari malformation. Am J Ophtalmol 1993;116:648-9.