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Pseudotumor cerebri associated with lithium therapy in two patients
1Department of Psychiatry and Behavioral Sciences, University of Southern California School of Medicine, Los Angeles 90033.
The Journal of Clinical Psychiatry
|June 1, 1990
Summary
Lithium treatment for bipolar disorder may cause pseudotumor cerebri, a condition of increased intracranial pressure. Careful medical monitoring is recommended to prevent this serious side effect.
Area of Science:
- Neurology
- Endocrinology
- Pharmacology
Background:
- Pseudotumor cerebri (PTC) is a neurological disorder characterized by increased intracranial pressure, headaches, and papilledema.
- Its exact etiology is often unclear, with numerous potential contributing factors identified.
- Lithium is a common medication for bipolar disorder, but its potential side effects require careful consideration.
Observation:
- Two cases of pseudotumor cerebri (PTC) are presented in patients undergoing lithium therapy for bipolar disorder.
- These patients exhibited classic symptoms of PTC, including chronic headaches and elevated intracranial pressure.
- Diagnostic imaging revealed normal or small ventricles, ruling out other common causes of increased intracranial pressure.
Findings:
- Lithium therapy is identified as a potential iatrogenic cause of pseudotumor cerebri.
- The mechanism may involve lithium's disruption of the antidiuretic hormone-cyclic adenosine monophosphate pathway, affecting sodium balance, thyroid-stimulating hormone, and glucose metabolism.
- This highlights a specific risk associated with lithium treatment.
Implications:
- Clinicians should be vigilant for PTC symptoms in patients treated with lithium.
- Careful medical monitoring is crucial to detect and manage lithium-induced pseudotumor cerebri.
- Understanding this association can improve patient safety and treatment outcomes for bipolar disorder.
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