Recovery from lithium neurotoxicity. A case study

Area of Science:

• Neuroscience
• Pharmacology

Background:

• Long-term lithium therapy is common for recurrent depressions.
• Patients may develop tolerance to lithium over time.
• Co-administration of antipsychotics like haloperidol requires careful monitoring.

Purpose of the Study:

• To describe a case of neurotoxicity syndrome in a patient treated with lithium and haloperidol.
• To highlight the potential risks of combining these medications.

Main Methods:

• A case report of a 68-year-old woman is presented.
• The patient received lithium for recurrent depression and haloperidol for a manic episode.
• Clinical symptoms, lithium levels, and recovery were documented.

Main Results:

• Neurotoxicity syndrome developed after adding haloperidol to lithium treatment.
• Symptoms included confusion, somnolence, agitation, extrapyramidal signs, ataxia, and EEG abnormalities.
• Lithium levels were within the therapeutic range (0.71 ± 0.19 mEq/L).
• Full recovery occurred after 5 months, with temporary memory impairment.

Conclusions:

• Combining lithium and haloperidol can induce neurotoxicity, irrespective of lithium levels.
• Patients on long-term lithium may be susceptible to neurotoxicity when haloperidol is introduced.
• This case underscores the importance of vigilant neurotoxicity monitoring in patients on combined therapy.