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An extrapyramidal syndrome after lithium therapy

P Tyrer, M S Alexander, A Regan

    The British Journal of Psychiatry : the Journal of Mental Science
    |February 1, 1980
    PubMed
    Summary

    Lithium carbonate can cause extrapyramidal syndrome, mimicking parkinsonism. This condition worsened with orphenadrine, suggesting lithium may block dopamine receptors, leading to adverse neurological effects.

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    Area of Science:

    • Neuropharmacology
    • Movement Disorders
    • Drug-induced side effects

    Background:

    • Lithium carbonate is a common mood stabilizer used in treating bipolar disorder.
    • Extrapyramidal syndromes are a group of symptoms associated with movement disorders.
    • Drug-induced parkinsonism is a known side effect of certain medications.

    Observation:

    • Two patients on lithium carbonate developed extrapyramidal syndromes.
    • The syndrome's symptoms were similar to drug-induced parkinsonism.
    • An anti-parkinsonian drug, orphenadrine, exacerbated the symptoms.

    Findings:

    • The adverse effect of lithium carbonate was reproducible under laboratory conditions.
    • Extrapyramidal symptoms and physiological tremor were monitored before and after orphenadrine administration.
    • Lithium carbonate's effect may be due to selective blockade of dopamine receptors.

    Implications:

    • This study highlights a potential adverse neurological effect of lithium carbonate.
    • Understanding the mechanism may inform safer prescribing practices.
    • Further research into lithium's interaction with dopamine pathways is warranted.

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