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Related Experiment Videos

[Drug-induced asterixis]

H Rittmannsberger1, F Leblhuber

  • 1Psychiatrische Abteilung Sektor, OO-Landes-Nervenklinik Wagner-Jauregg, Linz.

Deutsche Medizinische Wochenschrift (1946)
|April 22, 1994
PubMed
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Combining lithium and clozapine may increase the risk of drug-induced asterixis, a tremor characterized by electrical pauses. Reducing clozapine dosage led to symptom resolution in a patient with acute schizoaffective psychosis.

Area of Science:

  • Psychiatry
  • Clinical Pharmacology
  • Neuroscience

Background:

  • Schizoaffective disorder treatment often involves multiple psychotropic medications.
  • Lithium carbonate and clozapine are commonly used antipsychotics.
  • Extrapyramidal symptoms can occur with antipsychotic use.

Observation:

  • A 54-year-old woman with acute schizoaffective psychosis developed asterixis (flapping tremor) and unsteadiness.
  • Symptoms emerged after initiating lithium carbonate, zuclopenthixol, and clozapine, with additional biperiden for extrapyramidal symptoms.
  • Electromyography confirmed asterixis, with no other identifiable cause.

Findings:

  • Drug-induced asterixis was suspected, particularly with the combination of lithium and clozapine.
  • Symptom resolution occurred following a significant reduction in clozapine dosage.

Related Experiment Videos

  • This case highlights a potential adverse drug reaction in patients on combined lithium and clozapine therapy.

    • Implications:

    • Clinicians should be vigilant for asterixis in patients treated with lithium and clozapine concurrently.
    • Dosage adjustment of clozapine may be necessary to manage or prevent drug-induced asterixis.
    • Further research is warranted to elucidate the specific mechanisms and prevalence of this adverse effect.