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[Acute encephalomyopathy and persistent cerebellar syndrome after lithium salt and haloperidol poisoning]
M Gille1, S Ghariani, F Piéret
1Service de Neurologie, Clinique Sainte-Elisabeth, Bruxelles.
Insights
A patient experienced acute encephalopathy when lithium carbonate and haloperidol were combined. This neurological condition, characterized by cerebellar syndrome, persisted long after medication discontinuation, highlighting potential long-term risks.
Area of Science:
- Neuroscience
- Psychopharmacology
- Toxicology
Background:
- Lithium carbonate is a mood stabilizer for bipolar disorder.
- Haloperidol is a typical antipsychotic used for psychosis.
- Concurrent use of lithium and haloperidol can increase the risk of neurotoxicity.
Observation:
- A 44-year-old woman with bipolar disorder developed acute encephalopathy.
- Her condition worsened with hyperthermia, dehydration, and haloperidol reintroduction.
- Lithium levels remained within the therapeutic range throughout.
Findings:
- The patient presented with acute encephalopathy, a severe brain dysfunction.
- A persistent cerebellar syndrome was observed for over a year post-medication.
- This suggests a potential for lasting neurological damage from the drug combination.
Implications:
- Clinicians should exercise caution when prescribing lithium and haloperidol concurrently.
- Monitoring for neurotoxicity is crucial, even with therapeutic lithium levels.
- The findings underscore the importance of careful medication management in psychiatric patients.
Abstract:
A 44-year-old maniacodepressive woman developed acute encephalopathy due to the association of lithium carbonate and haloperidol. She was treated with lithium salts for many years and the serum level of lithium was within the therapeutic range. The encephalopathy was worsened by hyperthermia, dehydration, and reintroduction of haloperidol, 5 days after the first discontinuation of the neuroleptic. The clinical features were characterized by a persistent cerebellar syndrome, more than one year after the interruption of these medications.