Case Report
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Year 2024, Volume: 3 Issue: 2, 207 - 211, 18.10.2024

Abstract

References

  • Malhi GS, Gessler D, Outhred T. The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines. J Affect Disord. 2017;217:266-80.
  • Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20(2):97-170.
  • Skovbjerg BK, Helgestad OK, Oxlund CS, Christensen B, Henriksen JN. [Not Available]. Ugeskr Laeger. 2023;185(16).
  • Finley PR. Drug interactions with lithium: an update. Clinical Pharmacokinetics. 2016;55(8):925-41.
  • Ferensztajn-Rochowiak E, Rybakowski JK. Long-term lithium therapy: side effects and interactions. Pharmaceuticals. 2023;16(1):74.
  • Scherf-Clavel M, Treiber S, Deckert J, Unterecker S, Hommers L. Drug-Drug Interactions Between Lithium and Cardiovascular as Well as Anti-Inflammatory Drugs. Pharmacopsychiatry. 2020;53(5):229-34.
  • Spinewine A, Schoevaerdts D, Mwenge GB, Swine C, Dive A. Drug-induced lithium intoxication: a case report. J Am Geriatr Soc. 2005;53(2):360-1.
  • De Winter S, Meersseman W, Verelst S, Willems L, Spriet I. Drug-related admissions due to interaction with an old drug, lithium. Acta Clinica Belgica. 2013;68(5):356-8.
  • Handler J. Lithium and antihypertensive medication: a potentially dangerous interaction. J Clin Hypertens (Greenwich). 2009;11(12):738-42.

Lithium Toxicity Due to Drug-Drug Interactions: A Case Report

Year 2024, Volume: 3 Issue: 2, 207 - 211, 18.10.2024

Abstract

Lithium has a relatively narrow therapeutic range. As a result of drug-drug interactions, the blood level of lithium is highly affected. This case describes lithium toxicity and its management resulting from drug interactions with lithium. A 37-year-old woman with bipolar illness, essential hypertension, hypothyroidism, unipolar depression, and schizoaffective disorder was admitted to the emergency department with hand numbness, tremor, agitation, and tachycardia. When the patient's lithium blood level was 1.7 mmol/L, lithium treatment was discontinued, and he was hospitalized in the intensive care unit with a prediagnosis of lithium toxicity. The clinical pharmacist used the Lexicomp drug interaction database to examine interactions. Candesartan, hydrochlorothiazide and dexketoprofen were determined to be the cause of toxicity. The clinical pharmacist advised amlodipine as an antihypertensive because it did not interact, reducing lithium levels to 1.4-1.2 and 0.8 mmol/L. Lithium toxicity due to drug-drug interactions was resolved by clinical pharmacist intervention.

References

  • Malhi GS, Gessler D, Outhred T. The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines. J Affect Disord. 2017;217:266-80.
  • Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20(2):97-170.
  • Skovbjerg BK, Helgestad OK, Oxlund CS, Christensen B, Henriksen JN. [Not Available]. Ugeskr Laeger. 2023;185(16).
  • Finley PR. Drug interactions with lithium: an update. Clinical Pharmacokinetics. 2016;55(8):925-41.
  • Ferensztajn-Rochowiak E, Rybakowski JK. Long-term lithium therapy: side effects and interactions. Pharmaceuticals. 2023;16(1):74.
  • Scherf-Clavel M, Treiber S, Deckert J, Unterecker S, Hommers L. Drug-Drug Interactions Between Lithium and Cardiovascular as Well as Anti-Inflammatory Drugs. Pharmacopsychiatry. 2020;53(5):229-34.
  • Spinewine A, Schoevaerdts D, Mwenge GB, Swine C, Dive A. Drug-induced lithium intoxication: a case report. J Am Geriatr Soc. 2005;53(2):360-1.
  • De Winter S, Meersseman W, Verelst S, Willems L, Spriet I. Drug-related admissions due to interaction with an old drug, lithium. Acta Clinica Belgica. 2013;68(5):356-8.
  • Handler J. Lithium and antihypertensive medication: a potentially dangerous interaction. J Clin Hypertens (Greenwich). 2009;11(12):738-42.
There are 9 citations in total.

Details

Primary Language English
Subjects Clinical Pharmacy and Pharmacy Practice
Journal Section Research Articles
Authors

Melisa Tekşahin 0009-0008-0514-9476

Kadir Köseoğlu 0000-0002-7988-7411

Ahmet Çakır 0000-0002-9843-1604

Nesligül Özdemir 0000-0003-2551-9549

Publication Date October 18, 2024
Submission Date August 20, 2024
Acceptance Date September 10, 2024
Published in Issue Year 2024 Volume: 3 Issue: 2

Cite

EndNote Tekşahin M, Köseoğlu K, Çakır A, Özdemir N (October 1, 2024) Lithium Toxicity Due to Drug-Drug Interactions: A Case Report. Anatolian Journal of Pharmaceutical Sciences 3 2 207–211.

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