Lithium-Induced Neurotoxicity at Serum Lithium Levels within the Therapeutic Range

Abstract

Objective: To report the occurrence of lithium-induced neurotoxicity and extrapyramidal symptoms at serum lithium levels within the therapeutic range. Clinical picture: On two occasions, a 73-year-old patient presented with symptoms of lithium-induced neurotoxicity and extrapyramidal symptoms when her serum lithium levels were within the therapeutic range. Treatment and outcome: Both lithium-induced neurotoxicity and extrapyramidal symptoms resolved when lithium was withdrawn. Conclusion: Even when serum lithium levels are within the therapeutic range, lithium-induced neurotoxicity may occur. Patients on neuroleptics and the elderly in particular may be more vulnerable to these side effects.