The effect of lithium carbonate was investigated on the five cases of aplastic anemia with measuring of serum level and EKG check. Reticulocyte count increased slightly only in one case. Hemoglobin, WBC and platelet count did not show any significant increase in all cases. No apparent side effect, including EKG finding, was observed.
Anemia, Aplastic* ; Electrocardiography ; Lithium Carbonate* ; Lithium* ; Platelet Count ; Reticulocyte Count

Lithium is a well-known treatment for patients with mood disorders. Intoxication by lithium may be lethal particularly in elderly due to altered pharmacokinetics, renal impairment or multiple drug use. We presented a 74-year-old female patient who had been stabile with lithium carbonate 600 mg/day for 5 years and developed lithium intoxication after bronchiolitis. She presented with altered mental status. The neurological signs resolved slowly after lithium and moxifloxacin were stopped immediately and fluid resuscitation administered. Considering possible drug interactions on elderly patients receiving lithium is essential.
Aged ; Bronchiolitis ; Drug Interactions ; Female ; Humans ; Lithium Carbonate ; Lithium* ; Mood Disorders ; Pharmacokinetics ; Resuscitation

The authors report one-case of hyperthyroidism that occurred in a 56-year-old woman with bipolar disorder after 3 years of chronic lithium treatment. The high level in thyroid fuction test returned to normal after discontinuation of lithium. This case is shows that lithium-induced hyperthyroidism can be reversible.
Bipolar Disorder ; Female ; Humans ; Hyperthyroidism* ; Lithium Carbonate* ; Lithium* ; Middle Aged ; Thyroid Gland

Lithium, first used by Cade in 1949 for the treatment of mania, is now commonly used in several affective disorders. The precise mechanism of its action is not clearly understood but the side effects may be severe. Prolongation of succinylcholine and pancuronium which possible mechanism of interaction involves impaired acetylcholine synthesis and release at nerve terminal has been reported. The present report describes a case of prolonged neuromuscular blockade induced by succinylcholine in a manic depressive patient being treated with oral lithium carbonate.
Acetylcholine ; Bipolar Disorder ; Humans ; Juniperus ; Lithium Carbonate* ; Lithium* ; Mood Disorders ; Neuromuscular Blockade* ; Pancuronium ; Succinylcholine*

Because adenine is effective for managing cases of radiation-induced and drug-induced leukopenia, it may be effective in cases of antipsychotic-induced leukopenia and neutropenia. Here, we report our experience with patients with leukopenia and neutropenia caused by an antipsychotic overdose or discontinuation of lithium carbonate, in whom adenine administration ameliorated the white blood cell and neutrophil counts. The progress of patients suggests that adenine is effective in cases of leukopenia and neutropenia associated with lithium carbonate discontinuation and an antipsychotic overdose.
Adenine* ; Antipsychotic Agents* ; Humans ; Leukocytes ; Leukopenia* ; Lithium Carbonate* ; Lithium* ; Neutropenia* ; Neutrophils

The lithium is widely employed as a psychotropic agent, specially in manic illness. Lithium nephrotoxicity can be divided into three main categories: nephrogenic diabetes insipidus, acute intoxication, chronic nephropathy including interstitial nephropathy and glomerulopathy manifested as nephrotic syndrome. But, nephrotic syndrome induced by lithium is very rare. We reported a nephrotic syndrome induced by lithium in a 27-year-old woman who was taking lithium carbonate for 11 years due to bipolar disorder. Renal biopsy showed membranous nephropathy. After withdrawal of lithium, clinical symptoms and proteinuria significantly improved.
Adult ; Biopsy ; Bipolar Disorder ; Diabetes Insipidus, Nephrogenic ; Female ; Glomerulonephritis, Membranous* ; Humans ; Lithium Carbonate ; Lithium* ; Nephrotic Syndrome ; Proteinuria

BACKGROUND: Thiazides have been used in nephrogenic diabetes insipidus (NDI) patients to decrease urine volume, but the mechanism of antidiuretic effect is not known yet. Recently, it has been demonstrated that abundance of aquaporin-2 (AQP2) was decreased in lithium induced NDI. We performed this study to investigate the effect of hydrochlorothiazide (HCTZ) in lithium induced NDI rats and the change of AQP2 expression. METHODS: NDI was induced in 7 male Spraque- Dawley rats by feeding lithium carbonate containing rat chow (40 mmol/kg) for 5 weeks. 4 rats were control group. HCTZ 3.75 mg/day (n=3 among lithium treated; Li+TZ) or vehicle (n=4 among lithium treated and control; Li and Control, respectively) was infused to the rats through osmotic minipump for the last 7 days. Urine volume and urine osmolality were measured. Kidneys were processed for immunohistochemistry and immunoblotting using antibody to AQP2. RESULTS: Li+TZ showed decreased urine volume (46+/-11 mL/day for Li+TZ vs. 127+/-1 mL/day for Li, p<0.05) and higher urine osmolality (557+/-139 mmol/kgH2O for Li+TZ vs. 207+/-9 mmol/kgH2O for Li, p<0.05) comparing to Li. In semi-quantitative immunoblotting using whole kidney homogenate, Li+TZ showed increase in AQP2 expression comparing to Li (39+/-2% for Li+TZ vs. 20+/-9% for Li, p<0.05, % of normal controls). In immunohistochemistry, AQP2 expression in cortex was markedly decreased after lithium treatment. But, AQP2 expression was slightly increased after HCTZ treatment. CONCLUSION: HCTZ treatment partially increased urine concentrating ability and AQP2 expression in rats with lithium induced NDI. We concluded that partial improvement in urine concentrating ability might be associated with upregulation of AQP2.
Animals ; Antidiuretic Agents ; Aquaporin 2* ; Diabetes Insipidus, Nephrogenic* ; Humans ; Hydrochlorothiazide* ; Immunoblotting ; Immunohistochemistry ; Kidney ; Kidney Concentrating Ability ; Lithium Carbonate ; Lithium* ; Male ; Osmolar Concentration ; Rats* ; Thiazides ; Up-Regulation

Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment.
Agranulocytosis ; Antithyroid Agents ; Depressive Disorder ; Drug Therapy ; Goiter* ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Lithium Carbonate* ; Lithium* ; Mass Screening ; Thyroid Function Tests ; Thyroid Gland ; Thyrotoxicosis ; Thyroxine

A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis.
Amiloride ; Bipolar Disorder ; Creatine Kinase ; Diabetes Insipidus ; Diabetes Insipidus, Nephrogenic ; Female ; Fluid Therapy ; Humans ; Lithium ; Lithium Carbonate ; Middle Aged ; Muscles ; Osmolar Concentration ; Polydipsia ; Rhabdomyolysis ; Risperidone

Lithium has been established as a drug useful for the treatment of manic depressive disorder. It is now well recognized that long-term administration of this drug is associated with various antithyroid effects such as goiter, and subclinical and overt hypothyroidism. However, it has been associated less commonly with thyrotoxicosis. Recently we experienced a case of thyroitoxicosis during lithium therapy. A 24-year-old man treated with lithium carbonate 900 mg-1,200 mg/day for manic-depressive illness for four weeks. He then complained of nervousness, palpitation, tremor, heat intolerance, and sweating. Neck pain was not noted. At that time the results of thyroid function test were consistent with hyperthyroidism: T3 568.8 ng/dL, TSH 0.01 mU/mL, FT4 6.0 ng/dL, but 24 hr radioiodine uptake was 0.3%. We suspected this case as lithium induced thyrotoxicosis and discontinued lithium administration. After discontinuation of lithium thyrotoxic symptoms were subsided. One month later, thyroid hormon levels became normalized: T 100.2 ng/dL, TSH 0.06 mU/mL, FT4 0.97 ng/dL and 24hr radioiodine uptake was 16%. We report this case with review of literatures.
Antithyroid Agents ; Anxiety ; Depressive Disorder ; Goiter ; Hot Temperature ; Humans ; Hyperthyroidism ; Hypothyroidism ; Lithium Carbonate ; Lithium* ; Neck Pain ; Sweat ; Sweating ; Thyroid Function Tests ; Thyroid Gland ; Thyrotoxicosis* ; Tremor ; Young Adult