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The Toxic Effects of Lithium Combined with Quetiapine and Risperidoneon Organ Systems
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Case Report
VOLUME: 18 ISSUE: 2
P: 109-114
June 2020

The Toxic Effects of Lithium Combined with Quetiapine and Risperidoneon Organ Systems

J Turk Soc Intens Care 2020;18(2):109-114
DOI: 10.4274/tybd.galenos.2019.19970
Canan Salman Önemli 1
Özlem Sarıtabak 2
1. Sağlık Bilimleri Üniversitesi, Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Anestezi Kliniği, İzmir, Türkiye
2. SBÜ Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Anestezi Bölümü, İzmir
3. Sağlık Bilimleri Üniversitesi, Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji Kliniği, İzmir, Türkiye
4. Merkezefendi Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Manisa, Türkiye
5. Merkezefendi Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Manisa
6. Merkezefendi Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Manisa, Türkiye
No information available.
No information available
Received Date: 19.05.2019
Accepted Date: 26.09.2019
Publish Date: 05.06.2020
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ABSTRACT

Lithium, first approved by the American Food and Drug Administration (FDA) for mania treatment in 1970, is used as the gold standard in the treatment of bipolar disorder in these days. Its neuroprotective effects, its usefulness in preventing recurrences, its property to reduce suicidal acts and thoughts have led it to be preferred against this disease.Though risperidone, one of the antipsychotic drugs, in 1994 while quetiapine in 1997 received FDA approval for the treatment of schizophrenia, these have used for the bipolar disorder treatment in recent years. Studies have shown that response and remission rates are better in combination therapies than in monotherapy for bipolar disorder. Combination therapies are applied to cases that are considered to be resistant to treatment, to the patients who give partial response, or to those who do not respond to the initial treatment. However, the main disadvantage of these treatments is that they increase the side effects. It is known that the combination of lithium with antipsychotic, antidepressant and anticonvulsant drugs is a predisposing risk factor for high lithium levels. The narrow therapeutic index of lithium also poses a potential risk of toxicity. Therefore, neurotoxic, nephrotoxic and cardiotoxic side effects of lithium on organ systems may occur. Despite these frequently preferred combination therapies, the number of case reports of severe intoxication associated with them is scarce. In this study, we aimed to discuss the effect of severe toxicity due to triple combination therapy on organ systems.

Keywords: Lithium, combination therapy, toxic effects, hemodialysis, intensive care unit

References

1
Duval AE, Gallicchio VS. Lithium Treatment in Clinical Medicine: History, Current Status and Future Use. J Cell Sci Ther 2017;8:1-9.
2
Cade JF. Lithium salts in the treatment of psychotic excitement. Med. J. Aust 1949;2:349-52.
3
Mohandas E, Rajmohan V. Lithium use in special population. Indian J Psychiatry 2007;49:211-8.
4
Yıldız A, Ruiz P, Nemeroff CB. The Bipolar Book: History, Neurobiology and Treatment. Oxford University Press 2015;403-16.
5
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 patient with bipolar disorder. Bipolar Disorders 2018;20:97-170.
6
Shah N, Grover S, Rao GP. Clinical Practice Guidelines for Management of bipolar Disorder. Indian Journal of Psychiatry 2017;59:51-66.
7
Hirschfeld RMA, Bowden CL, Gitlin MJ, Keck PE, Suppes T, Thase ME et al. Practice Guideline for The Treatment of Patients With Bipolar Disorder Second Edition. Part B: Background Information and Review of Available Evidence. American Psychiatric Association 2010;26-56.
8
Hsu CW, Lee Y, Lee CY, Lin PY. Neurotoxicity and Nephrotoxicity Caused by Combined Used Of Lithium and Risperidone: A case report and literature review. BMC Pharmacology and Toxicology 2016;17:59.
9
Solmi M, Murru A, Pacchiarotti I, Undurraga J, Veronese N, Fornaro M, et al. Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review. Therapeutics and Clinical Risk Management 2017;13:757-77.
10
Muneer A. Pharmacotherapy of bipolar disorder with quetiapine: A recent literature review and an update. Clinical Psychopharmacology and Neuroscience 2015;13:25-35.
11
Özalp E, Karslıoğlu EH. Tedaviye Dirençli Bipolar Bozukluk. Psikiyatride Güncel Yaklaşımlar 2015;7:401-18.
12
Gunning JB, Henry TL, Hoegberg LCG, Gosselin S, Roberts DM. Lithium Poisoning. Journal of Intensive Care Medicine 2016;1-15.
13
Boeker H, Seidl A, Schopper C. Neurotoxicity related to combined treatment with lithium, antidepressants and atypical antipsychotics. Schweizer Archiv Fur Neurologie Und Psychiatrie 2011;162:72-6.
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