The Toxic Effects of Lithium Combined with Quetiapine and Risperidoneon Organ Systems
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Case Report
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
1. Sağlık Bilimleri Üniversitesi, Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Anestezi Kliniği, İzmir, Türkiye
2. 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

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