LITHIUM-INDUCED NEUROTOXICITY AT SERUM LITHIUM LEVELS WITHIN THE THERAPEUTIC RANGE

Objective: To report the occurrence of lithium-induced neurotoxicity a nd extrapyramidal symptoms at serum lithium levels within the therapeu tic range. Clinical picture: On two occasions, a 73-year-old patient p resented with symptoms of lithium-induced neurotoxicity and extrapyram idal symptoms when her serum lithium levels were within the therapeuti c range. Treatment and outcome: Both lithium-induced neurotoxicity and extrapyramidal symptoms resolved when lithium was withdrawn. Conclusi on: Even when serum lithium levels are within the therapeutic range, l ithium-induced neurotoxicity may occur. Patients on neuroleptics and t he elderly in particular may be more vulnerable to these side effects.