Persistent cerebellar deterioration in a patient with lobar pneumonia under lithium, carbamazepine, and trifluperidol treatment

We report on a patient with schizoaffective disorder who was on combination therapy of lithium, carbamazepine, and the neuroleptic trifluperidol. He e xperienced a lobar pneumonia and developed an acute and persistent cerebell ar deterioration which was most likely due to lithium toxicity, while the s erum lithium level was within the therapeutic range. The combination of lit hium, carbamazepine, and neuroleptics is common, and is generally considere d to be safe. The reported case suggests that this regimen might increase t he risk of intoxication with potentially disabling side-effects. (C) 1999 E lsevier, Paris.