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Extrapyramidal syndrome related to lithium-carbamazepine combination therapy at therapeutic serum levels.
Clin Neuropharmacol
July 2010
Department of Neurology and Neurosurgery, University Clinic of Navarra, Pamplona, Spain.
Neurological disturbances due to lithium-carbamazepine combination therapy are infrequent, and only a few cases have been reported so far. We describe a most unusual case of a patient with a history of bipolar disorder who developed ataxic gait, imbalance, and intention tremor after lithium-and-carbamazepine combination treatment with therapeutic serum levels of both drugs; he recovered completely when carbamazepine was discontinued. We also review the literature about this infrequent relationship, discuss on its proposed origin, and underline its importance as a potential adverse effect in elderly patients, yet with therapeutic or even subtherapeutic serum levels.
View Article and Find Full Text PDFPharmacokinetics of mood stabilizers and new anticonvulsants.
Psychopharmacol Bull
November 2002
Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University School of Medicine, 401 Quarry Road, Room 2117, Stanford, CA 94305-5723, USA.
Mechanisms of action, efficacy spectra, pharmacokinetics, and adverse effects differentiate the mood stabilizers lithium, carbamazepine (CBZ), and valproate (VPA). Lithium, which has a low therapeutic index, is excreted through the kidneys, resulting in renally mediated, but not hepatically mediated, drug-drug interactions. CBZ also has a low therapeutic index and is metabolized primarily by a single isoform (CYP3A3/4).
View Article and Find Full Text PDFSecond-generation antipsychotics in the emergency care setting. A prospective naturalistic study.
Gen Hosp Psychiatry
July 2000
Servizio Psichiatrico di Diagnosi e Cura, Ospedale Santo Spirito in Sassia, Rome, Italy.
The objective of this subject was to examine the impact of the replacement of standard neuroleptics with atypical antipsychotic agents in an intensive psychiatric care unit. A mirror-image study was conducted. Cases admitted in the first semester of the year (when most of patients were treated with standard neuroleptics) were compared to cases admitted in the second semester of the year, when atypical antipsychotic agents were routinely utilized as first line treatment of patients with psychotic signs.
View Article and Find Full Text PDFMetabolism and excretion of mood stabilizers and new anticonvulsants.
Cell Mol Neurobiol
August 1999
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California 94305-5723, USA.
1. The mood stabilizers lithium, carbamazepine (CBZ), and valproate (VPA), have differing pharmacokinetics, structures, mechanisms of action, efficacy spectra, and adverse effects. Lithium has a low therapeutic index and is renally excreted and hence has renally-mediated but not hepatically-mediated drug-drug interactions.
View Article and Find Full Text PDFLithium therapy in the treatment of manic-depressive illness. Present status and future perspectives. A critical review.
Arch Int Pharmacodyn Ther
January 1997
Bristol Myers Squibb, Pharmaceutical Research Institute, Waterloo, Belgium.
This article reviews critically the present status of lithium in the treatment and prophylaxis of manic-depressive illness compared to the two anticonvulsant drugs, carbamazepine and valproic acid. Lithium is used successfully in the prophylaxis and treatment of manic-depression. The mechanism by which it exerts its effects is still not very clear.
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