Unusual manifestation of therapeutic dose of lithium as syndrome of irreversible lithium-effectuated neurotoxicity

• Main Authors: Hemendra Singh, Sundernag Ganjekar, Anand Kalegowda, Murali Thyloth
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Journal of Mental Health and Human Behaviour
• Subjects: Lithium; neurotoxicity; syndrome of irreversible lithium-effectuated neurotoxicity
• Online Access: http://www.jmhhb.org/article.asp?issn=0971-8990;year=2015;volume=20;issue=2;spage=80;epage=81;aulast=Singh

Lithium is a commonly used mood stabilizer. However, because lithium has a low therapeutic index, lithium-induced drug toxicity is frequently seen in clinical practice. While most side effects of lithium use reverse after the drug is discontinued, in rare cases patients develop a persistent neurological side effect known as a syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). We report a case where the patient developed SILENT even when given a therapeutic dose of lithium. Our case also supports the biological mechanism of SILENT, which involves demyelination at multiple sites in the brain.