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Hypertensive bipolar: chronic lithium toxicity in patients taking ACE inhibitor


Citation

Masiran, Ruziana and Abdul Aziz, Mohammad Firdaus (2017) Hypertensive bipolar: chronic lithium toxicity in patients taking ACE inhibitor. BMJ Case Reports, 2017. ISSN ESSN: 1757-790X

Abstract

A patient with bipolar I disorder has been treated with lithium and haloperidol for the last 20 years and received an ACE inhibitor for his hypertension since 9 years ago. Despite regular clinic follow-ups and blood monitoring, he recently developed tremors and delirium. On hospital admission, serum level of lithium was far above toxic level. Mental state examination revealed an anxious and disorientated man with irrelevant speech. Immediate discontinuation of lithium resulted in slow reduction of serum lithium levels and gradual resolution of tremor but his delirium persisted for 2 weeks. His condition took a turn for the worse when he developed acute renal failure and arm abscess. We discussed about lithium toxicity and the vulnerability factors which have induced delirium and renal failure in this patient.


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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.1136/bcr-2017-220631
Publisher: BMJ Publishing Group
Keywords: Acute renal failure; Drug interactions; Psychiatry; Psychiatry (drugs and medicines)
Depositing User: Nurul Ainie Mokhtar
Date Deposited: 21 Mar 2019 07:54
Last Modified: 21 Mar 2019 07:54
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.1136/bcr-2017-220631
URI: http://psasir.upm.edu.my/id/eprint/62064
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