Article type: Review Article
Article
title: Lithium-associated
movement disorder: a literature review
Journal: Brain
Circulation
Year: 2022
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari
Caprara, Ícaro Durante, Ariane Rauber
E-mail: jamirrissardo@gmail.com
ABSTRACT
In 1949, Cade described “sedative effects” after
injecting guinea pigs intraperitoneally with lithium (LTM) carbonate. Based on
his experiments, he began treating psychiatric patients with LTM. This
literature review aims to evaluate the clinical epidemiological profile,
pathological mechanisms, and management of LTM-associated movement disorder
(MD). Relevant reports in six databases (Excerpta Medica, Google Scholar, Latin
American and Caribbean Health Sciences Literature, Medline, Scientific
Electronic Library Online, and ScienceDirect) were identified and assessed by
two reviewers without language restriction from 1949 to 2021. A total of 250
reports containing 1100 individuals who developed MD associated with LTM were
identified. The MDs encountered 148 parkinsonism (PKN), 114 dyskinesia (DKN),
97 myoclonus, 22 dystonia (DTN), 20 Creutzfeldt–Jakob-like syndrome, 11
akathisia, 10 restless legs syndrome (RLS) symptoms, 6 tics, 5 cerebellar
syndromes, and 3 stuttering. In the subgroup of cases not clearly defined,
there were 320 individuals with extrapyramidal symptoms, 135 with DTN, 37 with
DKN, 24 with PKN, and 7 with RLS. Other 141 individuals were only described as
presenting an abnormal involuntary movement without further explanation. The
mean age was 53.06 years (standard deviation [SD]: 15.64) and the predominant
sex was female, i.e., 56.20% (154/274). The mean LTM dose was 963.03 mg/day
(SD: 392.03). The mean serum LTM level was 1.53 mEq/L (SD: 1.08). The median
onset time was 3 months (1 day to 40 years). The mean recovery time was 0.94
months (SD: 0.87). 45.94% had a full recovery. LTM-induced MD was extensively
reported in the literature. Only general terms were used in the majority of the
reports. LTM polytherapy probably affected the identification of the MD cause.
Keywords: Bipolar disorder, drug-induced,
lithium, movement disorder, review
Full text available at:
DOI
10.4103/bc.bc_77_21
Citation
Rissardo
JP, Caprara AL, Durante I, Rauber A. Lithium-associated movement disorder: a
literature review. Brain Circ 2022;8:76-86
