Objective: To report the occurrence of lithium-induced neurotoxicity and extrapyramidal symptoms at serum lithium levels within the therapeutic range. Clinical picture: On two occasions, a 73-year-old patient presented with symptoms of lithium-induced neurotoxicity and extrapyramidal symptoms when her serum lithium levels were within the therapeutic range.
Treatment and outcome: Both lithium-induced neurotoxicity and extrapyramidal symptoms resolved when lithium was withdrawn.
Conclusion: Even when serum lithium levels are within the therapeutic range, lithium-induced neurotoxicity may occur. Patients on neuroleptics and the elderly in particular may be more vulnerable to these side effects.
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