A case of lithium-induced parkinsonism presenting with typical motor symptoms of Parkinson's disease in a bipolar patient

Int Psychogeriatr. 2016 Dec;28(12):2101-2104. doi: 10.1017/S1041610216001101. Epub 2016 Aug 12.

Abstract

Lithium is a mood stabilizer rarely associated with drug-induced parkinsonism (DIP). We present a case of an elderly woman with bipolar disorder who developed parkinsonian symptoms after chronic lithium administration despite therapeutic serum levels. Upon evaluation, classic parkinsonian signs of muscle rigidity, tremor, bradykinesia, freezing of gait, and cognitive decline were observed. Initially, she was diagnosed with Parkinson's disease (PD); however, DaTscan SPECT imaging clarified the diagnosis as DIP. As the daily lithium dosage was reduced, the patient's motor symptoms improved. This report emphasizes close monitoring of lithium levels in geriatric populations and the need to consider lithium-induced parkinsonism when PD symptoms appear in chronic lithium users.

Keywords: Parkinson's disease; bipolar disorder; comprehensive care; drug-induced parkinsonism; geriatrics; lithium.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bipolar Disorder / drug therapy*
  • Dose-Response Relationship, Drug*
  • Drug Monitoring / methods
  • Female
  • Humans
  • Lithium Compounds* / administration & dosage
  • Lithium Compounds* / adverse effects
  • Lithium Compounds* / blood
  • Neurologic Examination / methods
  • Parkinson Disease, Secondary / chemically induced
  • Parkinson Disease, Secondary / diagnosis
  • Parkinson Disease, Secondary / therapy
  • Psychotropic Drugs / administration & dosage
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / blood
  • Tomography, Emission-Computed, Single-Photon / methods
  • Treatment Outcome

Substances

  • Lithium Compounds
  • Psychotropic Drugs