Niethammer R, Keller A, Weisbrod M
Psychiatrische Universitätsklinik, Heidelberg.
Psychiatr Prax. 2000 Sep;27(6):296-7.
Lithium is used with great success in the treatment of manic patients and for prophylaxis of bipolar disorders. There are only few reports about neuropsychiatric side effects at therapeutic serum levels. We report on a 38 year old woman with bipolar disorder who was treated with lithium for 20 years without side-effects. Subsequent to a manic episode, she became disoriented at night and showed marked memory deficits. The patient did not show any neurological or gastrointestinal signs of intoxication. Lithium serum-levels were in therapeutic range. The psychiatric symptoms disappeared when lithium was stopped. We interpret these symptoms as delirant syndrome with pseudo-dementia at therapeutic lithium serum levels. This side-effect must be taken into account even in patients on successful longtime lithium therapy.
锂盐在治疗躁狂患者和预防双相情感障碍方面取得了巨大成功。关于治疗性血清水平下的神经精神副作用的报道很少。我们报告了一名38岁的双相情感障碍女性，她接受锂盐治疗20年且无副作用。在一次躁狂发作后，她夜间出现定向障碍并表现出明显的记忆缺陷。该患者未表现出任何神经或胃肠道中毒迹象。锂盐血清水平在治疗范围内。停用锂盐后精神症状消失。我们将这些症状解释为治疗性锂盐血清水平下伴有假性痴呆的谵妄综合征。即使是长期成功接受锂盐治疗的患者，也必须考虑到这种副作用。
