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

Published online by Cambridge University Press:  12 August 2016

Adriana P. Hermida ,
A. Umair Janjua ,
Oliver M. Glass ,
Camille P. Vaughan ,
Felicia Goldstein ,
Lynn Marie Trotti  and
Stewart A. Factor
Adriana P. Hermida*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
A. Umair Janjua
Affiliation:
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
Oliver M. Glass
Affiliation:
Department of Psychiatry and Behavioral Medicine, East Carolina University, Greenville, North Carolina, USA
Camille P. Vaughan
Affiliation:
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
Felicia Goldstein
Affiliation:
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
Lynn Marie Trotti
Affiliation:
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
Stewart A. Factor
Affiliation:
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
*
Correspondence should be addressed to: Adriana P. Hermida, M.D., Assistant Professor, Geriatric Psychiatry Fellowship Director, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive NE, Atlanta 30322, USA. Phone: (404) 728-6302. Email: ahermid@emory.edu.
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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

lithiumParkinson's diseasebipolar disorderdrug-induced parkinsonismcomprehensive caregeriatrics
Type
Case Report
Information
International Psychogeriatrics , Volume 28 , Issue 12 , December 2016 , pp. 2101 - 2104
Copyright
Copyright © International Psychogeriatric Association 2016 

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