General Hospital Psychiatry
Volume 32, Issue 1 , Pages 102-104, January 2010

Mania complicated with delirium following cessation of long-term lithium therapy

Department of Psychiatry, Tri-Service General Hospital, Neihu District, Taipei 114, Taiwan

Received 13 June 2009; accepted 8 September 2009. published online 21 October 2009.

Abstract 

Objective

To highlight the association between the use of lithium and the development of delirium following discontinuation of lithium therapy, a condition that substantially increases the risk of psychogenic events and other medical complications.

Method

Physical examination, laboratory studies including measurement of serum calcium and parathyroid hormone levels, measurement of urine osmolalities before and after desmopressin administration and a brain magnetic resonance imaging.

Results

A 49-year-old woman with a background history of bipolar disorder taking lithium presented with severe mania complicated with delirium following discontinuation of lithium therapy.

Conclusion

Mania in the context of lithium therapy may be complicated with delirium. Therefore, mental status should be closely monitored in patients receiving lithium in order to facilitate early detection and intervention of delirium to prevent further health complications.

Keywords: Hypercalcemia, Lithium, Nephrogenic diabetes insipidus

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 No financial support was received for this report. This article has not been submitted either in whole or in part to another journal.

PII: S0163-8343(09)00177-7

doi:10.1016/j.genhosppsych.2009.09.003

General Hospital Psychiatry
Volume 32, Issue 1 , Pages 102-104, January 2010