LITHIUM: A(N) (IN)VISIBLE ENEMY?

Abstract

57-year-old woman with a history of bipolar disorder type I. She was stable with lithium carbonate 400 mg id, sodium valproate 250 mg 2id and lorazepam 2.5 mg id. She was admitted to the emergency department after being found with prostration and psychomotor slowing with 5 days of evolution. She was hospitalized for 3 months, with diagnoses of osmolar demyelinating syndrome, with flaccid tetraparesis due to lateral pontic lesions; nephrogenic insipid diabetes secondary to chronic kidney disease (secondary to chronic lithium tubulopathy); acute pancreatitis secondary to chronic lithium intake and dehydration/hypernatremia and hyperparathyroidism secondary to chronic lithium intake. Prescribing a drug involves challenges and it can take more risks than the disease itself.