| Lithium toxicity after switch from fosinopril to lisinopril. | |
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MedLine Citation:
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PMID: 15729089 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is a small body of literature on the interactions between lithium and angiotensin-converting enzyme inhibitors (ACEIs), but little data documenting the differences between these agents in their impact on serum lithium levels. We present the case of a 46-year-old male who sustained a five-fold increase in his serum lithium level after switching from fosinopril to lisinopril, with a peak serum lithium level of 3.4 meq/l. There was also an increase in serum creatinine from 1.1 on fosinopril to 1.4 after switching to lisinopril. The patient was hospitalized, and intravenously hydrated with 0.5 normal saline, with a reduction of the serum lithium level to 0.7 meq/l by 72 h after admission. The hospital course was marked by two episodes of bradycardia, but was otherwise uneventful, and the patient was discharged without any neurological sequelae. This case demonstrates that ACEIs may have differential effects on renal function, and the potential for significant alterations in lithium clearance that may not be clinically evident for several weeks. Lithium-treated patients who have a change in ACEI, especially those who are older or have below average renal function, must have diligent monitoring for the first 4-6 weeks after switching to detect potentially serious changes in serum lithium levels. |
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Authors:
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Jonathan M Meyer; Adrian Dollarhide; In-Lin Tuan |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: International clinical psychopharmacology Volume: 20 ISSN: 0268-1315 ISO Abbreviation: Int Clin Psychopharmacol Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-24 Completed Date: 2005-07-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8609061 Medline TA: Int Clin Psychopharmacol Country: England |
Other Details:
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Languages: eng Pagination: 115-8 Citation Subset: IM |
Affiliation:
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Department of Psychiatry, Veterans Affairs San Diego Healthcare System, University of California, San Diego, CA 92161, USA. jmmeyer@ucsd.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin-Converting Enzyme Inhibitors
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adverse effects*,
therapeutic use Antimanic Agents / adverse effects*, blood Bipolar Disorder / drug therapy, psychology Bradycardia / chemically induced Fosinopril / adverse effects*, therapeutic use Heart Rate / drug effects Humans Lisinopril / adverse effects*, therapeutic use Lithium / adverse effects*, blood Male Middle Aged Psychotic Disorders / drug therapy, psychology |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Antimanic Agents; 7439-93-2/Lithium; 83915-83-7/Lisinopril; 98048-97-6/Fosinopril |
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