Abstract

The mechanism of side effect of lithium is also poor understood but probably as a result of excessive effects at therapeutic sites. Tremor is frequently reported to be the most common movement side effects, severe Parkinsonism as a result of neurotoxicity has been reported though rarely.

We present a patient with subacute severe reversible Parkinsonism and acute delirium following long term lithium therapy, misdiagnosed and treated as a case of idiopathic Parkinson’s disease. Factors like advanced age and medications all increase the risk of toxicity.

It is pertinent to take this into consideration when prescribing lithium to prevent dangerous interactions as seen in this patient. Also, providers should understand the wide array of presentation of lithium toxicity to prevent misdiagnosis and unnecessary or harmful treatments.

Keywords: Lithium toxicity; Parkinson’s disease; Bipolar disorder; delirium