Researchers analyzed the case of a Chinese-American woman with bipolar disorder who was experiencing extrapyramidal symptoms (EPS) following the re-initiation of lithium carbonate, highlighting a rare but important side effect of this commonly used mood stabilizer. Despite previously tolerating lithium without similar effects, she developed neurological symptoms such as stiffness and restlessness shortly after restarting the medication, emphasizing the need for clinicians to recognize the potential for lithium-induced EPS in patients, regardless of their lithium therapy duration. In this particular case, the patient’s EPS symptoms did not improve with the administration of benztropine, a typical treatment for antipsychotic-induced EPS, and only resolved after lithium discontinuation. This underscores that lithium-induced EPS may not respond to traditional anticholinergic treatments, and discontinuation of lithium may be necessary.
Reference: Orji GI, Mansoor M, Bellegarde SB, et al. Extrapyramidal Symptoms in a Bipolar 1 Patient Following Re-initiation of Lithium: A Case Report. Cureus. 2023 May 22;15(5):e39361. doi: 10.7759/cureus.39361. PMID: 37362457; PMCID: PMC10285111.
