Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case reported concerns a symptomatic transitory sinus node abnormality in a 75 years old woman treated with Lithium Carbonate (750 mg/d) for a manic-depressive psychosis. This patient, admitted to the hospital for bradycardia and repeated episodes of syncope was shown to present sinus pauses greater than 3 seconds. Lithium therapy was discontinued. 72 hours later electrophysiologic studies, performed to evaluate sinus node function, were normal. It is therefore the author's opinion that in patients receiving Lithium therapy who present syncope, dizziness, or bradycardia a sinus node abnormality of iatrogenic origin must be considered. The importance of this diagnosis is in the rapid reversibility of the sinus node dysfunction with discontinuation of therapy.
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PMID:[Reversible sinus dysfunction during treatment with lithium carbonate]. 31 73

Lithium salts have been widely used for several years in the treatment of manic-depressive psychosis. Various side-effects of lithium salts have been described. The present case report present two patients in whom sinus node dysfunction leading to syncope was caused by lithium. One of the cases showed signs of depressed sinus node function even when not on lithium, but no symptoms arose until lithium treatment was commenced. The second case showed no signs of depressed sinus node function when lithium was withdrawn. To study the prevalence of sinus node dysfunction in patients on lithium therapy, 97 consecutive patients on lithium were examined. The examination included case history, ECG and carotid massage. In two patients lithium could not be ruled out as being responsible for sinus node depression and in one patient the same was true for the atrioventricular node. None of these patients had any symptoms. It is concluded that lithium treatment may result in sinus node dysfunction. This side-effect is, however, not common. Lithium treatment can obviously be instituted in all patients without a history suggesting sinus node dysfunction. Patients with a history of dizziness and/or syncope should not be given lithium until thorough cardiological examination has been carried out. Likewise, a cardiological examination should be performed if patients on lithium develop symptoms of this type.
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PMID:Syncope caused by lithium treatment. Report on two cases and a prospective investigation of the prevalence of lithium-induced sinus node dysfunction. 37 17

In a double-blind study, effects of lithium on skilled performance, information processing, and mood were studied in 12 healthy men. Lithium was administered for 1 week and the average, steady state, serum lithium concentration on the morning of testing was 0.8 mEq/liter. Lithium had a non-specific, minor, but consistent effect of prolonging reaction times. Most subjects reported increased anxiety, faintness-dizziness, nervousness-shakiness, and feeling "blue" during and immediately after lithium treatment.
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PMID:Effects of one-week lithium treatment on skilled performance, information processing, and mood in healthy volunteers. 380 28

(1) Lithium is the first-line treatment for patients with acute mania. For patients with psychosis or intense agitation, an oral neuroleptic can be added (haloperidol or chlorpromazine, the best-assessed drugs of this class). (2) The licensed indications for oral olanzapine, a neuroleptic, explicitly mention the treatment of acute mania. (3) The clinical evaluation dossier on olanzapine in this setting (10 mg to 15 mg/day) is not particularly impressive. In particular, clinical trials included patients with a variety of associated psychotic symptoms. (4) The only comparative trial against another neuroleptic, haloperidol at a high starting dose (10 mg), showed that olanzapine was no more effective. The same applies to a trial comparing olanzapine with disodium valproate. (5) One placebo-controlled trial tested olanzapine as an additional treatment in patients who did not respond adequately to lithium or valproate disodium. Olanzapine potentiated the antimanic effects of the original treatment but also increased the incidence of adverse effects. (6) In patients with acute mania, the main adverse effects of olanzapine are drowsiness, weight gain, dizziness, and dry mouth. In the trial comparing olanzapine with haloperidol, olanzapine caused fewer extrapyramidal side effects but more weight gain than haloperidol. (7) Olanzapine costs 20 times more than haloperidol in France. (8) In practice, olanzapine is just another neuroleptic approved for the treatment of acute mania in patients with psychotic symptoms and agitation. There is no evidence that olanzapine has the best risk-benefit ratio in this category.
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PMID:Olanzapine: new indication. New indication in acute mania: just another neuroleptic. 1514 54