Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The familial transmission risk of developing bipolar disorder for first=degree relatives of the patient is 1.5-10.2%, however, the risk of any affective primary disorder is 15-20% in such relatives. Pregnancy places additional stress on patients, and physiological changes are particularly acute during postpartum. The risk of abnormalities and teratogenicity from psychotropic drugs is significant: taking of phenothiazines, tricyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines, lithium, valproate, and clonazepam require extreme caution. In 225 pregnancies exposed to lithium in the 1st trimester congenital malformations occurred in 11%. Premature birth and macrosomia may also increase, thus halting lithium well before planned conception with weekly serum monitoring is advised. Recurrence of the illness can be managed by electroconvulsive therapy. About 40% of patients can experience postpartum mania or depression. Taking drugs up to delivery can result in behavioral teratogenesis in the neonate even in the absence of physical malformations. Lithium toxicity causes lethargy, hypotonia, tachycardia, coma, cyanosis, and chronic twitching in the newborn. Breast feeding is discouraged in women taking lithium because of the high rate of transmission to the infant. The stress of parenting can also trigger relapses of the disease. The deleterious effect of a manic or depressive mother on the child's development is manifested in criticism and stressing achievement often leads to low self-esteem. It behooves the psychiatrist to frankly reveal the risks of pregnancy to couples who wish to have a child or to advise about the pregnancy to term so they can make an informed decision.
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PMID:Family planning for women with bipolar disorder. 158 11

Lithium toxicity is usually insidious in onset and presents with a wide spectrum of clinical symptoms. Symptoms vary from mild lethargy to seizures and coma. Although mild to moderate intoxication can be managed with intravenous saline, cases not responding or severe cases should be treated by hemodialysis. Iatrogenic fluid and electrolyte disorders often complicate therapy.
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PMID:Management of lithium intoxication. 642 90

Psychotropic drugs, as well as some psychiatric disorders, can produce neurotoxic and life-threatening abnormalities of water and electrolyte balance that require prompt and appropriate medical intervention. Compulsive fluid intake by psychotic patients (primary polydipsia) can produce delirium due to water intoxication with hyponatremia. Several psychotropic drugs cause water retention by decreasing renal clearance, as in the syndrome of inappropriate antidiuretic hormone secretion. Lithium and other agents interfere with renal resorption of water to cause nephrogenic diabetes insipidus. Clinical signs in these disorders range from lethargy and confusion to stupor, seizures, coma, and death. This overview provides a conceptual framework for differentiating among and safely managing these relatively common disorders.
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PMID:Primary and drug-induced disorders of water homeostasis in psychiatric patients: principles of diagnosis and management. 1037 Apr 44

The purpose of this study was to review the use of lithium in pregnancy and its effects on the neonate. This was a case study and review of the published literature. Lithium is commonly used in the treatment of psychiatric disorders, specifically bipolar depression. Bipolar disorders that require treatment with lithium demand special consideration when the woman becomes pregnant. Reported neonatal problems with maternal lithium therapy include Ebstein's anomaly, poor respiratory effort and cyanosis, rhythm disturbances, nephrogenic diabetes insipidus, thyroid dysfunction, hypoglycemia, hypotonia and lethargy, hyperbilirubinemia, and large-for-gestational-age infants. Lithium can have adverse effects on the fetus and newborn infant, but data suggest normal behavioral patterns in childhood.
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PMID:Case report and review of the perinatal implications of maternal lithium use. 1211 21

Lithium has many medical and psychiatric uses. These include cluster and migraine headaches, alcoholism, impulsive behavior, and bipolar disorder. Toxicity from lithium can occur by overdose (intentional or accidental) or, more commonly, from alteration in its clearance by the kidney. We present two cases of lithium toxicity. The first is a 57-year-old male who presented with confusion, ataxia, and lethargy. The second case involves a 52-year-old female with bizarre behavior who was unable to care for herself. Both patients received dialysis and recovered without sequelae.
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PMID:Lithium toxicity: two case reports. 1213 13

Lithium medication during pregnancy is uncommon and the problems of a neonate who has been exposed to lithium represents a rare situation in neonatology. The clinical presentation and management of a newborn whose mother received lithium during pregnancy is presented. The newborn manifested a four day course of lethargy with unexplained high lithium levels in the adult toxic range. The infant improved clinically under intravenous hydration therapy, nevertheless lithium serum levels increased again and we did not know for certain if our clinical instinct or the actual figures were correct. Finally we noticed that our confusion had resulted from test tubes containing lithium heparine.
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PMID:Lethargy in a newborn: lithium toxicity or lab error? 1295 92

Lithium is the treatment of choice for acute manic, mixed, and depressive episodes of bipolar disorder, along with long-term prophylaxis. A significant proportion of patients taking lithium develop lithium-associated hypercalcemia. Most cases are due to lithium-associated hyperparathyroidism with underlying parathyroid adenoma or hyperplasia. We present a 67-year-old woman who presented with increasing lethargy and loss of concentration and was found to have slightly raised serum calcium levels with inappropriately low urinary calcium excretion levels characteristic of hypocalciuric hypercalcemia. She had been on lithium therapy for over 15 years for bipolar disease. She had no other cause for these findings and had no family history to suggest familial hypocalciuric hypercalcemia. Neck imaging ruled out any parathyroid adenoma or hyperplasia. A diagnosis of lithium-associated hypocalciuric hypercalcemia was discussed with the patient, and she remains stable under surveillance.
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PMID:A Case of Lithium-Associated Hypocalciuric Hypercalcemia. 3298 44