Toxicology International

Acute High Dose Lithium‑Induced Exacerbation of Obsessive Compulsive Symptoms


Affiliations

  • Central Institute of Psychiatry, Department of Psychiatry, Ranchi, Jharkhand, India

Abstract

Obsessive compulsive disorder (OCD) is a chronic neuropsychiatric disorder whose pathophysiology is linked to serotonergic dysfunction. More recently, the role of glutamate has also been posited. Lithium is used as an adjunctive for the treatment of OCD which is found to enhance serotonergic transmission. We present a case of OCD who was on stable dose of sertraline developed exacerbation of obsessive compulsive symptoms with acute high dose of lithium but improved after dose reduction.

Keywords

Glutamate, lithium, obsessive compulsive disorder

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References

Robins LN, Helzer JE, Weissman MM, Orvaschel H, Gruenberg E, Burke JD Jr, et al. Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 1984;41:949‑58.

Pittenger C, Bloch MH, Williams K. Glutamate abnormalities in obsessive compulsive disorder: Neurobiology, pathophysiology, and treatment. Pharmacol Ther 2011;132:314‑32.

Dixon JF, Los GV, Hokin LE. Lithium stimulates glutamate “release†and inositol 1,4,5‑trisphosphate accumulation via activation of the N‑methyl‑D‑aspartate receptor in monkey and mouse cerebral cortex slices. Proc Natl Acad Sci U S A 1994;91:8358‑62.

World Health Organization. The ICD–10 classification of Mental and Behavioural Diosrders: Diagnsotic Criteria for Research. Geneva: WHO; 1993.

Menzies L, Chamberlain SR, Laird AR, Thelen SM, Sahakian BJ, Bullmore ET. Integrating evidence from neuroimaging and neuropsychological studies of obsessive‑compulsive disorder: The orbitofronto‑striatal model revisited. Neurosci Biobehav Rev 2008;32:525‑49.

Dixon JF, Hokin LE. Lithium acutely inhibits and chronically up‑regulates and stabilizes glutamate uptake by presynaptic nerve endings in mouse cerebral cortex. Proc Natl Acad Sci U S A 1998;95:8363‑8.


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