Lithium Intoxication Due to Carbamazepine-Induced Renal Failure

Abstract

OBJECTIVE:

To report the case of a patient with manic—depressive disorder who developed lithium intoxication following carbamazepine-induced acute renal failure.

CASE SUMMARY:

A 33-year-old white man with bipolar manic—depressive disorder was treated with lithium for the last 18 months. Three weeks prior to admission, carbamazepine 600 mg was added to the drug regimen due to a recurrence of the psychiatric disorder. He was admitted with signs of lithium intoxication. Acute renal failure due to carbamazepine-induced interstitial nephritis was diagnosed.

DISCUSSION:

The combination of carbamazepine and lithium is known to cause neurotoxicity. We describe a different interaction in which the toxic lithium concentrations were the result of carbamazepine-induced acute renal failure.

CONCLUSIONS:

When considering adding carbamazepine to lithium, careful follow-up of the patients is warranted to prevent this indirect drug interaction.