A utilização do lítio no transtorno afetivo bipolar e seus efeitos adversos, evidenciando a ataxia cerebelar
Keywords:
Bipolar disorder, Mania, lithium carbonate, ataxia, neurotoxicityAbstract
The bipolar affective disorder is a psychiatric condition that involves episodes of change in mood (depression or mania). The etiology of the disease is not properly known, but many studies point to the existence of complex disorders, including changes in receptor and post-receptors of neurotransmitters. As treatment of this pathology, there are several classes of medicines that have been used as therapeutic strategies to address major problems that the patient is exposed to. Within the area of drug therapy, lithium is still used the most, although side effects are often observed in the literature, they may bring serious consequences to the patient of Bipolar affective disorders. The present article is a literature review based on sites Pubmed, Medline, Lilacs and Scielo, including articles between the period from 1998 to 2009. The aim is to clarify one of the most common adverse effects in the use of lithium in the treatment of bipolar disorder: the cerebellar ataxia.
References
ALDA, M. Transtorno bipolar. Rev. Bras. Psiquiatr., v. 21, suppl.2, p. 14-17, 1999.
AZEVEDO, Y; MARQUES, C. A; IACOPONI, E. Ataxia prolongada associada à intoxicação por lítio. Casos clínicos Psiquiatria, v. 2, n. 1, p. 18-20, 2000.
FROSCH, M. P; ANTHONY, D. C; de GIROLAMI, U. O sistema nervoso central. In: ROBBINS, S. L; COTRAN, R. S. Patologia: bases patológicas das doenças. Tradução: Maria da Conceição Zacarias et al. 7. ed. Rio de Janeiro: Elsevier, 2005. cap. 28.
GOODWIN, G. M. Consensus Group of the British Association of Psychopharmacology. Evidence - Based Guidelines for Treating Bipolar Disorder: Recomendations from the British Association for Psychopharmacology. J Psychopharmacol., v. 17, p. 149-173, 2003.
LACERDA, A. L. T; SOARES, J. C; TOHEN, M. O papel dos antipsicóticos atípicos no tratamento do transtorno bipolar: revisão da literatura. Rev. Bras. Psiquiatr., v. 24, n. 1, p. 34-43, 2002.
LAFER, B; SOARES, M. B. M. Tratamento da depressão bipolar. Rev. Psiq. Clín., v. 32, supl 1, p. 49-55, 2005.
LANG, E. J; DAVIS, S. M. Lithium neurotoxicity: the development of irreversible neurological impairment despite standard monitoring of serum lithium levels. Journal of Clinical Neuroscience, v. 9, n. 3, p. 308-309, 2002.
NIETHAMMER, M; FORD, B. Permanent lithium-induced cerebellar toxicity: three cases and review of literature. Movement Disorders, v. 22, n. 4, p. 570-573, 2007.
ROCCA, C. C. A; LAFER, B. Alterações neuropsicológicas no transtorno bipolar. Rev Bras Psiquiatr., v. 28, n. 3, p. 226-237, 2006.
SANCHES, M; ROBERTO, J. M. Transtorno afetivo bipolar: um enfoque transcultural. Rev. Bras. Psiquiatr., v. 26, supp l.3, p. 54-56, 2004.
SOARES, J. C; GERSHON, S. The lithium ion: a foundation for psychopharmacological specificity. Neuropsychopharmacology, v. 19, p. 167-182, 1998.
TAMADA, R. S; LAFER, B. Indução de mania durante o tratamento com antidepressivos no transtorno bipolar. Rev. Bras. Psiquiatr., v. 25, n. 3, p.171-176, 2003.
YAZICI, O. et al. Predictors of lithium prophylaxis in bipolar patients. J Affect Disord., v. 55, p. 133-142, 1999.
