What is Lithium-Ibuprofen neurotoxicity?

Question

Hi doctor,

I am a 27-year-old female. I have been taking Lithium 1200 mg for five years. Last year, I got an injury, and it required regular pain management. So I was told to take Ibuprofen at a maximum dose. Within a week, I developed ataxia, muscle weakness, and spasticity, memory loss, polyuria, incontinence, tremors, blue hands, chest pain, weakness, and inability to lift my legs.

I was referred for an evaluation for multiple sclerosis and Parkinson's disease. My symptoms began to get reduced when I stopped taking NSAIDS. I have been prescribed them again at a maximum dose after surgery, and I was hospitalized for the same symptoms. My kidney function was normal. I was unaware that NSAIDS can cause serious complications in lithium users by causing toxicity.

My symptoms matched the symptoms of lithium toxicity. However, all the laboratory tests did not demonstrate any kidney problems. Is it possible to have neurological or lithium toxicity due to these medications without involving the kidneys? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

It is purely a drug-to-drug interaction, and it is well known with lithium. In fact, lithium interacts with many drugs, and it is one of the drugs with a narrow therapeutic index. The symptoms of lithium toxicity can develop even in the absence of kidney damage, as they are mainly caused by increased lithium concentration in the blood.

You have not mentioned the reason for taking Lithium. It is necessary to check your blood levels at regular intervals and not take any medications without consulting the doctor.

I hope this helps.

Kindly revert in case of further queries.

Thank you.