Lithium Neurotoxicity Due to Second-Generation Antipsychotics Combined With Lithium: A Systematic Review


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Lithium neurotoxicity can occur when lithium is combined with SGAs. Early detection and prompt management are needed. Do you know the causative factors?

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Lithium Neurotoxicity Due to Second-Generation Antipsychotics Combined With Lithium: A Systematic Review

© Copyright 2019 Physicians Postgraduate Press, Inc.

Target Audience

Primary care clinicians

Learning Objectives

Increase prevention and early detection of lithium neurotoxicity

Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
Activity expires: 

CME Background

Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.

CME Objective

After studying this article, you should be able to:

  • Increase prevention and early detection of lithium neurotoxicity

Statement of Need and Purpose

Clinicians report using guidelines for monitoring lithium use, but studies have shown discrepancies between guideline recommendations and actual monitoring of lithium in clinical practice. Many clinicians depend on a “trial and error” approach to prescribing lithium. Clinicians need education about the risk of combining lithium with SGAs in order to minimize adverse effects and toxicity. Clinicians also need education to help patients understand drug interactions with lithium, the need for adequate hydration, and when to contact their physician about possible toxicity.

Release, Expiration, and Review Dates

This educational activity was published in May 2019 and is eligible for AMA PRA Category 1 Credit™ through June 30, 2021. The latest review of this material was May 2019.

Disclosure of off-label usage

The authors have determined that, to the best of their knowledge, no investigational information about pharmaceutical agents that is outside US Food and Drug Administration–approved labeling has been presented in this article.



Faculty Affiliation

Ivan Netto, MBBS, MD*
Department of Psychiatry, Byramjee Jeejeebhoy Medical College and Sassoon General Hospital, and Parmar Plaza Clinic, Wanowrie, Pune, Maharashtra, India

Vivek H. Phutane, MBBS, MD, FRANZCP
Department of Rural Health, Melbourne Medical School, The University of Melbourne, Melbourne, and Department of Psychiatry, Goulburn Valley Area Mental Health Service, Shepparton, Victoria, Australia

Bipin Ravindran, MBBS, MD, FRANZCP
Hunter New England Health Services, Mental Health Centre, The Mater Hospital, Waratah, New South Wales, Australia

*Corresponding author: Ivan Netto, MBBS, MD, E-10 Parmar Plaza Clinic, Parmar Plaza, Shivarkar Rd, Pune 411001, Maharashtra, India (

Financial Disclosure

All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Larry Culpepper, MD, MPH, Editor in Chief of The Primary Care Companion for CNS Disorders, has been a consultant for Alkermes, Harmony Biosciences, Merck, Shire, Supernus, and Sunovion. No member of the CME Institute staff reported any relevant personal financial relationships.

Drs Netto, Phutane, and Ravindran have no personal affiliations or financial relationships with any commercial interest to disclose relative to this article.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation


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