Correlation of Neuroleptic Dose and Neurotoxicity in Patients Given Lithium and a Neuroleptic Brief Reports

A combination of lithium carbon-ate and a neuroleptic is frequently used in the treatment of bipolar disorder. Nevertheless, lithium-neuroleptic combinations have been under scrutiny by numerous investigators ( 1,2) ever since the public4tion of Cohen and Cohen’s report (3) of neurotoxicity follow-ing combined use of lithium and halopenidol. Most studies have concluded that judicious use of combinatjons of lithium and a neu-roleptic is helpful and safe. How-ever, reports suggesting that they may be hazardous continue to ap-pear (4). In this study we conducted a retrospective examination of the records of 90 patients admitted to a 104-bed acute care psychiatric division of a general hospital, all of whom had been given a discharge diagnosis of bipolar disorder. Thin-ty were manic type, 30 depressed type, and 30 mixed type. We were interested in determining the fre-quency with which combiiations of lithium and a neuroleptic were administered in these subgroups of patients and the frequency with which the combined treatment me-suited in neumotoxicity. The pa