Lithium Intoxication after Bariatric Surgery: A Case Report

Detalhes bibliográficos
Autor(a) principal: Marques, André Ribeirinho
Data de Publicação: 2021
Outros Autores: Alho, António, Martins, João Malhadas, Bairrão, Margarida
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868
Resumo: Bariatric surgery is a therapeutic option to treat obesity in (carefully selected) patients with psychiatric disorders. About half of the patients referred for bariatric surgery have a diagnosis of (at least one) mental disorder and most of them are treated with psychotropic drugs. This procedure may modify the bioavailability of drugs and lithium is no exception. However, although absorption seems to decrease in most drugs, in the case of lithium, there is a high risk of toxicity. In this article, we describe the case of a 44-year-old female patient with lithium intoxication after bariatric surgery. We conducted a review of the published clinical cases in the scientific literature about lithium toxicity after bariatric surgery, and we propose potential preventive clinical solutions. It is essential to increase awareness of changes to the absorption of psychotropic drugs in the post-surgery period, particularly in the case of lithium. Regular postoperative clinical and laboratory monitoring of lithium serum levels is strongly recommended.
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spelling Lithium Intoxication after Bariatric Surgery: A Case ReportIntoxicação por Lítio após Cirurgia Bariátrica: Um Caso ClínicoBariatric SurgeryLithium /adverse effectsLithium/poisoningCirurgia BariátricaLítio/efeitos adversosLítio/intoxicaçãoBariatric surgery is a therapeutic option to treat obesity in (carefully selected) patients with psychiatric disorders. About half of the patients referred for bariatric surgery have a diagnosis of (at least one) mental disorder and most of them are treated with psychotropic drugs. This procedure may modify the bioavailability of drugs and lithium is no exception. However, although absorption seems to decrease in most drugs, in the case of lithium, there is a high risk of toxicity. In this article, we describe the case of a 44-year-old female patient with lithium intoxication after bariatric surgery. We conducted a review of the published clinical cases in the scientific literature about lithium toxicity after bariatric surgery, and we propose potential preventive clinical solutions. It is essential to increase awareness of changes to the absorption of psychotropic drugs in the post-surgery period, particularly in the case of lithium. Regular postoperative clinical and laboratory monitoring of lithium serum levels is strongly recommended.A cirurgia bariátrica é uma opção terapêutica no tratamento da obesidade em doentes, selecionados cuidadosamente, com perturbação psiquiátrica. Cerca de metade dos doentes referenciados para cirurgia bariátrica têm diagnosticada, pelo menos, uma perturbação mental, estando a maioria medicada com psicofármacos. Este procedimento pode alterar significativamente a biodisponibilidade dos fármacos e o lítio não é exceção. Contudo, apesar da absorção parecer diminuir na maioria dos fármacos, no caso do lítio existe um elevado risco de toxicidade. Neste artigo, descreve-se o caso de uma doente de 44 anos com um quadro de intoxicação por lítio pós-cirurgia bariátrica. Realizou-se uma revisão dos casos clínicos descritos na literatura de toxicidade ao lítio pós-cirurgia bariátrica e apresentam-se potenciais soluções clínicas preventivas. É essencial uma maior consciencialização das alterações na absorção dospsicofármacos pós-cirurgia, particularmente no caso do lítio. Recomenda-se fortemente uma monitorização, de forma mais regular, pós-cirúrgica clínica e laboratorial dos níveis séricos de lítio.Ordem dos Médicos2021-05-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868oai:ojs.www.actamedicaportuguesa.com:article/12868Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 382-386Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 382-3861646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/6130https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/11866https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/11902https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/12063Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessMarques, André RibeirinhoAlho, AntónioMartins, João MalhadasBairrão, Margarida2022-12-20T11:06:43Zoai:ojs.www.actamedicaportuguesa.com:article/12868Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:14.687961Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Lithium Intoxication after Bariatric Surgery: A Case Report
Intoxicação por Lítio após Cirurgia Bariátrica: Um Caso Clínico
title Lithium Intoxication after Bariatric Surgery: A Case Report
spellingShingle Lithium Intoxication after Bariatric Surgery: A Case Report
Marques, André Ribeirinho
Bariatric Surgery
Lithium /adverse effects
Lithium/poisoning
Cirurgia Bariátrica
Lítio/efeitos adversos
Lítio/intoxicação
title_short Lithium Intoxication after Bariatric Surgery: A Case Report
title_full Lithium Intoxication after Bariatric Surgery: A Case Report
title_fullStr Lithium Intoxication after Bariatric Surgery: A Case Report
title_full_unstemmed Lithium Intoxication after Bariatric Surgery: A Case Report
title_sort Lithium Intoxication after Bariatric Surgery: A Case Report
author Marques, André Ribeirinho
author_facet Marques, André Ribeirinho
Alho, António
Martins, João Malhadas
Bairrão, Margarida
author_role author
author2 Alho, António
Martins, João Malhadas
Bairrão, Margarida
author2_role author
author
author
dc.contributor.author.fl_str_mv Marques, André Ribeirinho
Alho, António
Martins, João Malhadas
Bairrão, Margarida
dc.subject.por.fl_str_mv Bariatric Surgery
Lithium /adverse effects
Lithium/poisoning
Cirurgia Bariátrica
Lítio/efeitos adversos
Lítio/intoxicação
topic Bariatric Surgery
Lithium /adverse effects
Lithium/poisoning
Cirurgia Bariátrica
Lítio/efeitos adversos
Lítio/intoxicação
description Bariatric surgery is a therapeutic option to treat obesity in (carefully selected) patients with psychiatric disorders. About half of the patients referred for bariatric surgery have a diagnosis of (at least one) mental disorder and most of them are treated with psychotropic drugs. This procedure may modify the bioavailability of drugs and lithium is no exception. However, although absorption seems to decrease in most drugs, in the case of lithium, there is a high risk of toxicity. In this article, we describe the case of a 44-year-old female patient with lithium intoxication after bariatric surgery. We conducted a review of the published clinical cases in the scientific literature about lithium toxicity after bariatric surgery, and we propose potential preventive clinical solutions. It is essential to increase awareness of changes to the absorption of psychotropic drugs in the post-surgery period, particularly in the case of lithium. Regular postoperative clinical and laboratory monitoring of lithium serum levels is strongly recommended.
publishDate 2021
dc.date.none.fl_str_mv 2021-05-02
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868
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dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/6130
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/11866
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/11902
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12868/12063
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2020 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 382-386
Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 382-386
1646-0758
0870-399X
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