Lithium toxicity, coumadin & delirium

[momsmeds]

Can chronic prescribed use of lithium carbonate in an 85 year old elderly patient being treated for bi-polar disorder/depression for past five years coupled with recent prescription of coumadin (within the past 2 months) cause lithium toxicity manifested by delirium symptoms in the elderly patient, as well as very low heart rate? Delirium in this instance manifested as inability to communicate & sudden onset of just muttering and moaning within a week's timeframe, after previously being able to effectively communicate with caretakers by talking.

[ILADVOCATE]

Might be a potential but you also have to see what other prescription and non prescription medications she is taking and make a list and have her see a doctor right away. What you describe is dangerous and her doctor could check for interactions and know what to do. In the meantime you could also post the question in the "ask a pharmacist" forum as we can't give medical advice, just our opinion.

[momsmeds]

Thanks for your quick reply. Much appreciated.

[jimgreg]

the only way that this would happen is if the patient is on a ace inhibitor for blood p..or the kidney funcshion is ver high..like the creatine is above 1.7   the (GFR) IS BELOW 59.....THIS IS EVEN A LONG SHOT...NOW THERE IS ONE MORE THING IM AWARE  OF SINCE I DID GO SEVRE TOXIC MYSELF IS THAT WHEN YOUR ON COUMADIN IF YOU DEHYDRATE THE LITHIEM SEREM LEVELS WILL RISE TO TOXIC LOW LEVELS EVEN LIKE 1.0-01.2......AND THE COUMMIDAN LEVELS WILL BE THE PT INR  WILL BE BETWEEN 3.0  -4.2   ONLY IF PATIENT IS SEVRE DEHYDRATED THIS IS VERY UNCOMMON IN THE DURATION OF THE LITHIUM CARBONATE...THE ONLY WAY I COULD SEE THIS I A WEEK PERIOD WOULD BE SEVRE RENAL  END STGE....