A 46-year-old woman with bipolar disorder has been stable on lithium carbonate for five years. She presents with two days of nausea, vomiting and unsteadiness on her feet, and her hands now shake so coarsely that she spills her tea. Over the past fortnight her general practitioner commenced several new medications for unrelated problems. Her serum lithium concentration is 2.1 mmol/L (therapeutic 0.6-0.8). Which one of the following newly commenced medications is the most likely cause of her presentation?
More from AMC
See allA 17-year-old girl presents six hours after a deliberate ingestion of tablets taken from the family bathroom cabinet. She complains of nausea, repeated vomiting…
A 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…
A 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…
A 26-year-old backpacker is snorkelling off Port Douglas in far north Queensland in December when she feels a mild sting on her forearm, leaving only faint redn…
A 34-year-old man in suburban Sydney felt a sharp pinprick on the back of his hand while moving pot plants stacked against the house. Over the next two hours he…