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Long-term Therapy With Moderate-Dose Lithium Carbonate

James R. Coppeto, MD; Mario L. R. Monteiro, MD; Simmons Lessell, MD; Leslie Bear, MD; Manuel Martinez-Maldonado, MD

Arch Neurol. 1983;40(12):754-755.

Abstract
• Downbeat nystagmus developed in a 67-year-old hypomagnesemic woman while she was receiving lithium carbonate for depression. This nystagmus abated each time lithium carbonate therapy was withdrawn, and no alternative causes of nystagmus were demonstrated. However, this nystagmus occurred despite serum lithium carbonate levels in the nontoxic range. Total-body magnesium deficiency may have enhanced the toxic effect of lithium carbonate on cerebellomedullary connections.

Author Affiliations
From the Department of Ophthalmology, University of Connecticut Medical Center, Farmington (Drs Coppeto and Monteiro), the Departments of Ophthalmology, Neurology, and Anatomy, Boston University Medical Center (Dr Lessell), and the Departments of Medicine and Physiology, University of Puerto Rico School of Medicine, San Juan (Dr Martinez-Maldonado). Dr Bear is in private practice in Jackson, Miss.

Footnotes
Accepted for publication March 29, 1983.

Reprint requests to 1906 N Main St, Water-bury, CT 06704 (Dr Coppeto).

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