The effects of chronic lithium treatment on psychomotor performance related to driving

Article Abstract:

Lithium carbonate is a drug which is commonly used by psychiatric outpatients. Since it does not cause sedation at therapeutic levels, it initially raised little concern in terms of driving safety. Studies evaluating the effects of lithium on the driving skills of psychiatric patients who are in remission and living in the community have yielded inconsistent results. To assess driving safety in persons taking lithium, 16 psychiatric outpatients who were taking lithium with no other medications were compared with 22 healthy volunteers who were not on any type of medication. The patients were all in remission from manic-depressive psychosis, were between the ages of 18 and 65 years, and did not have any other psychiatric diagnosis or neurological disorder. The volunteers were matched with the patients on sex, age and driving experience. A microcomputer and driving simulator, with a steering wheel and two foot pedals which served as the brake and accelerator, were used to assess different measures of reaction time, tracking ability and mistakes (such as missed traffic lights). The screen display included a roadway with changing traffic lights and two arrows moved by the computer. Tracking ability reflected how closely the drivers were able to follow the arrows. Computer analysis demonstrated no significant differences between patients and volunteers in the number of mistakes made. However, patients had a significantly slower reaction time than volunteers, and demonstrated poorer tracking ability. Results suggest that patients and physicians should be warned that lithium may affect driving ability or the ability to operate other machinery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Automobile driving, Motor vehicle driving, Lithium, Lithium (Metal)

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Development of an alcohol withdrawal clinical pathway: an interdisciplinary process

Article Abstract:

Development of an alcohol withdrawal clinical pathway has been carried out in an interdisciplinary process. As many as 40% of all patients in general hospitals are admitted because of complications related to alcoholism. There is little in the way of specific clinical pathways treatment protocols or guidelines for interdisciplinary care for alcohol-dependent patients in the literature. In what is available there is a lack of consistency in recommended treatment regimes. The pathway developed by a team at Denver Health Medical Center identifies the patient, treats symptoms, and includes intervention for the underlying problem.

Care and treatment, Alcoholism, Alcoholism treatment, Drug withdrawal symptoms, Substance withdrawal syndrome

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