Background: The human immunodeficiency virus (HIV) infection is a chronic disease with significant comorbidity with mental disorders. Patients with mental health problems are at an increased risk of contracting HIV and infected patients are also at an increased risk of developing mental health problems, both cases contributing to a worse global prognosis. This cross-sectional study intends to characterize a sample of patients followed in a psychiatric department in order to understand the crucial role of Liaison Psychiatry in this area.
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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