Chlorpromazine levels can be reduced to subtherapeutic concentrations by lithium
, and one study suggested that lithium
may reduce olanzapine plasma
may increase amisulpride levels. The development of severe extrapyramidal adverse effects or severe neurotoxicity has been seen in one or more patients given lithium
, chlorprothixene, clopenthixol, clozapine
, flupen- tixol, fluphenazine, haloperidol
, levomepromazine, loxapine, mesoridazine, molin- done, olanzapine
, sulpiride, thioridazine, tiotixene, trifluoperazine or zuclopenthixol. Sleep-walking has been described in some patients taking chlorpromazine-like drugs and lithium
. Additive QT-prolonging effects also possible, see drugs that prolong the QT interval.
Monitor the outcome of concurrent use being aware that on occasion dosage adjustments may be needed to manage adverse effects. Withdraw one or both drugs if severe neurotoxicity occurs.