Although the combined use of
lithium and
carbamazepine is beneficial in many patients, mild to severe neurotoxicity is reported to have developed in some, and possibly sinus node dysfunction in others.
Monitor the outcome of concurrent use carefully, but note that signs of
toxicity have developed even with
lithium levels within the normal range. Risk factors appear to be a history of neurotoxicity with
lithium therapies and compromised medical or neurological functioning.