Which of the following is a known adverse effect of lithium?

Patients on lithium chronically may develop iatrogenic hypothyroidism. (Approx. 5% of patients taking the drug > 18 months.) Lithium exes this effect by interfering with the synthesis and release of thyroid hormone. Thus any patient experiencing prolonged depressive symptoms while taking lithium needs to have his/her thyroid assessed Agranulocytosis is commonly repoed for patients taking the atypical antipsychotic drug clozapine or carbamazepine, which is sometimes employed as a second-line treatment for bipolar disorder. Altered judgement is incorrect. Neurological side effects of lithium include tremor, chorea athetosis, ataxia, motor hyperactivity, dysahria, and aphasia. Lithium is not known to cause aplastic anemia. Aplastic anemia is a serious potential adverse effect of the mood stabilizer carbamazepine. Carbamazepine would present an alternative to lithium in this patient, but a periodic blood count must be performed to assess for aplastic anemia Ref: Meyer J.M. (2011). Chapter 16. Pharmacotherapy of Psychosis and Mania. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.