Bipolar Disorder and the "War on Drugs"
Bipolar disorder, also known as, "manic-depressive illness," is a brain disorder that results in unusual shifts in a person's mood, energy, and ability to function. More than two million American adults (or, about one per cent of the population aged eighteen and older in any given year) are afflicted by this affective disorder (1). Yet, because it cannot be revealed by a blood test or other physiological means, patients may suffer for years before it is properly diagnosed and treated. Fortunately, once one is diagnosed with bipolar disorder, the acute symptoms of the disease can be effectively mitigated by lithium and certain anticonvulsant drugs, the most popular being Depakote (also known as
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One study proclaimed that mania was reduced by 64 per cent, and depression, 46 per cent (3). The duration of both manic and depressive recurrent episodes was also reduced (by 19 and 32 per cent, respectively).
The most striking impact was found for the hospitalization rate, which fell by 82 per cent (3). This has considerable economic significance, as hospitalization accounts for a major proportion of direct costs in major psychiatric illness. It is important to note that all of this evidence far exceeds the available support for possible alternatives to lithium treatment, including application of anticonvulsant, antipsychotic, or sedative agents. Still, investigators have yet to discover the pharmacological effects of lithium that are responsible for its ability to eliminate mania. Many posit that the drug stabilizes the population of certain classes of neurotransmitter receptors in the brain (particularly serotonin receptors), preventing wide shifts in neural sensitivity, and in turn, influencing mood (4).
Unfortunately, however, some patients cannot tolerate the side effects of lithium, and because of the potential danger of overdose researchers have been searching for alternative medications. This spurred the trend of prescribing Depakote. In a review published by the American Psychiatric Association, valproate (Depakote) was reported to be more efficacious than lithium among manic patients with mixed
Aretaeus of Cappadocia began the process of detailing symptoms in the medical field in the early 1st century in Greece. The ancient Greeks and Romans were responsible for the terms “mania” and “melancholia” now known as manic and depression. In 1970, lithium is approved to treat mania. In 1980, bipolar disorder replaces manic-depressive disorder.
The terms ‘manic–depressive illness’ and ‘bipolar disorder’ are comparatively recent, and date back from the 1950s and 1980s respectively. The term ‘bipolar disorder’ (or ‘bipolar affective disorder’) is thought to be less stigmatizing than the older term ‘manic–depressive illness’, and so the former has largely superseded the latter. However, some psychiatrists and some people with bipolar disorder still prefer the term ‘manic–depressive illness’ because they feel that it reflects thenature of the disorder more accurately.
Although the effectiveness of lithium in management of bipolar disorder is well established, health professionals should be aware of the potential major side effects related to long-term lithium treatment.
Lithium is the medication most extensively used to treat the mania and depression of Bipolar I. Marketed under the brand names of Eskalith or Lithobid (Martin, 2011), Lithium is often prescribed as maintenance therapy due to its highly-reported success in reducing the frequency/severity of mania, preventing mania, lessening depression and reducing the risk of suicide (Wyatt, 2011). What is more, researchers have found that the earlier Lithium is used, the higher the reduction of morbidity among
First of all, lithium, or lithium carbonate, is a very effective mood stabilizer (a medication that treats moods extending days to weeks, not moments) first approved by the FDA in the 1970’s. (Google) It was the first mood stabilizer which treated both manic and depressive episodes. Other mood stabilizers include anticonvulsants, medications originally developed to treat seizures (NIMH). This includes LTG. Mood stabilizers vary in their anti-manic and antidepressant effects. Lithium is more effective in treating mania. Lamotrigine is more useful for depressive symptoms. Both medications are Food and Drug Administration (FDA) approved for the prophylactic (preventing disease) treatment of BD, and lamotrigine may be especially effective in rapid-cycling BD. (Merriam Webster,
Previous antidepressant use was linked with an increased risk of an after diagnosis of either mania or bipolar disorder, a risk that happens every year ranging from 1.3 to 1.9 percent. The researchers explained that their findings show a significant connection between antidepressant therapy in patients with unipolar depression and an increased occurrence of mania. They also added that this link stayed the same even after they adjusted factors such as, age and gender in the
Bipolar disorder is a mood disorder that comprises of both maniac episode and ordinarily one or more depressing episodes. The disorder has a lifetime occurrence of 1-2%. Psychological factors such as family environment, life events social support and cognitive style play an integral role on the onset, course, and the whole expression of the ailment. Pharmacology of the disorder is multifarious and speedily evolving field. The development of new methods of treatment has greatly assisted refine concepts of the disorder subtypes and generated significant new management choices. Although mood stabilizers in conjunction with antipsychotics may arguably be the traditional medical options for bipolar disorder, other alternative
Preston, O’Neal & Talaga (2017) explain that Bipolar disorder is set apart from depressive disorder due to its mania or hypomania symptoms. Bipolar disorder is unique in its levels of symptoms and differentiate them from any other diagnosis. The levels of noreepinephrine, serotonin and dopamine are compromised in the brain that throw off the chemical imbalance. Anotherwards, the Dopamine and glutamate levels spike which typical results in a manic state. The use of lithium allows for the noreepinephrine, serotonin and dopamine to function at their optimal levels. Lithium has been in use for over sixty years and has been successful in the reduction of suicide risk (Malhi, Tanious, Das, Coulston & Berk, 2013). “Lithium reduces excitatory
There are not nearly as many treatments for bipolar disorder. In fact, there is only one treatment that seems to have lasting effects. This treatment uses therapy with a professional coupled with medications. “Antibipolar drugs, also called mood stabilizers, help steady the mood of those with a bipolar disorder” (Chapter 2, 2009). The advances in treatment are due to the discovery of lithium as a medication. This drug works extremely well to eliminate manic episodes and even help with the depression. The drugs
Developing what are the therapeutic levels of Lithium should also comment that Lithium is a metal that is not free in nature. Authors determined plasma levels of lithium, recognizing its clinical effects in the acute phase of bipolar disorder in its manic stage and in reducing the frequency and severity of relapses of this mental illness.
Lithium is an antimanic agent labeled for acute treatment and maintenance therapy of bipolar disorder. Off-label it is also used for bipolar depression as well as non-bipolar depression as an addition to standard antidepressant therapy. Although the exact mechanism of action is still unknown, it is thought to influence reuptake of serotonin and/or norepinephrine. Lithium, however, has many potentially severe adverse reactions and warnings including: heart failure, impaired renal function, nephrogenic diabetes insipidus, thyroid disease, and since lithium has a narrow therapeutic index, lithium toxicity is also common. Despite the risks associated with the use of this medication, it continues to be the mainstay for maintenance
A psychoactive drug is a chemical compound that can change out brain function and results in the changing of one’s perception, mood, or consciousness. These substances can be used for the recreation purpose or therapeutic and can alter one's consciousness. Lithium is one of these psychoactive drugs. The different form of salt lithium is used as mood-stabilizing drugs, primarily in the treatment of bipolar disorder, where they have a role in treating depression and, particularly, of mania, both acutely and in the long-term. As a mood stabilizer, lithium is probably more effective in preventing mania than in preventing depression, but it does reduce the risk of suicide in people with bipolar disorder. In depression alone, lithium can be used
Lithium is a top choice for acute mania and for maintenance in ‘classic’ bipolar disorder. Because of its narrow therapeutic range, blood levels must be monitored; also heart and kidney function (EKG, blood and urine tests). Medications such as diuretics, that block its excretion require caution.