Bipolar Disorder and the Essay

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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…

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