Lamotrigine: A Case Study

There is more to the treatment of bipolar disorder than medication, but the medication Lithium has been the primary treatment since the 1960’s. In four studies

Bipolar Disorder is an increasingly common mood disorder that effects millions of people worldwide. In order to understand the plight of any psychiatric patient suffering from this ailment or to be prepared to treat this disease, it is pertinent to first fully understand what this mental disorder truly is. The first misconception surrounding bipolar disorder is that it is just one disease, contrarily it can be divided into two different sub categories. The National Institute for Mental Health defines Bipolar I Disorder as “manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks”. Likewise, they define Bipolar II disorder as “a pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes”.

Lamotrigine is an anticonvulsant drug that has been approved by the FDA; it is used for the treatment of epilepsies and for the maintenance treatment of bipolar disorder. Unlike other conventional antidepressants, lamotrigine can be used for treatment of major depression without inducing mania (17, 59). Lamotrigine is less effective in the treatment of acute mania or acute depression, however it is found to be effective in delaying the onset of mania (60). Several studies has shown that lamotrigine in combination with conventional

Not taking medicine at all or taking the wrong medication will increase mood swings, lower the performance in school, work, and other activities, effect one’s social life. Medicines usually include mood stabilizer such as risperidone, anticonvulsant like lamictal. Some patients who is diagnosed with bipolar II may need antidepressant. The patient has to give the medicine time to work it may take four to six weeks. Along with medication, the patient needs psychotherapy. Therapy is constant help and support for the patients, which may help influence and help cope as well.

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

Jann States that sufferers of BPD are three times more likely to suffer a depressive episode than a manic or hypomanic episode. (Jann, 2014) The Joanna Briggs institute Identified that the suicide rate for bipolar suffers are 15 times higher than that of non-affected individuals of the same age and sex. Eighty percent of these suicides occur during a depressive episode. (Hung Chu, 2016). Therefore appropriate pharmacological therapy not only during the maintenance period to reduce reoccurrence but also during these acute episodes is highly important. Pharmaceutical treatment includes the use of medication such as mood stabilizers, anti-psychotics and anti-depressants. The Joanna Briggs institute recommends that combination therapy involving both mood stabilizers such as Sodium valproate or lithium valproate and antipsychotics risperidone, olanzapine, quetiapine and haloperidol is best to treat acute mania associated with Bipolar. As it increases adherence to medication regime. (Tufanaru, 2016) The same institute encourages the use Olanzapine as a monotherapy or in combination with fluoxetine in the treatment of Depression associated with Bipolar disorder. (Hung chu, 2016) Lithium continues to be the first line mood stabilizer under current guidelines but may be used in conjunction with Carbamazepine where depression is evident. (Hung chu, 2016) The Australian and New Zealand Journal of Psychiatry 2015 also shows preference for combination therapy

Lithium Carbonate is the most commonly drug that is prescribed for treating bipolar disorder (May, Hickey, Triantis, Palazidou, & Kyriacou, 2015). It works as a mood stabilizer that significantly reduces excessive behaviors and suicidal tendencies. However, the way that lithium exerts its impact on mood is still unknown. One study suggests that key of lithium therapeutic actions are the neuroprotective effects (Malhi, Tanious, Das, Coulston, & Berk 2013). For instance, lithium has been demonstrated to decrease the oxidative stress that involves in multiple episodes of mania and depression. Other study recommends that lithium stabilize electrical

Lithium is the medication most extensively used to treat the mania and depression of Bipolar I. However, due to the high incidence of inadequate preventive response, as well as a host of undesirable side effects and a "narrow therapeutic index," health care providers have sought other mood stabilizing medications for either monotherapy or use with Lithium. One such medication is Carbamazepine, used either in monotherapy or in combination with other medications. While pharmacotherapy is classically used to treat Bipolar I Disorder, health care providers are finding that psychosocial treatments can assist in more effective treatment of some facets of the disease, encouraging patient collaboration, participation and education, which ultimately may enhance long-term mood stabilization, occupational and social functioning, and quality of life.

The severe mood fluctuations of bipolar or manic-depressive disorders have been around since the 16-century and affect little more than 2% of the population in both sexes, all races, and all parts of the world (Harmon 3). Researchers think that the cause is genetic, but it is still unknown. The one fact of which we are painfully aware of is that bipolar disorder severely undermines its victims ability to obtain and maintain social and occupational success. Because the symptoms of bipolar disorder are so debilitation, it is crucial that we search for possible treatments and cures.

Based on the possible causes of bipolar disorders, which are thought to be a biological disorder

Bipolar disorder is a chemical imbalance in the mind that has yet to be unwound; it causes numerous emotional episodes that can happen immediately without a word. With a number of mental illnesses to diagnose them, it requires significant time and perception with a health care provider. Treatment is additionally a viewpoint that takes arranging and reflection, generally on how the patient feels in response to the solution that they are taking and different types of treatment. Albeit, bipolar disorder is a complex ailment to diagnose, there are a few option medicines utilized as a part of conjunction with drugs that can be successful in dealing with this mental illness.

Bipolar Disorder, also known as manic/depressive disorder once was a disorder that carried a severe societal stigmatism. It now has carries less stigmatism but is a disorder which has become difficult to diagnosis and extremely prevalent in today’s society. Due to the manic characteristic of the disorder it differentiates itself from the typical form of depression. Even though both depression and bipolar disorder can be due to an imbalance in brain chemistry and biology, genetics, or effected by traumatic stressors that happen in daily life, bipolar disorder has definitive treatment which applies solely to this specific disorder. Bipolar Disorder, as noted in the 2010 Global Burden of Disease Study, is ranked Internationally as the 18th

Bipolar disorder is a chronic illness that is commonly mistreated by physicians in an everyday doctor’s office setting. It has been said that 69% of people with Bipolar Disorder are misdiagnosed because the signs and symptoms present similar to major depressive disorder. With misdiagnosis or without early recognition, physicians can delay proper treatment for 5-10 years (Wieseke, A. et al., Bantz, D., & May, D. 2011, p. 8). While having said it is common to misdiagnose this disorder, only four percent of adults and two percent of children in America are diagnosed (Lorenz, J., 2014, Overview of Bipolar Disorder, para. 3-4). This is a chronic illness and should not be treated lightly because having been diagnosed with Bipolar Disorder can reduce

The field of mental health can be complicated as it involves patients that present with a variety of diagnosis, where every patient may get a different form of treatment and medication. One can say that mental health disorders can be convoluted as the psychiatrists are faced with the arduous task of prescribing medication, via trial and error. Particularly because irregularities are found between the use of antidepressants and bipolar disorder (Bauer et al., 2013). This writer was inspired first hand while having the privilege of fulfilling an internship at Riverside County Mental Health Emergency Services. During that time period, this writer had the opportunity to see different patients that presented acutely with various mental health diagnosis. One case, in particular, was captivating, as the patient, presented with an existing diagnosis of Bipolar 1 but in acute mania. The psychiatrist made a recommendation to start a mood stabilizer along with an anti-psychotic, and recommended avoiding the use antidepressants due to antidepressant-induced mania or rapid cycling. As Vasquez et al. (2013), “Opinions concerning the value of antidepressants to treat bipolar depression vary markedly and reflect the strikingly limited and inconsistent state of available research-based information” (Vasquez et al., 2013, p. 1674). This particular case left this writer thinking if there were any exceptions to the rules of the use of antidepressants when treating Bipolar

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