And mania

G. L. Gessa, W. Fratta, L. Pani, and G. Serra, Depression and Mania From Neurohiology to Treatment, Lippincott-Raven, Hagerstown, Md., 1995, p. 1. 

Depression and mania are both affective disorders but their symptoms and treatments are quite distinct. Mania is expressed as heightened mood, exaggerated sense of self-worth, irritability, aggression, delusions and hallucinations. In stark contrast, the most obvious disturbance in depression is melancholia that often co-exists with behavioural and somatic changes (Table 20.1). Some individuals experience dramatic mood swings between depression and mania. This is known as "bipolar disorder which, like mania itself, is treated with lithium salts or neuroleptics. 

Suicidality, Violence and Mania Caused by Selective Serotonin... 

Baldessarini, R., Drugs and the treatment of psychiatric disorders depression and mania, in Goodman and Gilman s The Pharmacological Basis of Therapeutics, 9th ed., Hardman, J.G. and Limbird, L.E., Eds., McGraw-Hill, New York, 1996,... 

Table 12.1. Symptoms of the affective disorders major depression and mania. 

Affective disorders A group of psychoses characterised by a pathological and long-lasting disturbance of mood or affect. They include the unipolar disorders (e.g., depression and mania), and bipolar disorders (e.g., manic depression). 

Unipolar disorder An affective disorder characterised by chronic dysphoria. The two contrasting forms of unipolar disorder are major depression and mania. 

Giannelis, E. P., Krishnamoorti, R. and Manias, E. Polymer-Silicate Nanocomposites Model Systems for Confined Polymers and Polymer Brushes. Vol. 138, pp. 107-148. 

Giannelis, E.P., Krishnamoorthy, R. and Manias, E. (1999) Polymer-silicate nanocomposites Model systems for confined polymers and polymer brushes. Advances in Polymer Science, 138, 107-147. 

There is evidence for the contribution of serotonin dysfunction to mania, and in the mechanism of action of mood stabilizers [19], however, specific data on the serotonergic system and mania are fewer and variable. Moreover, altered functioning of other neurotransmitters in mania such as norepinephrine, dopamine, acetylcholine, and GABA, and their interaction with serotonin, are also likely to be involved in the pathogenesis of mood disorders. Differences in these neurotransmitter systems possibly underlie differences in the pathogenesis of depressive and manic episodes. 

The effects of Li+ upon this system have been reviewed in depth by Mork [131]. Animal studies originally demonstrated that Li+ inhibits cAMP formation catalyzed by adenylate cyclase in a dose-dependent manner [132]. The level of cAMP in the urine of manic-depressive patients changes with mental state, being abnormally elevated during the switch period between depression and mania it is proposed that Li+ s inhibitory effect upon adenylate cyclase activity may correct this abnormality. Subsequent research, in accord with the initial experiments, have shown that Li+ s interference with this second messenger system involves more than one inhibitory action. At therapeutic levels, Li+ inhibits cAMP accumulation induced by many neurotransmitters and hormones, both in... 

Koller, J., Baumer, U. and Mania, D. (2001). High-tech in the middle Palaeolithic Neandertal-manufactured pitch identified. European Journal of Archaeology 4 385-397. 

Emotions are subjective mood states that interact reciprocally with cognitive processes. Personality refers to traits of emotion and behavior that are more stable over time. Normal and pathological emotional states can be measured, to some degree, with objective tests to quantify changes in mood over time (or after drug treatment). Thus, several clinical scales have been developed for anxiety, depression, and mania. These measures are particularly useful for evaluating the effectiveness of psychotherapeutic herbs. 

Shock Therapy. The early 20th century saw the development of the first effective biological treatments for depression, the shock therapies. The first shock treatments used injection of horse serum or insulin. A major advance in treatment occurred with the advent of electroconvulsive therapy (ECT) in 1934. Although initially used to treat schizophrenia, ECT was soon found to be highly effective for other psychiatric disorders including depression and mania. ECT remained the primary biological psychiatric treatment until the widespread release of psychiatric medications in the 1950s. 

It is common for both the depressive and manic phases to occur simultaneously in what is termed a mixed state or dysphoric mania. During these mixed episodes, the patient s mood is characterized by symptoms of both a depression and mania. Mixed episodes often have a poorer outcome than classic euphoric mania and, as a rule, respond better to certain anticonvulsants and atypical antipsychotic drugs than to lithium. As many as 50% of admissions to inpatient psychiatric facilities for the treatment of manic episodes appear to be for mixed manic states. The recognition... 

Electroconvulsive Therapy (ECT). Introduced in the mid-1930s, ECT was initially used to treat schizophrenia (for which it is not effective) but was later found to be very effective in the treatment of major depression and mania. It gained widespread use and was the primary biological psychiatric treatment until the introduction of newer psychiatric medications in the 1950s. 

Disorders that are characterised by changes in mood are known as affective disorders, which are depression and mania, now known as unipolar and bipolar affective disorders, respectively. Mood is considered to depend upon the concentration of an amine neurotransmitter in some parts of the brain. 

Toxicology. Tetraethyl lead (TEL) affects the nervous system and causes mental aberrations, including psychosis and mania, convulsions, and death. 

Neuropsychiatric events Life-threatening or fatal neuropsychiatric events, including suicide, suicidal and homicidal ideation, depression, relapse of drug addiction/overdose, and aggressive behavior have occurred in patients with and without a previous psychiatric disorder during peginterferon alfa-2b treatment and follow-up. Psychoses, hallucinations, bipolar disorders, and mania have been observed in patients treated with alpha interferons. 

Depression and mania are described in Chapter 16 they are mentioned here because of their close relation to reward and punishment systems. The passive anhedonia of melancholia, with inability to derive pleasure from usual enjoyments and general lack of motivation, indicates underactivity in reward... 

Breggin, P. Suicidality, violence and mania caused by selective serotonin reuptake inhibitors (SSRIs) A review and analysis. Int J Risk Saf Med 2004 16,31-49. 

Although studies reviewed thus far support the efficacy of lithium treatment for acute mania, the presence of concurrent depression or depressive symptoms during mania, the so-called mixed state, has been associated with poor lithium response. In 1976, Himmelhoch et al. observed that patients with mixed states were significantly less likely to demonstrate a good treatment response than were manic patients [42% vs. 81%] in a retrospective chart review of 84 consecutively referred patients with bipolar disorder. Secunda et al. [1985] reported on 18 patients with mania studied as part of the Collaborative Study of the Psychobiology of Depression and found that patients with concomitant depression and mania [n = 8] had a significantly lower rate of... 

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