Antidepressant, lithium

Consider augmentation ) (non-SSRI antidepressant, lithium, thyroid hormone,... 

Meltzer HY, Simonovic M, Sturgeon RD, et al Effect of antidepressants, lithium and electroconvulsive treatment on rat serum prolactin levels. Acta Psychiatr Scand Suppl 290 100-121, 1981... 

First-order kinetics The amount of drug eliminated per unit of time is directly proportional to its concentration. In this state, the mechanisms for biotransformation and elimination are not saturated (e.g., benzodiazepines, tricyclic antidepressants, lithium carbonate). 

Antipsychotic drugs are also indicated for schizoaffective disorders, which share characteristics of both schizophrenia and affective disorders. No fundamental difference between these two diagnoses has been reliably demonstrated. They are part of a continuum with bipolar psychotic disorder. The psychotic aspects of the illness require treatment with antipsychotic drugs, which may be used with other drugs such as antidepressants, lithium, or valproic acid. The manic phase in bipolar affective disorder often requires treatment with antipsychotic agents, although lithium or valproic acid supplemented with high-potency benzodiazepines (eg, lorazepam or clonazepam) may suffice in milder cases. Recent controlled trials support the efficacy of monotherapy with atypical antipsychotics in the acute phase (up to 4 weeks) of mania, and olanzapine and quetiapine has been approved for this indication. 

Affective disorders such as depression and manic-depression are found frequently in the general population as well as in rehabilitation patients. Drugs commonly prescribed in the treatment of (unipolar) depression include the tricyclics and MAO inhibitors as well as the newer second-generation antidepressants. Lithium is the drug of choice for treating bipolar disorder, or manic-depression. All of these drugs... 

Manic-depressive syndrome antidepressants, lithium prophylactically... 

In combination with tricyclic antidepressants, lithium is used in treating recurrent endogenous depression. In combination with neuroleptics, it is used in the management of schizoaffective disorders. In combination with neuroleptics, it is used to control schizophrenia. Lithium is also used in the case of patients with alcoholism associated with depression and has been used to correct the neutropenia that occurs during cancer chemotherapy. 

CARBONIC ANHYDRASE INHIBITORS ANTIDEPRESSANTS -LITHIUM L plasma concentrations of lithium, with risk of inadequate therapeutic effect t renal elimination of lithium Monitor clinically and by measuring blood lithium levels to ensure adequate therapeutic efficacy... 

BACLOFEN ANTIDEPRESSANTS -LITHIUM Enhancement of hyperkinesias associated with lithium Uncertain Consider alternative skeletal muscle relaxant... 

NON-DEPOLARIZING ANTIDEPRESSANTS-LITHIUM Antagonism of effects of nondepolarizing muscle relaxants Uncertain Monitor intraoperative muscle relaxation closely may need t doses of muscle relaxants... 

ACICLOVIR/ VALACICLOVIR ANTIDEPRESSANTS-LITHIUM t lithium levels, with risk of toxicity Possible 1 renal excretion Ensure adequate hydration monitor lithium levels if intravenous acidovir or >4g/day valacidovir is required... 

First, two-drug combinations lithium" or lamotrigine plus an antidepressant" lithium plus lamotrigine... 

Contents Introduction, history and brain basics—Older antidepressants tricyclics and monoamine oxidase inhibitors—Selective serotonin reuptake inhibitors—Second generation antidepressants—Lithium, a medication for bipolar depression—Natural depressants—Teens and antidepressants trends and attitudes—Case study one girl s experience with antidepressants. 

Caution is recommended when eplerenone is used with alpha blockers, antipsychotics, amifostine, baclofen, corticosteroids, tetracosactide and tricyclic antidepressants. Lithium, ciclosporin, and tacrolimus should generally not be used with eplerenone. Antacids, cisapride, midazolam and simvastatin had no effect on eplerenone pharmacokinetics. Eplerenone had no important effect on cisapride, midazolam, warfarin or contraceptive steroid pharmacokinetics, but caused a slight increase in digoxin levels. 

A study in 14 treatment-resistant depressed patients aged between 61 and 82 found that 7 showed eomplete improvement and 3 showed partial improvement, 3 to 21 days after lithium was added to treatment with the tricyclic or related antidepressants. Lithium adverse effects occurred in 6 patients 4 of whom stopped lithium as a result. One of them was successfully restarted at a lower dose. Tremor was the most frequent adverse effect, and reversible neurotoxicity with a stroke-like syndrome was the most severe. The antidepressants used were amitriptyline, doxepin, maprotiline and trazodone. A meta-analysis of 9 studies on the acute treatment of unipolar or bipolar depression indicated that the combined use of a mood stabiliser (lithium in 6 studies) and a tricyclic antidepressant was associated with an increased risk of switches into (hypo)mania, when compared with a mood stabiliser alone. It was suggested that monotherapy with a mood stabiliser should be tried to see if it is effective, before adding an antidepressant. Tricyclics were considered to be second-line antidepressants, with SSRIs the preferred choice. ... 

Lithium salts are used clinically. Lithium chloride (Li Cr) is an antidepressant, lithium bromide (Li Br ) is a sedative, and lithium carbonate (Li2 C03 ) is used to stabilize mood swings in people who suffer from bipolar disorder. Scientists do not yet know why lithium salts have these therapeutic effects. 

---