Bipolar affective disorder assessment

Whatever the mechanism of action of Li+ in the treatment of bipolar affective disorder turns out to be, there is no doubt that the functions of one or more of the neurotransmitters and hormones are involved to some extent. Much of the published data on the effects of Li+ on these systems is equivocal or even contradictory, in many cases reflecting differences in the experimental procedures, in particular the levels of Li+ employed. Often, where it has been looked for, there are differences observed between the acute and chronic effects of Li+. Therefore, the therapeutic relevance of many of these Li+-induced effects is difficult to assess. 

Of 23 patients with bipolar affective disorder taking neuroleptic drugs, 15 developed akathisia and 18 had parkinsonism during their entire inpatient treatment (217). The patients initially received high-potency neuroleptic drugs (maximum 2000 mg/day of chlorpromazine equivalents) and were assessed weekly. Akathisia developed in 44% of the patients with severe headache or nausea who received prochlorperazine 10 mg intravenously (n = 100) within 1 hour (218). None of the 40... 

Glueck et al. assessed hypocholesterolemia in 203 patients hospitalized with affective disorders (depression, bipolar disorder, and schizoaffective disorder), 1595 self-referred subjects in an urban supermarket screening, and 11,864 subjects in the National Health and Nutrition Examination Survey II (a national probability sample) [34], Low plasma cholesterol concentration (<160 mg/dL) was much more common in patients with affective disorders than in those found in urban supermarket screening subjects or in the National Health and Nutrition Examination Survey II subjects. When paired with supermarket screening subjects by age and sex, patients with affective disorders had much lower TC, LDL, HDL, and higher TG concentrations. However, there was no evidence that low plasma cholesterol could cause or worsen affective disorders [34]. 

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