Bipolar disorder manic

Lithium is the simplest therapeutic agent for the treatment of depression and has been used for over 100 years—lithium carbonate and citrate were described in the British Pharmacopoeia of 1885. Lithium therapy went through periods when it was in common use, and periods when it was discouraged. Finally, in 1949, J.J.F. Cade reported that lithium carbonate could reverse the symptoms of patients with bipolar disorder (manic-depression), a chronic disorder that affects between 1% and 2% of the population. The disease is characterized by episodic periods of elevated or depressed mood, severely reduces the patients quality of life and dramatically increases their likelihood of committing suicide. Today, it is the standard treatment, often combined with other drugs, for bipolar disorder and is prescribed in over 50% of bipolar disorder patients. It has clearly been shown to reduce the risk of suicide in mood disorder patients, and its socioeconomic impact is considerable—it is estimated to have saved around 9 billion in the USA alone in 1881. 

Prevention or treatment of acute mania, manic phase of bipolar disorder (manic-depressive illness) PO 900-l,200mg/day. Maintenance 300mgtwiceaday. May increase by 300mg/dayqlwk. 

Bipolar disorder, manic prophylaxis of bipolar disorder MDD aggressive behavior, conduct disorder adjunct treatment in refractory MDD... 

Bipolar disorder (manic-depressive illness) represents one of the most dramatic presentations in all of medicine and simultaneously poses one of the more difficult therapeutic challenges. It is characterized by mania or hypomania, alternating irregularly or intermingling with episodes of depression however, a small group (approximately 1%) may only experience recurrent manic episodes (i.e., unipolar mania). The estimated risk of developing a bipolar disorder is 0.5% to 1%, and the incidence of new cases per year is in the range of 0.01 % for men and 0.01 % to 0.03% for women (1). Bipolar spectrum can be conceived of as a continuum of more to less severe clinical presentations ... 

Chlorpromazine Blockade of D2 receptors >> 5 2 receptors .-Receptor blockade (fluphenazine least) muscarinic (M)-receptor blockade (especially chlorpromazine and thioridazine) Hx-receptor blockade (chlorpromazine, thiothixene) t central nervous system (CNS) depression (sedation) t decreased seizure threshold t QT prolongation (thioridazine) Psychiatric schizophrenia (alleviate positive symptoms), bipolar disorder (manic phase) nonpsychiatric antiemesis, preoperative sedation (promethazine) pruritus Oral and parenteral forms, long half-lives with metabolism-dependent elimination Toxicity Extensions of effects on a - and M- receptors blockade of dopamine receptors may result in akathisia, dystonia, parkinsonian symptoms, tardivedyskinesia, and hyperprolactinemia... 

Haloperidol Blockade of D2 receptors >> 5HT2A receptors Some a blockade, but minimal M receptor blockade and much less sedation than the phenothiazines Schizophrenia (alleviates positive symptoms), bipolar disorder (manic phase), Huntington s chorea, Tourette s syndrome Oral and parenteral forms with metabolism-dependent elimination Toxicity Extrapyramidal dysfunction is major adverse effect... 

An effective treatment for bipolar disorder (manic -depressive illness) is the administration of lithium salts 445/1111-11133 Inhibition of the hydrolysis of inositol phosphate by Li+ (Fig. 11-9) may be related to its therapeutic effect. Reduced phosphatidylinositol turnover may dampen responses to neurotransmitters.1114 Li+ may affect gene expression in neuropeptide-secreting neurons.1115 Bipolar disorder apparently has more than one cause. There are strong indications of genetic susceptibility,1116 and genes that increase susceptibility have been located on chromosomes 4,12,13,18,21, and X.1117... 

Valproic acid (Depakene, Depakote, other trade names) is classified as a carboxylic acid, and is used primarily to treat absence seizures or as a secondary agent in generalized tonic-clonic forms of epilepsy. This drug is also used to treat bipolar disorder (manic-depression), especially during the acute manic phase (see Chapter 7). 

The major or most severe psychiatric disorders include depressive disorders, bipolar disorder (manic-depressive illness), and schizophrenia. Depression and bipolar disorder are classified as mood disorders, because the predominant feature of these conditions is an inappropriate or abnormal emotional state. Schizophrenia, on the other hand, is classified as a thought disorder, because the predominant symptoms involve disturbances in perception and thinking. 

Lithium (Li) has been used in the treatment of bipolar disorder (manic depression) for approximately 50 years. Over 2000 British patients use Li for this disease. The illness is characterized by alternative states of depression and mania, or overexcitement. At times, the cycle of mood changes continue for several weeks or for one year with good results (intervals) between the phases. In Texas, a correlation has been noted between the influence of Li-salts and the drinking water as well as the increase in visits to psychiatric (mental) public health hospitals. 

Bipolar disorder manic and depressive episodes (see chapter 6)... 

Bipolar disorder (manic-depressive illness) is one of the most common of the severe chronic psychiatric disorders. The cyclic mood disorder is characterized by recurrent fluctuations in mood, energy, and behavior encompassing the extremes of human experiences.Bipolar disorder differs from recurrent major depression (or unipolar depression) in that a manic, hypomanic, or mixed episode occurs during the course of the illness. Bipolar disorder is a lifelong illness with a variable course and requires both nonpharmacologic and pharmacologic treatments for mood stabilization. ... 

Early morning waking e. Bipolar disorder (manic-depression)... 

Other practical applications of the alkali metals and their compounds include sodium and potassium in living systems, lithium as treatment for bipolar disorder (manic depression), elemental sodium and lithium as reducing agents, lithium in a new generation of batteries, cesium in photoelectric devices, potassium-argon dating, and lithium as a source of tritium to fuel the hydrogen economy. 

---