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Depression bipolar forms

There is, however, a unique risk in the bipolar form that antidepressant treatment may trigger a switch into mania. This may occur either as the natural outcome of recovery from depression or as a pharmacological effect of the drug. Particular antidepressants (the selective serotonin reuptake inhibitors) seem less liable to induce the switch into mania than other antidepressants or electroconvulsive therapy. Treatment for mania consists initially of antipsychotic medication, for instance the widely used haloperidol, often combined with other less specific sedative medication such as the benzodiazepines (lorazepam intramuscularly or diazepam orally). The manic state will usually begin to subside within hours and this improvement develops further over the next 2 weeks. If the patient remains disturbed with manic symptoms, additional treatment with a mood stabilizer may help. [Pg.71]

It is not always easy to assess the success of antidepressant treatment accurately because depression often tends to spontaneous healing or remission. Cyclic and periodic forms of endogenous depression follow a phasic pattern the depressive episode lasting weeks or months can, in the bipolar form, shill into mania or there is a gradual lightening of the depression, as may be... [Pg.10]

Modem psychiatric treattnents were introduced in 1949, when lithium carbonate was discovered as treatment for mania by Australian psychiatrist John F. Cade (Figure 1.45). After Cade s initial report, lithium therapy was principally developed in 1954 by Mogens Schou (Aarhus University, Denmark). In 1969, 20 years after its discovery by John Cade and after a decade of trials, the Psychiatric Association and the Lithium Task Force recommended lithium to the FDA for therapy of mania. A breakthrough had been achieved in the treatment of manic depression, and the genetically related forms of recurrent depression. Bipolar disorders, which afflict about 1% of adults, are now treated with drugs called mood stabilizers, especially lithium and valproic acid, both discovered decades earlier, but nothing better has yet emerged. ... [Pg.42]

Affective (mood) disorders are characterized by changes in mood. The most common manifestation is depression, arranging from mild to severe forms. Psychotic depression is accompanied by hallucinations and illusions. Mania is less common than depression. In bipolar affective disorder, depression alternates with mania. [Pg.50]

In clinical psychiatric terms, the affective disorders can be subdivided into unipolar and bipolar disorders. Unipolar depression is also known as psychotic depression, endogenous depression, idiopathic depression and major depressive disorder. Bipolar disorder is now recognised as being heterogeneous bipolar disorder I is equivalent to classical manic depressive psychosis, or manic depression, while bipolar disorder II is depression with hypomania (Dean, 2002). Unipolar mania is where periods of mania alternate with periods of more normal moods. Seasonal affective disorder (SAD) refers to depression with its onset most commonly in winter, followed by a gradual remission in spring. Some milder forms of severe depression, often those with an identifiable cause, may be referred to as reactive or neurotic depression. Secondary depression is associated with other illnesses, such as neuro-degenerative or cardiovascular diseases, and is relatively common. [Pg.172]

The term "bipolar disorder" originally referred to manic-depressive illnesses characterized by both manic and depressive episodes. In recent years, the concept of bipolar disorder has been broadened to include subtypes with similar clinical courses, phenomenology, family histories and treatment responses. These subtypes are thought to form a continuum of disorders that, while differing in severity, are related. Readers are referred to the Diagnostic and Statisticial Manual of Mental Disorders of the American Psychiatric Association (DSM-IV) for details of this classification. [Pg.193]

Lithium salts are used in the treatment of bipolar affective disorder (i.e., manic depression) and occasionally in mania (but its slow onset of action is somewhat of a disadvantage in this case). Its mechanism of action is still open to debate, but lithium has effects on brain monoamines, on neuronal transmembrane sodium flux, and on cellular phosphatidylinositides related to second messenger systems. Lithium is administered in two salt forms, lithium carbonate (8.98) and lithium citrate (8.99). Side effects are common and include diarrhea, kidney failure, and drowsiness with tremor. [Pg.534]

ECT should be considered for more severe forms of depression (e.g., those associated with melancholic and psychotic features, particularly when the patient exhibits an increased risk for self-injurious behavior) or when there is a past, well-documented history of nonresponse or intolerance to pharmacological intervention. Limited data indicate that bipolar depressed patients may be at risk for a switch to mania when given a standard TCA. A mood stabilizer alone (i.e., lithium, valproate, carbamazepine, lamotrigine), or in combination with an antidepressant, may be the strategy of choice in these patients. Some elderly patients and those with acquired immunodeficiency syndrome may also benefit from low doses of a psychostimulant only (e.g., methylphenidate) (see also Chapter 14, The HIV-Infected Patient ). Fig. 7-1 summarizes the strategy for a patient whose depressive episode is insufficiently responsive to standard therapies. [Pg.143]

For patients with bipolar affective disorder (manic-depressive illness) lithium, usually in the form of lithium carbonate, has been the main prophylactic agent for the last forty years. However, during the last ten years certain anticonvulsants (carbamazepine and sodium valproate) have also been found to be effective. [Pg.179]

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... [Pg.642]

FIGURE 5—6. Bipolar disorder can become rapid cycling, with at least four switches into mania, hypomania, depression, or mixed episodes within a 12-month period. This is a particularly difficult form of bipolar disorder to treat. [Pg.146]

FIGURE 10—6. Depressive and anxious symptoms are not only a hallmark of major depressive disorder but are frequently associated with other psychiatric disorders, including bipolar disorder, schizophrenia, and schizoaffective disorder with organic causes of depression, such as substance abuse with childhood mood disorders (child) with psychotic forms of depression and with mood and psychotic disorders resistant to treatment with drugs (treatment-resistant), among others. [Pg.372]

The form of depression discussed previously is often referred to as major depressive disorder or unipolar depression, in contrast to bipolar or manic-depressive disorder. As these terms imply, bipolar syndrome is... [Pg.86]

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). [Pg.109]

The three most common types of depression are major depression, dysthymia, and bipolar disorder. Major depression, which may occur once but usually occurs several times in a person s life, will interfere with the ability to work, eat, sleep, study, and take pleasure in formerly enjoyed activities. Dysthymia is less severe than major depression but will interfere with feeling good and functioning well. Bipolar disorder (formerly called manic-depression) can be more serious than the other forms of depression. In this illness the person s mood swings from symptoms of depression to extreme excitement with over-activity and feelings of elation. This type of depression can progress to serious mental illness if not treated. [Pg.54]

There are a few surprising medical uses among the alkali and alkaline earth metals. Lithium combined with chlorine has been used for decades to treat a form of depression called bipolar disorder. Scientists are not exactly sure how lithium affects depression, but they think it may somehow change chemical messages in the brain. Doctors use barium, one of the heaviest alkaline earth metals, to get a better look at the stomach and intestines. They give their patients a drink called barium sulfate that travels to the gut. Bariums 56 electrons absorb X-rays and light up the stomach and intestines to reveal ulcers and other problems. [Pg.37]

Lithium is an alkaline earth element that is used medicinally in the form of salts such as lithium chloride and lithium carbonate. Its main use is in the prevention or attenuation of recurrent episodes of mania and depression in individuals with bipolar mood disorder (manic depression). Lithium also has clearly established antima-nic activity, although its relatively slow onset of action often necessitates the use of ancillary drugs, such as antipsychotic drugs and/or benzodiazepines, at the start of therapy. If lithium alone is ineffective for recurrent bipolar mood disorder, combining it or replacing it with car-bamazepine or valproate may be of value reports with lamotrigine and olanzapine are also encouraging. [Pg.125]

The treatment of bipolar disorder is complex, and depends on the particular phase of illness. The mood stabilizers form the foundation of treatment. These include lithium and the anticonvulsant drugs, valproate, and carbamazepine (Bowden, 1998 McElroy and Keck, 2000 Post, 2000). Recently, lamoh igine has been found effective in some patients (Post, 2000). The goal of treatment with mood stabilizers is reduction of frequency and severity of episodes of depression and mania. [Pg.503]


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Depression bipolar

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