Manic depressive illness

Treatment of Manic—Depressive Illness. Siace the 1960s, lithium carbonate [10377-37-4] and other lithium salts have represented the standard treatment of mild-to-moderate manic-depressive disorders (175). It is effective ia about 60—80% of all acute manic episodes within one to three weeks of adrninistration. Lithium ions can reduce the frequency of manic or depressive episodes ia bipolar patients providing a mood-stabilising effect. Patients ate maintained on low, stabilising doses of lithium salts indefinitely as a prophylaxis. However, the therapeutic iadex is low, thus requiring monitoring of semm concentration. Adverse effects iaclude tremor, diarrhea, problems with eyes (adaptation to darkness), hypothyroidism, and cardiac problems (bradycardia—tachycardia syndrome). 

Bipolar disorder or manic depressive illness, refers to a severe mental illness characterized by recurring episodes of mania and depression. 

Wyatt RJ, Henter I (1995). An economic evaluation of manic-depressive illness—1991. Soc Psychiatry PsychiatrEpidemiol Oy 213—19. 

Bell, C. Mehta, H. (1980). The misdiagnosis of black patients with manic depressive illness. /. Natl. Med. Assoc., 72(2), 141-5. 

Goodwin FK. Manic-Depressive Illness. NewYork. Oxford University Press, New York 1990. 

Ikonomov O, Manji HK. Molecular Mechanisms Underlying Mood-Stabilization in Manic-Depressive Illness The Phenotype Challenge. Am J Psychiatry 1999 156 1506-1514. 

Manji HK, Chen G. Lithium upregu-lates the cytoprotective protein bcl-2 in vitro and in the CNS in vivo, a role for neurotrophic and neuroprotective effects in manic-depressive illness. J Clin Psychiatry 2000 61 82-96. 

Manji, H. K. and Lenox, R. H. Ziskind-Somerfeld Research Award. Protein kinase C signaling in the brain molecular transduction of mood stabilization in the treatment of manic-depressive illness. Biol. Psych. 46 1328-1351,1999. 

Bipolar disorder, previously known as manic-depressive illness, is a cyclical, lifelong disorder with recurrent extreme fluctuations in mood, energy, and behavior. Diagnosis requires the occurrence, during the course of the illness, of a manic, hypomanic, or mixed episode (not caused by any other medical condition, substance, or psychiatric disorder). 

Schwab AB, O Connell ME, Long SE (1995) The use of lifiiium concenh ation data and isotopic ratios as hydrologic tracers in a first-order catchment. Geol Soc Am Prog Abst 27 A97 Schou M (1988) Lithium h eahnent of manic-depressive illness—Past, present and perspectives. J Am Med Ass 259 1834-1836... 

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. 

Manic-depressive illness connotes a psychotic disorder of affect that occurs episodically without external cause. In endogenous depression (melancholia), mood is persistently low. Mania refers to the opposite condition (p. 234). Patients may oscillate between these two extremes with interludes of normal mood. Depending on the type of disorder, mood swings may alternate between the two directions (bipolar depression, cyclothymia) or occur in only one direction (unipolar depression). 

Lithium ions inhibit thyroxine release. Lithium salts can be used instead of iodine for rapid thyroid suppression in iodine-induced thyrotoxicosis. Regarding administration of lithium in manic-depressive illness, see p. 234. 

MAPROTILINE HYDROCHLORIDE For the treatment of depressive illness in patients with depressive neurosis (dysthymic disorder) and manic-depressive illness, depressed type (major depressive disorder) also effective for the relief of anxiety associated with depression. 

Manic-depressive Illness - For the control of manifestations of the manic type of manic-depressive illness. 

Mania For the treatment of manic episodes of manic-depressive illness. Maintenance therapy prevents or diminishes the frequency and intensity of subsequent manic episodes in those manic-depressive patients with a history of mania. 

Lithium was first used to treat manic-depressive illness in 1949, but was not used in the United States until 1970 due to concerns for its toxicity. When used as a therapeutic agent, lithium blood levels must be kept within a very narrow range (i.e., a narrow therapeutic index). Lithium appears to be non-essential, but it is readily absorbed by the intestine and is found in plants and meat. Normal daily intake is about 2 mg. Lithium is used in some manufacturing processes, as a lubricant, and as an alloy. 

Bipolar disease, or recurrent unipolar disease may be manic-depressive illness. This disease can manifest as typical bipolar disease, with alternating depressive and manic episodes, or as recurrent depression (or more rarely recurrent mania). The age of onset and frequency of recurrence may be highly variable, with at best a single episode, where the disease may be suspected from family history. The intensity of individual episodes may vary from the maximal intensities of depression, also called melancholia, or mania justifying rapid hospitalisation to barely pathological mood swings, where it is an alternation and... 

The most common mood disorders are major depression (unipolar depression) and manic-depressive illness (bipolar disorder). Major depression is a common disorder that continues to result in considerable morbidity and mortality despite major advances in treatment. Approximately 1 in 10 Americans will be depressed during their lifetime. Of the 40,000 suicides occurring in the United States each year, 70% can be accounted for by depression. Antidepressants are now the mainstay of treatment for this potentially lethal disorder, with patients showing some response to treatment 65 to 80% of the time. 

Mr. Smith is 28 years old and has no active medical problems. He has been treated with Li+ for manic-depressive illness for 1 year, and his mood has been stable. He now reports the gradual onset of fatigue, weight gain, and cold intolerance. Which single laboratory test is most likely to lead to the correct diagnosis ... 

Every person with whom I spoke had theories about the source of his or her difficulties. The great majority of interviewees attributed their bad, often crippling feelings to their immediate experiences as well as to their brain chemistry. Their ideas about the source of depressive illness rarely extended to the ways in which society is organized as a whole or to how broad cultural changes influenced their well-being. Alice was an exception. Could it be, as she suggested, that manic-depressive illness is most likely to arise in a manic society ... 

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. 

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