Manic-depressive illness treatment

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). 

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. 

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. 

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. 

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. 

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. 

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. 

Joffe RT, Swinson RP Total sleep deprivation in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 77 483-487, 1988 Joffe RT, Swinson RP, Levitt AJ Acute psychostimulant challenge in primary obsessive-compulsive disorder. J Chn Psychopharmacol 11 237-241, 1991 Johns CA, Greenwald BS, Mohs RC, et al The chohnergic treatment strategy in aging and senile dementia. Pharmacological Bulletin 19 185-197, 1983 Johnson BB, Naylor GJ, Dick EG, et al Prediction of chnical course of bipolar manic depressive illness treated with hthium. Psychol Med 10 329-334, 1980... 

Stokes PE, Shamoian CA, Stoll PM, et al Efficacy of lithium as acute treatment of manic-depressive illness. Lancet 1 1319-1325, 1971... 

Despite this favorable result, lithium was hardly considered as a psychopharmaceutical for many years. There were a variety of reasons for this. Firstly, mania is not a very common psychosis and there is spontaneous remission in many cases. There were thus not so many occasions where lithium treatment was indicated. Secondly, lithium salts were considered to be toxic because for some time they had been given in excessive doses to patients with heart failure and in this way, had led to a number of fatalities (Cade, 1970). Thirdly, a few years after Cade s first publication psychiatrists attention had been claimed by chlorpromazine and the subsequent neuroleptics and antidepressants, thus explaining why lithium almost fell into oblivion. It was onl> in the 1960s that it once more attracted some interest, after the Danish psychiatrist Mogens Schou had shown that lithium salts were not only useful in the manic phase of manic depressive illness but also could prevent depressive episodes in patients suffering from bipolar psychoses. 

Chouinard G. The use of benzodiazepines in the treatment of manic depressive illness. J Clin Psychiatry 1988 49(suppl) 15-19. 

Davis JM, Noll KM, Sharma R. Differential diagnosis and treatment of mania. In Swann AC, ed. Mania new research and treatment. Washington, DC American Psychiatric Press, 1986 1-58. Mendlewicz J, Fieve RR, Rainer JD, et al. Manic-depressive illness a comparative study of patients with and without a family history. Br J Psychiatry 1972 120 523-530. 

Schou M. Lithium treatment of manic-depressive illness a practical guide, 3rd ed. Basel, Switzerland Karger, 1986. 

Prien RF, Caffey EM Jr, Klett CJ. Factors associated with lithium responses in the prophylactic treatment of bipolar manic-depressive illness. Arch Gen Psychiatry 1974 31 189-192. 

Bipolar disorder, once known as manic-depressive illness, was conceived of as a psychotic disorder distinct from schizophrenia at the end of the 19th century. Before that both of these disorders were considered part of a continuum. It is ironic that the weight of the evidence today is that there is profound overlap in these disorders. This is not to say that there are no pathophysiologically important differences or that some drug treatments are differentially effective in these disorders. According to DSM-IV, they are separate disease entities while research continues to define the dimensions of these illnesses and their genetic and other biological markers. 

O-antigen of 180 structures of 430 Lipoprotein(s) 58 bacterial 428 Liposomes 392, 392-394 NMR spectra 396 Liquid crystals 392-394 Liquid crystalline phases 392 Lithium salts, in treatment of manic-depressive illness 564 Lithostatine 443 Liverworts 29... 

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... 

Sapse, Anne-Marie and P.von Rague Sclileyer Lithium Chetnistrs A Theoretical and Exfienmental Overview. John Wiley Sons. Inc.. New York. NY. 1994. Schou. M, Lithium Treatment of Manic Depressive Illness A Practical Guide. S. 

The use of lithium in medicine has been the subject of recent reviews by Birch,81 Birch and Sadler29 and references therein, and Tosteson.82 Historically, the use of lithium in medicine began with the treatment of gout and rheumatics in 1859. For the following 90 years, lithium was proposed for a variety of disorders and then discarded for example, lithium bromide was considered to be an effective sedative. In 1949 lithium was introduced into psychiatric practice and lithium carbonate, LijCOj, became the first of the modern psychotropic drugs. In a review of double-blind trials Schou and Thomsen (1975) support the prophylactic use of this drug in bipolar (manic-depressive) illness. 

As described in the previous section, azophenol crown 4 (n = 1) shows a characteristic coloration only for Li+ ion among alkali metal ions. After extensive examinations in a number of solvent systems, lithium analytical conditions were determined as shown in Table 2 [18a]. The resulting reddish purple color is very stable and its absorbance is maintained for 10-90 min after developing color. The calibration curve for Li+, in other words, sensitivity is linear from 25-250 ppb. Na+ does not interfere, but K+, Rb+, Ca2+, Sr2+, Ba2+, and Mg2+ interfered in the determination with a similar coloration. This method was applied to the analysis of a commercial pharmaceutical preparation, a lithium carbonate tablet, since the Li2C03 tablet has been used for medical treatment of manic depressive illness [18 b]. On the other hand, the azophenol crown 4 (n = 1) is also useful as a reagent for colorimetric determination of Rb+ and Cs+ [19]. 

Manji HK, Moore GJ, Chen G. Clinical and preclinical evidence for the neurotrophic effects of mood stabilizers implications for the pathophysiology and treatment of manic-depressive illness. Biol Psychiatry 2000 48(8) 740-54. 

Schou M. Treatment of Manic-Depressive Illness A Practical Guide. 3rd edn.. Basel Karger . 1989. 

Monji A, Yoshida I, Tashiro K, Hayashi Y, Tashiro N. A case of persistent manic depressive illness induced by interferon-alfa in the treatment of chronic hepatitis C. Psychosomatics 1998 39(6) 562-4. 

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