Mood, lithium carbonate

Q3 Manic depressive disorder involves mood swings, and several agents can be used to stabilize mood lithium carbonate or citrate are often used. There appears to be little difference in the therapeutic usefulness of these two salts. Lithium salts are widely used mood stabilizers. They are useful prophylactically in treating both acute mania and bipolar conditions. 

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). 

The clinical value of lithium has been recognized since 1949. Lithium carbonate is used in manic depressive psychoses for the treatment of recurrent mood changes.261,262 Mood stability may only occur after months rather than weeks. The drug is administered orally in doses up to 2 g day-1 (30 mmol day-1). The serum Li concentration should be in the range of 0.4-0.8 mmol 1. ... 

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. 

For more than 40 years, Li+ has been used to treat mania. While it is relatively inert in individuals without a mood disorder, lithium carbonate is effective in 60 to 80% of all acute manic episodes within 5 to 21 days of beginning treatment. Because of its delayed onset of action in the manic patient, Li+ is often used in conjunction with low doses of high-potency anxiolytics (e.g., lo-razepam) and antipsychotics (e.g. haloperidol) to stabilize the behavior of the patient. Over time, increased therapeutic responses to Li+ allow for a gradual reduction in the amount of anxiolytic or neuroleptic required, so that eventually Li+ is the sole agent used to maintain control of the mood disturbance. 

Huang S, Fortune KP, Wank SA, et al Multiple affinity states of different cholecystokinin receptors. J Biol Chem 269 26121-26126, 1994 Hudson JL, Pope HG, Jonas JM, et al Phenomenologic relationship of eating disorders to major affective disorder. Psychiatry Res 9 345-354, 1983 Huey LY, Janowshy, DS, Judd LL, et al Effects of lithium carbonate on methylphenidate-induced mood, behavior, and cognitive processes. Psychopharmacology 73 161-164, 1981... 

Nagel K, Adler LE, Bell L, et al. Lithium carbonate and mood disorder in recently detoxified alcoholics a double-blind, placebo-controlled pilot study. Alcohol Clin Exp Res 1991 15 978-981. 

Bipolar affective (manic- depressive) Characterized by episodes of mania. Cyclic mania alone, rare depression alone, occasional mania-depression, usual. About 10-15% of all depressions. May be misdiagnosed as endogenous if hypomanic episodes are missed. Lithium carbonate stabilizes mood. Mania may require antipsychotic drugs as well depression managed with antidepressants. 

Lithium carbonate, a salt of lithium, is a mood-stabilizing agent used to treat the psychiatric disorder known as mania. Mania is characterized by behaviors such as elated mood, feelings of greatness, racing thoughts, and an inability to sleep. We don t know how lithium carbonate helps to stabilize these patients moods. 

Judd, L., Hubbard, B., Janowsky, D. S., Huey, L., 8c Attewell, P. (1977a). The effect of lithium carbonate on affect, mood, and personality of normal subjects. Archives of General Psychiatry, 34, 346-351. 

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. 

Two patients who were taking lithium carbonate for mood disorders and who underwent coronary artery bypass grafting developed refractory hypotension during cardiac surgery, which responded to methylthioninium chloride (116). The authors suspected that chronic lithium therapy had caused cardiac embarrassment and recommended that lithium be withdrawn before cardiac surgery. 

The most common is augmentation is with the mood stabiliser lithium carbonate. Indeed, lithium may be effective as monotherapy for depression but is not preferred because of its adverse effect profile and need for plasma concentration monitoring. Its prescription in combination with antidepressants that have failed to produce remission is more usual and evidence suggests that up to 50% of patients who have not responded to standard antidepressants can respond after lithium augmentation. Addition of lithium requires careful titration of the plasma concentration up to the therapeutic range, with periodic checks thereafter and monitoring for toxicity (see p. 389). 

A new use for lithium carbonate was discovered in 1949 when John Cade (1912-1980), an Australian physician, found that patients with bipolar disorder benefited from taking the substance. Bipolar disorder is a condition once known as manic-depressive disorder. The condition is characterized by dramatic mood swings. A person can be very happy and carefree one moment, but terribly depressed the next moment. Some patients become so depressed that they commit suicide. Until 1949, there was no effective treatment for bipolar disorder. 

In the 1940s, scientists discovered that lithium carbonate helps to even out a persons high and low mood swings. By the 1970s, lithium... 

Lithium is the lightest of the alkali metals (group la) the salts of this monovalent cation share some characteristics with those of Na and K. Traces of the ion occur normally in animal tissues, but has no known physiological role. In the U.S., the drug forms are the salts, lithium carbonate and lithium citrate. Therapeutic concentrations of LT have almost no discernible psychotropic effects in normal individuals. is not a sedative, depressant, or euphoriant, characteristics that differentiate it from other psychotropic agents. The precise mechanism of action of LL as a mood-stabilizing agent remains unknown. 

C. Clinical Use Lithium carbonate is used in the treatment of bipolar affective disorder (manic-depressive disease). Maintenance therapy with lithium decreases manic behavior and reduces both the frequency and the magnitude of mood swings. Drug therapy with neuroleptics or benzodiazepines may also be required at the initiation of lithium treatment. Antidepressant drugs may be required adjunctively during maintenance. Alternative drugs of value in bipolar affective disorder include carbamazepine, clonazepam, gabapentin, and valproic acid. 

Lithium carbonate is used specifically for the prophylaxis or prevention of recurrent mood changes in patients suffering from manic depressive psychoses, the recurrent affective disorders. It is of limited use for other psychiatric states, with the possible exception of pathological aggression, where it does seem to have a role to play. Despite many scares, lithium is a very safe drug in experienced hands. The ability of lithium to reduce or abolish recurrent mood swings has undoubtedly improved immensely the quality of life of many patients and their families and saved the lives of many who would otherwise have been led to suicide. ... 

Inositol54a-5 evidence that Lithium carbonate treats mania by reducing CNS inositol levels CSF inositol levels are low in depressed patients double-blind study showed inositol monotherapy effective in treatment of depression including significant improvements in mood, agitation and anxiety symptoms... 

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. ... 

Lithium carbonate, Li2C03, was the first mood-stabilizing drug approved by the FDA for the treatment of mania and manic-depressive illness, also known as bipolar disorder. Calculate the percent composition by mass of lithium carbonate. 

Lithium salts are used clinically. Lithium chloride (Li Cr) is an antidepressant, lithium bromide (Li Br ) is a sedative, and lithium carbonate (Li2 C03 ) is used to stabilize mood swings in people who suffer from bipolar disorder. Scientists do not yet know why lithium salts have these therapeutic effects. 

The molten carbonate fuel ceU uses eutectic blends of Hthium and potassium carbonates as the electrolyte. A special grade of Hthium carbonate is used in treatment of affective mental (mood) disorders, including clinical depression and bipolar disorders. Lithium has also been evaluated in treatment of schizophrenia, schizoaffective disorders, alcoholism, and periodic aggressive behavior (56). 

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