Medicines and Drugs Used in Major Mental Illnesses

Mania/Manic Depressive Illness.

Symptoms: An elated mood, racing thoughts, increased menta activity, hostility, irritabilty, throught and/or reduced sleep are the symptoms of mania. There is also a loss of contact from reality and perceptual disturbance, A milder form is called hypomania.

In manic depressive illness (bipolar disorder), there is a swing of mood between mania and depression. Such cycles Occur 2 to 4 times in a year. Treatment of mania and bipolar disorder is different to that of endogenous depression.

Drugs

Lithium Carbonate

This drug is effective in the treatment during the manic phase of manic depression as a more stabilizing agent, prevention of mania in manic depressive illness, recurrent unipolar depression, and as an antidepressant in all patients who do not fall into a definite group. It does not produce any depressant or stimulant effect in a normal man. The efficacy and safety of lithium salts for acute mania and prevention of recurrent attacks of manic depressive illness is now highly impressive.

Dosage: During an acute attack, lithium carbonate is given orally in a dose of 400 to 450 mg 4 times a day. The maintenance dose is 300 mg, four times a day.

Adverse Effects: Fatigue, muscular weakness, slurred speech, ataxia, tremors of the hands excessive urination and thirst may occur. Nausea, vomiting, and diarrhoea may also occur, but these are not serious and can be minimized by giving the drug with food or in smaller doses at specified intervals. Higher doses may cause muscular twitchings and convulsions.

Precautions

The total daily dose should be given in several divided portions at fixed intervals.

The drug should not be administered on an empty stomach.

Salt intake should be increased as lithium increase excretion of sodium from the body.

Anti-psychotic and tricyclic antidepressants can be given with lithium, but the doses; should be as low as possible, as their combination may cause difficulty in passing urine.

Proper treatment necessitates estimation of blood levels of lithium periodically.


Alternatives to lithium are carbamazepine and sodim valproate (drugs used in convulsive disorders) and olanzapine (a drug used in psychosis). Among the other treatments are; phototherapy and psychotherapy. In phototherapy the patient is placed in a room lit by light to simulate the season. It is most effective in mild seasonal depression.

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