MANIA-TREATMENTS
Mania is a kind of mental disorder just opposite to depression in which there are uncontrolled mood elevation,with practically impossible grandiose ideas,expansiveness,pressurised talks,flow of ideas,decreased sleep,restlessness,and over activities.
Schizophrenia and other bipolar affective diseases may induce mania into a person.
Anti-Manic Drugs:-
1.Lithium-Drug of choice
2.Antiepileptics-Valproic acid,and carbamazepine are he best choices.We will discuss about these drugs later on under a separate post wih the heading Antiepileptics.
Lithium:-
Lithium is a metallic basic element with a light alkaline property and mostly available in medicine as slow and controlled release carbonate.
Mechanism
The mechanism of action is still not clear but thought to affect the enzyme inositol-I-phosphate which affects neurotransmitters.
Clinical Use
Mostly to control both positive(schezophrenia and mania) and negative (Depression) bipolar mental disorders.Litghium is a primary choice of manic disorders but can be used as an adjuant in the treatments of schezophrenia and depression.
Kineics
Well absorbed orally and excreted through the kidneys.
Contraindications
Because lithium can cross into the placenta and milk it is highly contraindicated during pregnancy and lactation.
Side Effects
1.In acute intoxication severe tremor,ataxia,seizures,and confusion leads to coma ma may occur.
2.Diabetic insipidus (Lithium is a potential inhibitor of Anti Diuretic Hormone-See he video below)
3.Weight gain
4.Stomach pain and vomiting and diarrhea
5.Thyroidal dysfunction-Hypothyroidsm
6.Depression of T-waves in ECG
7.Leucocytosis (Elevation of WBC count to above normal)
In general lithium has a very narrow therapeutic index and hence all lithium medication should be taken under a doctor's strict supervision.
Drug Interaction
Since lithium competes with sodium in absorption and as well as in tubular elimination effectively by inhibiting the antidiuretic hormone and excessive intake of sodium may cause a dip in lithium plasma level.
Thiazide diuretics may enhance sodium excretion and thereby elevate lithium plasma level.
Toxicity Antidotes
1.Diuretics other than thiazides may decrease plasma levels of lithium by increasing its excretion.Sodium bicarbonate can be used effectively.
2.Hemo or peritonial dialysis.
No comments:
Post a Comment