Drugs used to treat severe psychiatric disorders involving excessive mood swings
Mood-stabilizing drugs are used for the treatment of bipolar affective disorder, which is also known as manic-depressive disorder, and less commonly for severe depression. In bipolar affective disorder, cycles of mania (elation) and severe depression may occur. Lithium is the drug most commonly used to treat this disorder and can control or reduce the intensity of mania. It may also prevent or reduce the frequency of attacks and lift depression. Two other drugs, carbamazepine and valproic acid, may be used as mood stabilizers if lithium is ineffective in treating bipolar affective disorder or if it causes unacceptable side effects.
How are they used?
Lithium is taken orally. It may take at least 3 weeks before the drug’s effects are noticeable and several weeks more for it to take full effect. For this reason, a rapidly acting antipsychotic drug is often prescribed at the same time for initial control of mania. Lithium will then be continued to prevent further episodes.
Treatment with lithium can cause nausea, diarrhoea, tremor, and excessive thirst. These side effects usually reduce in severity if treatment is continued. High levels of lithium may cause blurred vision, increased gastrointestinal disturbances, drowsiness, rash, and possibly hypothyroidism (underactivity of the thyroid gland) and kidney damage. For this reason, your doctor will carry out regular tests to monitor lithium levels in the blood, and you should report any side effects promptly to your doctor. Carbamazepine or valproic acid may be given if lithium is unsuitable, but may cause memory and coordination problems. If you are taking either of these drugs, your doctor may also carry out regular blood tests to monitor blood levels of the drugs.
If you are taking lithium, you will be given a treatment card, bracelet, or pendant, which you should carry with you at all times. You should be careful not to make changes in your diet that might alter the amount of salt you take in because this may affect lithium levels in your body. It is also important to avoid dehydration, which may occur if you develop diarrhoea or vomiting or travel to a region with a hot climate.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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