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Lithium treatment
for Bipolar Disorder?
 The
use of lithium for the treatment of bipolar disorder has been nothing
less than a true miracle drug for many individuals who have struggled
with this difficult disorder for many years. However, determining the
correct lithium dosage for a given patient is considered a very
delicate process, requiring constant analysis of urine and blood
samples, as well as other laboratory tests. Too low of a dose of
lithium can have little or no effect, and too high of a dose can be
toxic, resulting in symptoms of nausea, vomiting, sluggishness,
tremors, dizziness, slurred speech, sodium imbalance, seizures, kidney
dysfunction, and even death. The correct dose however, can bring
significant improvement in mood within five to 14 days. Some patients
respond better to other drugs such as the antiseizure drugs
Carbamazepine (Tegretol) or valproate (Depakote), or a combination of
such drugs.
Origin of lithium treatment:
The discovery of
the effectiveness of lithium, like many other medical discoveries was
found quite accidentally. An Australian psychiatrist John Cade in
1949, hypothesized that manic behavior is caused by a toxic level of
uric acid in the body. He began testing his theory by injecting
guinea pigs with uric acid, but first combined lithium to increase its
solubility.
Cade was very
surprised to see that the guinea pigs became lethargic rather than
manic after their injections. He suspected that lithium had produced
this effect, and later administered lithium to 10 human beings who had
mania, and discovered that it calmed and normalized their mood.
Although many countries began using lithium for bipolar disorder soon
after that time, it was not until 1970 that the Food and Drug
Administration approved it for use in the United States.
Effectiveness of lithium:
A significant
amount of research on lithium has overwhelmingly concluded that it is
effective in treating manic episodes. More than 60% of individuals
treated with lithium are believed to have improved manic symptoms when
taking this medication. Also, most of them experience fewer
subsequent episodes if they continue taking their medication. One
study found that the risk of relapse is 28 times higher for patients
who stop taking lithium. These findings suggest that it may also have
a preventative effect in actually preventing symptoms from
developing. Accordingly, many contemporary clinicians continue
patients on some level of lithium even after their manic episodes
subside. It is also believed that lithium helps patients to overcome
depressive episodes, although it is probably to a lesser degree than
to the degree that it helps with their manic episodes.
These findings
have also led researchers to investigate whether lithium might also be
helpful in cases of unipolar depression, but have had somewhat mixed
results. Some studies have found that lithium is helpful for patients
with unipolar depression and occasionally prevents recurrences.
However, it is possible that “unipolar” patients helped by lithium
actually have a bipolar disorder, whose manic episode is yet to
appear.
Another advantage
of using lithium is that it has sometimes been found to enhance the
effectiveness of antidepressant drugs prescribed for unipolar
depression. In one study up to two thirds of “tricyclic
nonrespondent” patients were converted to “responders” when lithium
was added to the antidepressant drug therapy.
Adapted from information from
Abnormal Psychology by Ronald J. Comer
Additional information and
webpage by
Paul Susic MA Licensed Psychologist Ph.D Candidate
(Health Psychology)
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