Bipolar Mood Disorder - Is An Older Drug Still A Good Treatment Option?

Bipolar mood disorder, also called manic depression, is a serious condition often leading to unemployment, marital problems, alcohol abuse, and is associated with multiple relapses. 10-20% of patients commit suicide. Lithium has played an important role in the prevention of bipolar disorder since the 1960's and became widely used as the first line of treatment soon thereafter.

Lithium carbonate and lithium citrate are known to alter the periods of the rhythmic cycling of the brain, and help to even out the moods of people suffering from manic depressive disorder. It is usually taken by mouth in capsule, tablet, or liquid form. Lithium has become unpopular because it can be toxic and alternatives are available. Despite this, lithium has the largest body of research available for any mood stabilizer, while alternative has not been as well researched. When 12 placebo controlled trials examining the value of lithium to prevent relapses were combined, the relapse rate on placebo and lithium was 80% and 35%.

Side effects of lithium should be reported to your health care provider and can include:

More common:

diarrhea

drowsiness

loss of appetite

muscle weakness

nausea, vomiting

slurred speech

These symptoms can progress to:

blurred vision

clumsiness or loss of balance

confusion

dizziness

seizures

trembling

Rare or uncommon:

difficulty speaking or swallowing

fainting

hair loss

hoarseness

slow, fast, or irregular heartbeat (palpitations)

pain, coldness, or blue coloration of fingers or toes

rough, dry skin

sensitivity to cold

swelling in the neck

unusual tiredness or weakness

unusual weight gain

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

increased thirst

increased frequency and urgency to pass urine

muscle twitches

nausea

skin rash

stomach bloating, full feeling

trembling of the hands

Lithium levels can be elevated to dangerous levels by changes in the diet, strenuous exercise, surgery or illness. Try to keep your weight at a constant level and avoid crash dieting. Keep your doctor informed of any of the mentioned circumstances to avoid an imbalance in the dosage. Lithium should not be taken by people with severely impaired kidney function.

Despite the potential side effects, evidence suggests that lithium should be the first choice to prevent manic episodes in most patients with bipolar disorder. Lithium's most important role is to prevent and decrease the occurrence of manic episodes and alternative drugs should only be considered when Lithium is not tolerated well by patients.

Mariette Smith is a clinical epidemiologist with an avid interest in conditions affecting the mind and brain, and various treatment options, including lithium for bipolar mood disorder. See more at Restored Minds

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