Lithium as a Mood Altering Drug Essay

Lithium as a Mood Altering Drug

Introduction

Bipolar disorders are common medical conditions in the world today. This condition is also referred to as manic – depressive illnesses, which are known for causing unusual mood shifts, activity levels, energy, and the ability of carrying out day to day tasks. The condition has got very severe disorders, which are usually different from the normal downs and ups that people go through from time to time. Bipolar disorder symptoms usually result to damaged relationships, poor school or job performance, and even suicide. However, bipolar disorders can be treated, and all the people who suffer from this illness can continue leading productive and full lives (NIH, 2010). Lithium is one of the best ways used to treat bipolar disorders; however, its use has decreased in the recent years as far as treatment of the bipolar diseases is concerned.

Bipolar disorders

Ordinarily, this disorder develops in the life of a person when he or she is in the late teenage or early adult years. Normally, half of all cases start before the people attain the age of twenty five. Some of these people usually have their first symptoms during their childhood age, while others get the symptoms early in life. It is not very easy to identify the bipolar disorders as it starts. This is because the symptoms are usually seen like separate problems, and not as parts of the larger problem (NIH, 2010).

There are several symptoms of the diseases. One of them is intense emotional states which usually occur in some distinct periods referred to as “mood episodes” (NIH, 2010). Additionally, a person with bipolar disorders exhibits over excited or joyful states referred to as “manic episodes”, (NIH, 2010), as well as a hopeless or sad state referred to as “depressive episode” (NIH, 2010). Sometimes, a mood episode may be characterized by symptoms of both depression and mania, a condition referred to as a “mixed state” (NIH, 2010). The people suffering from the disorder also suffer from irritability, as well as drastic changes in sleep, energy and activity (NIH, 2010).

             Bipolar disorders are in most cases inherited. Children who have one parent with this condition usually have twenty seven percent chances of receiving the effect. For children who have both their parents with this condition, they have increased chances of suffering from the condition, which is estimated to seventy five percent. Bipolar disorder is usually categorized into four major categories. The first one is referred to as Bipolar I disorder, which has characteristics of major manic and depressive episodes. Bipolar II is the second category which is characterized by major depressive episodes. However, in this case, these episodes usually take the form of hypomania. This is a mild maniac from, which does not require the patient to go for check up. Cyclothymia is the third category, and is described as “a minor, chronic form of bipolar disorder thought to be a part of a continuum, with bipolar disorder at the upper boundary and normal mood swings at the lower boundary” (Essortment, 2010).

People who are manic “high” may be termed as over talkative, overactive, and can even have a great deal of energy. They usually switch from a topic to another, as if they cannot get their thoughts out fast enough. Generally, their span of attention is usually very small, and they can be easily distracted. At times, the “high” person can be angry or irritable, and can also have inflated or false ideas about their position or importance in the world. They may be equipped with grand schemes which may range from romantic sprees to business deals, and may also be elated. In several cases, the patients can have a very poor sense of judgment. In extreme cases, mania is known to increase in psychotic states. Maniac “low” depressed patients usually experience less energy, sleeping and eating pattern changes, hopelessness, helplessness, worthlessness, sadness, suicidal thoughts and guilt (Psychology Info, 2010).

 History

 Lithium carbonate discovery took  place in 1949, when John Cade MD revealed that it would be used as a treatment for the forms of violence that were seen in Manic-Depressive Disorder(MDD) as well as the prevention of suicide and violence. It was approved in the United States in 1970 in order to cure manic depression or the bipolar disorder. It is famous for the positive effects it has on several neurological disorders such as depression. Aspartate or lithium orotate is usually marketed as a supplement, and is used in very small doses so as to treat conditions like stress, alcoholism, manic depression, Alzheimer’s and aggression (Article Base, 2010).

 John Cade was studying mice and the effects that uric acid had on them. Uric acid is insoluble; therefore, Cade came up with a soluble salt referred to as lithium ureate. It was through his discovery that lithium had very little effects on mice. After a very extensive testing, he discovered that lithium had a very little effect on the patients who were going through depression, but had a very profound effect on manic patients. There are some ways in which lithium is considered as effective. To start with, the response rate of mania maintenance through the use of lithium is between seventy to eighty percent. The only case where lithium does not work effectively is with the groups of people who are not easy to work with, for instance, the disadvantaged, under motivated and noncompliant (Essortment, 2010).

 Lithium was initially used as a mood stabilizer in the nineteenth century after being discovered. It is known to be very effective for both manic and acute depression long term phases, better known as bipolar disorders. The lithium treatment is known to affect the brain’s neurons, where it acts as a mood stabilizer (Williams, et al, 2004).

Benefits of Lithium as a Bipolar Treatment

             Lithium has been known to be a very effective therapy for Bipolar disorder; a condition which is also known as manic depression. Lithium ions are believed to act at some specified membrane sites of intercellular structures, for instance lysosomes and mitochondria. It is known to be very effective in children as it reduces mania symptoms such as hyperactivity, poor judgment and rushed speech, lack of sleep, anger as well as aggression. Lithium aspartate is a health supplement which is bio-available than all the other forms of lithium used for clinical depression treatment (Article Base, 2010).

Recent research has revealed that there are low doses of lithium preserves which renew the brain cells. Eight out of the possible ten persons who are given lithium have been reported to increase the brain grey matter up to three percent after a period of four weeks. Lithium is also known to enhance the replication of DNA, which is the initial step in the formation of cells. Additionally, it is known to protect against adverse effects of alcohol, tobacco, caffeine, drugs as well as downers and uppers (Article Base, 2010).

Lithium is a brand which is usually dispensed as tablets, liquid or capsules. As an effective treatment of bipolar disorders, lithium requires a long type form of treatment. The healthcare providers are the ones who determine the lithium treatment length that is right for the person. It is important for people suffering from bipolar disorders to take lithium as prescribed by the doctor. When people with bipolar disorders take lithium, they are assisted as their level of suicidal action and thinking is reduced (Nami, 2010).

Lithium carbonate is the most used treatment for bipolar disorders. It serves as a very effective mood enhancer in over eighty percent of the people who suffer from bipolar illness. Despite its risk for toxicity, it is the most prescribed agent for the bipolar affective disorders (Article Base, 2010).

Other lithium uses

Besides treatment of bipolar disorders, lithium is also used to treat suicidal attempts. This is because there is a close link between suicide and bipolar disorders. The rates of suicide for those with bipolar disorders are usually stated to be twenty percent. Lithium is known to be very effective in reducing suicide. However, its reduction increases the risks of suicide. Lithium is also believed to be effective in the treatment of cancer. This is because it is known to increasing the white blood cell count, and therefore helps to do away with the effects of chemotherapy and radiation. At the moment, there have been studies by several scientists on whether lithium can have any effect on HIV/AIDS (Essortment, 2010).

One of these scholars is known as Vincent S. Gallicchio, a director in the University of Kentucky. He states that if there is a combination of AZT (Zidovudine) and lithium, there would be less toxic effects, increased immunity and reduction of the virus in the human body. This is because lithium is known to enter the nuclei of the cells, where it influences the DNA. Therefore, if lithium is found as effective, it would be very useful in poor countries especially if the disease is endemic, and where their governments are not in any position to offering expensive antiviral treatment (Essortment, 2010).

Bipolar disorders are known to affect a large part of America. One percent of Americans are known to experience these disorders. On average, the people with bipolar disorders experience three to four episodes in one year. It is a functioning disease, as the people who suffer from it can function without any difficulties (Essortment, 2010).

Lithium is known to end the severe manic symptoms in a period of five to fourteen days, or even several months until the condition is fully controlled. Antipsychotic medications are in several cases used in the initial days so as to treat manic symptoms until lithium starts to be effective. In the same way, anti depressant may be combined with lithium so as to relieve the patient of the depressive phase. A person may experience an episode of bipolar disorders, while others may experience several in their life time. For those people with a continued episode of the disorders, lithium treatment is given very serious considerations (Psychology Info, 2010).

There are people who are known to respond effectively to the lithium treatment. Others still have mild mood swings even as the lithium treatment continues. Others will have the mood swing, but in a less frequent and severe manner. Unfortunately, there are other manic- depressive patients who cannot be helped by any form of treatment (Psychology Info, 2010).

  Mechanism of Lithium Treatment

Lithium acts by exerting some mood-stabilizing effects. The way it does this is through different molecular mechanisms, which have been used to explain all the actions it performs. Neurologists have previously conducted their research on mice and revealed that there are three putative mechanisms of lithium as mood stabilizers. To start with, lithium is known to reduce a component referred to as brain inositol, inhibit the action of another component referred to as GSK3 activity as well as disrupt the formation of a component referred to as Akt.Arr2.PP2A in the brain neurons. As it acts through these mechanisms, it also competes with the binding of magnesium (Beaulieul & Caron, 2008).

Lithium is known to be a prototypical member of the mood stabilizers. Due to its three putative mechanisms’, it is well know to treat psychiatric diseases such as cyclothymia and bipolar disorders. These illnesses are known to affect the US population, and they are characterized by depressive and manic symptoms. Additionally, lithium is also used in combination therapy so as to treat resistant forms of depression. It is also known to lower the suicidal rates of bipolar disorder, schizoaffective disorders and major depression (Beaulieul & Caron, 2008).

Lithium treatment of bipolar disorders

Bipolar disorders are usually diagnosed and the medications provided by practicing doctors. The medications are usually prescribed by psychiatrics, clinical psychologists and psychiatric nurse practitioners as well as advanced nurse specialists. It is important for the psychiatrist to verify the type of treatment that is effective before administering it to the patients (NIH, 2010).

 Lithium is one of the most used moods- stabilizing medications, which is used to treat the bipolar disorder. Generally, people with the disorder continue with the treatment for several years. Several of these medications are referred to as anticonvulsants, and are known to treat seizures, and also control moods. Lithium is also referred to as Eskalith or Lithobid, which was the first medication which was approved by the Food and Drug Administration (FDA) of the US (NIH, 2010).

 Lithium is also used to treat people with thyroid gland problems. Its treatment causes low thyroid levels in several people. The low thyroid function is also referred to as hypothyroidism, and is usually associated with the rapid cycling in people with bipolar disorders, especially among the women. Thyroid levels are known to contribute a lot to the energy and mood changes. Therefore, people with bipolar disorders may be required to take thyroid medication, in addition to those of bipolar disorders so as to keep the thyroid levels in balance (NIH, 2010).

The classification of mood altering drugs takes place according to their perceived norms to the public as well as their ability, effects on the brain, perceived effects by the user, legitimate medical use and the mood altering effects. This type of classification separates these substances into three categories. The first category includes the drugs which require prescription from a physician, those which are termed as illicit as well as those that can be bought in stores. The perception of the users is also used to classify the drugs. Some of them are referred to as uppers, spacers and downers. Some of these drugs can fall in one or more categories (Stimmel, 1979).

There are other mood altering drugs which include amitriptyline(Elavi), imipramine (Tofranil), which are some of the examples of tricyclic anti depressants, tranylcypromine(parmate),phenelzine(nardil), maprotiline(ludiomil) as well as lithium carbonate, which is used in manic depressive illness(Zimberg, 1982).

Effects of lithium as a bipolar disorder treatment

As the human body tries to adapt to the lithium medication, there are several effects which occur. These include weight gain, tremor, drowsiness, vertigo, nausea, stomach pain, diarrhea, fatigue or general body weakness. Others include thyroid problems, excessive thirst, increased urination as well as memory problems (Help Guide, 2010).

 It is very vital for all people who are under lithium medication to take frequent blood tests. This is necessary so as to ensure that the dose administered is at an effective range. Doses that are very high are known to be very toxic. The doctor has to check the blood level of the patient during the first two weeks that lithium is administered. Even after the right dose is determined and the levels are proven to be steady, the blood tests are usually frequent. However, the patients are supposed to frequently go for check up. There are factors that influence the levels of lithium in the body of a person. This includes weight gain or loss, changes in sodium intake, drugs such as aspirin, diuretics and ibuprofen, menstrual cycle, seasonal changes and dehydration (Help Guide, 2010).

How to counter toxic lithium levels

Patients are advised to go for blood tests as much as they can. Additionally, they are advised not to suddenly change the salt intake in their food. They should also drink a lot of fluids, especially if they are exposed to hot weather or are involved in heavy exercises. Alcoholic drinks are also known to be causes of water loss. Therefore, people who take alcohol and are on lithium medication should ensure that they take a lot of water. If there are other complications, the patient is usually advised to see a doctor so that he or she can prescribe a new dosage (Help Guide, 2010).

Decrease in the use of lithium in Treating Bipolar Disorder

It is very important for women on lithium medication to inform their physicians just incase they plan to conceive. This is in relation to the treatment types, and assessing the ways in which the fetus may interact with the medication type. This is because lithium is known to have several effects during the first trimester in the pregnancy period. This is because there is usually an increased risk of a condition referred to as “Ebstein’s anomaly” (NIH, 2010), a defect of the valves in the heart. This risk is very high, because in researches conducted by the medical health experts, one in every twenty thousand people experience these effects. This reveals that even if lithium has its risk, the chances of being at risk during this period are very low. Therefore, in order to ensure that there are no such risks involved low doses of lithium should be used in pregnant women (Nami, 2010).

Lithium should also be controlled in pregnant women because if they use too much of it, their babies might be affected. There have been cases where new born infants have been said to have too much lithium in their bodies. This condition has resulted to grasp reflexes, muscle weakness and poor sucking, lethargy and shallow respirations. There have also been rare cases of thyroid abnormalities which have been reported. Breasts feeding mothers should also been made aware that lithium is dangerous if at all the babies feed on it. This is because infants who are breastfed by mothers who are on excess lithium treatment have higher chances of developing muscle weakness, lethargy and heart rhythm changes (Nami, 2010).

Rules in taking lithium

There are several ways in which the drugs are taken. To start with, they can be taken as capsules, twice or thrice on a daily basis. There are also patients who are advised to take the tablets once in a day. The number of times to take the treatment depends on the capability of the person to tolerate all the effects of the drugs, especially the stomach upsets. Ordinarily, the patients are advised to take lithium together with food so as to avoid or decrease stomach upsets. Lithium should not be used together with tea, cola or coffee since caffeine is known to decrease the lithium levels in the body. The patient should also use a calendar or pillbox so as he or she cannot forget to take all the medications (Nami, 2010).

There are also other effects which are seen just incase the patient with a bipolar disorder overdoses. Some of them experience difficulties in concentration, confusion, diarrhea, vomiting, muscle weakness, tremor and twitching. In severe cases, the people can develop difficulties in respiration, seizures, comas and death (Nami, 2010).

Conclusion

            Clearly, lithium is a very effective cure of bipolar disorders. This is only if all the rules are followed to the letter. However, the numerous side effects that it has are the sole reason as to why it is not preferred, as there has been an emergence of other drugs with fewer effects. All the same, the fact that it has assisted several people to deal with their bipolar disorders cannot be ruled out.

References

Article Base. (2010). Lithium and its benefits. Retrieved from
http://www.articlesbase.com/health-articles/lithium-and-its-benefits-521365.html

Beauliel, J. & Caron, M. (2008). Looking at lithium: Molecular moods and complex

            Behavior, 8, (5), +241.

Essortment. (2010).The treatment of bipolar disorder using lithium. Retrieved from

            http://www.essortment.com/all/treatmentbipola_rins.htm

Help Guide (2010).The bipolar medication guide. Retrieved from

            http://helpguide.org/mental/bipolar_disorder_medications.htm

Williams R, Dalton E & Ryves W, et al, (2004).A molecular cell biology of lithium. Biochemical

            Society Transcactions, 32 (5), +802

Nami. (2010). Lithium. Retrieved from

http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=51&ContentID=66291

 NIH (2010).Introduction: Bipolar disorder. Retrieved from

            http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

Psychology Info. (2010).Medication for bipolar disorder. Retrieved from

            http://www.psychologyinfo.com/depression/meds-bipolar.htm

Stimmel B. (1979).Alcoholism, drug addiction and the road to recovery. New York: Routledge.

 Zimberg Sheldon. (1982).The clinical management of alcoholism. New York: Routledge Mental

            Health.