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Bipolar Disorder: Managing Mania

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Treatments for Mania in Bipolar Disorder

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Lithium

Lithium (brand names Eskalith, Lithobid) is the drug used and studied longest for treating bipolar disorder. Lithium helps reduce the severity and frequency of manic states and may also help relieve or prevent bipolar depression in some sufferers.

Studies show that lithium can significantly reduce risk of suicide among people with bipolar disorder. Lithium also helps prevent future manic episodes. As a result, it may be prescribed for long periods of time (even in between episodes) as maintenance therapy.

What It Is: Lithium is a drug that acts on a person's central nervous system (brain and spinal cord). Doctors don't know exactly how lithium works to stabilize a person's mood, but one current theory is that it helps foster the growth and survival of nerve cells in brain pathways that regulate mood, thinking and behavior. Its intended effect is to help people with bipolar disorder have more control over their emotions, sleep, energy, and possible extremes in behavior.

What to Expect: It usually takes at least several weeks for lithium to begin working. Your doctor will want to take regular blood tests during your treatment because lithium can affect kidney or thyroid function. Lithium works best if the amount of the drug in your body is kept at a constant level. It is important that the level of Lithium in your body not be too low or too high. Your doctor will also probably suggest you drink eight to 12 glasses of water or fluid a day during treatment and maintain a normal amount of salt in your food. Both salt and fluid can affect the levels of lithium in your blood, so it's important to consume a steady amount every day.

The dose of lithium that patients need varies among individuals and as phases of their illness change. Although bipolar disorder is often treated with more than one medicine, some people can control their condition with lithium alone.

Risks and Side Effects: About 75% of people who take lithium have some side effects, although they may be minor. They may become less troublesome after a few weeks as your body adjusts to the drug. Sometimes, side effects can be relieved by tweaking the dose of lithium. Never change your dose or drug schedule on your own. Do not change brands of this medication without checking with your doctor or pharmacist first. If you are having any problems, talk to your doctor about your options.

Common side effects of lithium can include:

  • Weight gain
  • Impaired memory
  • Poor concentration
  • Mental slowness
  • Hand tremor (Particularly bothersome tremors can be treated with additional medication)
  • Drowsiness or tiredness
  • Hair loss
  • Acne
  • Excessive thirst
  • Increased urination
  • Decreased thyroid function (which can be treated with thyroid hormone)
  • Decreased kidney function
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