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Lithium And Bipolar Disorder



Aditi Mishra

Remedial for Quiz 3

           
            In 1949, with the publication of John Cade, the world came to know about Lithium as a treatment method of bipolar disorder. Bipolar disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. A lot of treatments were and are available but lithium, the third smallest atom, has a lot of physiological effects and is used for therapeutic treatments. Martin Alda from the Psychology department, Dalhousie University, in his article ‘Lithium in the treatment of bipolar disorder: Pharmacology and pharmacogenetics’, has extensively talked about lithium’s mechanisms, its uses and its advantages and disadvantages.
            Lithium is mostly used to cure bipolar disorder. There have been controversies attached to the use of the element to treat mania and depression. Yet, it has been extensively used since the 19th century. This element has a lot of pharmacological effects on multiple signaling pathways. The article explicitly gives numerous clinical factors of lithium such as: reduces risks of suicide, its prophylactic treatment runs in families, for a full clinical effect the plasma levels needed by a patient should be 0.6 and 1.0 mmol/L, works best in patients with classical features of BD and is neuro protective in vitro and likely in vivo.
            For some researchers the effects of lithium are ambiguous and don’t give clear evidence on how the treatment works. But there are some strong facts which boost the psychologists on using lithium to treat bipolar disorder. Initial research in BD suggested an increased residual in sodium during episodes of depression and mania which then come to a state of normalization during the course of the patient’s lithium treatment. One question that comes to mind is the unique function of lithium that enables it to treat BD. Lithium, as researchers measured its neuronal excitability which showed that lithium reduced the resting membrane potential and reduced neuronal excitability.
            Despite lithium being universally accepted as a treatment to BD, its use as been significantly decreasing. The main reason is its toxicity and side effects. The side effects that prove hazardous to the patients are nausea, excessive urination, diarrhea and tremors. These side effects can be reduced by balancing the levels of lithium in the therapy. In contrast, side effects like weight gain and cognitive impairment from lithium is more distressing and very difficult to manage. Not only this, but lithium also does affect the kidneys, the thyroid glands and the parathyroid glands which in turn causes a lot of health issues to the patients.
            Researchers thus have formulated some methods through which the side effects can be monitored and controlled. These methods are: watchful waiting, lower dose, alter time of medication administration, changing to a different lithium formulation, antidotes for specific side effects, and change medication to a different mood stabilizer.Though bipolar disorder can be treated with therapies such as CBT, Behaviour therapy and psychotherapy, medications such as SSRIs can also come into better use. Yet, the whole usage of lithium is a milestone in psychopathology and creates new areas in the discovery of various elements that can be used to treat psychological disorders
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