A young manic patient who showed poor response to lithium, neuroleptics and ECT and developed severe cxtrapyramidal side effects restricting the use of neuroleptics in high doses; showed marked clinical improvement with a combination of carbamazepine and lithium with sustained recovery. The case reported to illustrate the possible synergistic action suggested earlier, encouraging the authors to...

Many, if not all, great discoveries in psychopharmacology resulted, as Donald Klein noted,[1] “from chance observations of unexpected clinical benefits or as inadvertent outcomes of blind pharmaceutical searches.” One of such discoveries, by Cade J[2] in the late 1940's, was the calming anti-manic effect of lithium. Cade first noticed a calming effect of lithium in guinea pigs. He decided to te...

Sir: In the only 2 studies that estimate prevalence of mania secondary to traumatic brain injury (TBI), Jorge et al. diagnosed mania in 9% of 66 consecutive brain-injured patients and Van Reekum et al. found 22% of 18 TBI patients developed a bipolar spectrum disorder after mild or moderate TBI. Both of these estimates are higher than the known lifetime prevalence of bipolar I disorder, which i...

Lithium salts are used in the treatment of mania and as prophylaxis against manic depressive disorder. The aim of these studies was the in vitro investigation of the effect of lithium on phospholipids of human erythrocyte membranes. Erythrocytes were treated with lithium for 1 h. Phospholipids phosphatidylinositol (PI), phosphatidylserine (PS), phosphatidylethanolamine (PE), and phosphatidyloch...

BACKGROUND A previous factor analysis of Young Mania Rating Scale and Montgomery-Åsberg Depression Rating Scale items identified composite factors of depression, mania, sleep disturbance, judgment/impulsivity, and irritability/hostility as major components of psychiatric symptoms in acute mania or mixed episodes in a series of trials of antipsychotics. However, it is unknown whether these facto...

Quetiapine extended release (XR) and lithium are treatments with proven efficacy in acute mania. This randomized study evaluated the efficacy and safety of lithium or placebo as add-on to quetiapine XR in adult patients with manic or mixed symptoms of bipolar I disorder. In this 6-week, double-blind study (Trial D144AC00003), adult patients with DSM-IV-TR-diagnosed bipolar I disorder (current e...

Olanzapine is an atypical antipsychotic currently with indications for the treatment of schizophrenia, acute mania and the prevention of relapse in bipolar disorder. A growing body of clinical evidence supports these indications. Acute mania trials have demonstrated superior efficacy of olanzapine to placebo, equal or superior efficacy to valproate and superior efficacy in combination therapy w...

Lithium, by inhibiting inositol phosphate metabolism, interferes with the phosphatidylinositol ("phosphoinositide") cycle, which is stimulated by numerous hormones and neurotransmitters. To examine the relevance of this action to neurotransmission, we evaluated effects of lithium treatment on smooth muscle responses to transmitters. In lithium-pretreated tracheal muscle, the relaxation followin...

Lithium is an element which has been used as salts of chloride or carbonate for many years in the treatment of some psychological disorders such as mania, bipolar or schizophrenic diseases. Chronic application of lithium may induce some serious nephropathies such as natriuresis, renal tubular acidosis, tubulointerstitial nephritis progression to progressive chronic kidney disease and hypercalce...

Acute Mania Quetiapine XR (FDA approved for the treatment of acute mania) monotherapy has been shown to be more effective than placebo in treating acute mania with improvement starting at day 4. Aripiprazole adjunctive therapy was more effective than placebo adjunctive therapy in treating manic symptoms in BD manic patients with inadequate response to lithium or divalproex in a 6 week trial. Ol...