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Drug: Lithium

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Lithium is the first choice of treatment for bipolar disorders and it is indicated that Lithium is effective in the alleviation of manic and depressive episodes. 75-80% of patients who take Lithium as directed show improvement. One patient, on page 177 of the textbook, states that Lithium prevents his “disastrous highs” and “diminishes depression”. Patients who continue to take Lithium between episodes are significantly less likely to experience a relapse.

Potential Side effects:

Nausea, memory problems, weight gain, and impaired coordination.


The nonresponse rate in rapidly cycling patients and patients who exhibit comorbidity with alcohol abuse is as high as 50%. It was also found that at least half of the patients that Lithium is prescribed for fail to take it on a regular basis or stop using Lithium against their physician’s advise.

Drug: Anticonvulsants- Carbamazepine ( Tegretol), Valproic Acid ( Depakene)

Anticonvulsant medications are prescribed to patients who do not respond to Lithium. Approximately 60% of the patients will respond positively to them. Like Lithium, they can be helpful in treating the severity and frequency of relapses and anticonvulsants can also be used to treat acute manic episodes. Valproic Acid may be more effective than Lithium for the treatment of rapid cycling patients and those with mixed symptoms of depression and mania in a single episode.

Potential Side effects:

Nausea, vomiting, diarrhea, and sedation.


There were no limitations listed in the textbook or lecture notes, but one can surmise that just like Lithium, not all will respond positively and there will be patients who will not take their medication regularly and/or stop it altogether.

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