A REVIEW ON USE OF LITHIUM IN BIPOLAR DISORDER

Bipolar disorder (previously called manic depressive illness) is a medical condition involving changes in the brain function leading to dramatic mood swings. It is characterized by the occurrence of at least one manic or mixed-manic episode, commonly treated with mood stabilizers. Sometimes, antipsychotics and antidepressants are used along with mood stabilizers. Lithium, a very effective mood stabilizer, was the first anti-manic depressant drug approved by the USFDA in the 1970's. Though the specific biochemical mechanism of its action is unknown, preclinical studies have shown that lithium alters sodium transport in nerve cells and effects a shift toward intraneuronal metabolism of catecholamine. Although lithium is drug of choice in the treatment of bipolar disorder, the safe dose range is relatively narrow, and therapeutic drug monitoring is needed in order to prevent toxic reaction after its oral administration. So, there is scope for the alternative route of administration of lithium, which gives optimum drug levels and produces effects in low dose.