MANIA. ... Combining an antipsychotic agent with a mood stabilizer often improves control of manic symptoms, and further reduces the risk of relapse. Weight gain from the additive effects of antipsychotic agents and mood stabilizers (lithium, valproic acid) presents a significant clinical problem. MAJOR DEPRESSION .

1. presented by zuhaib AKhtar Baloch
student of pharm-D 5th semester
University of Balochistan sub Campus Mastung

2. × Mania, also known as manic syndrome, It’s a bipolar
disorder , a state of abnormall elevated
arousal, affect, and energy level, or "a state of
heightened overall activation with enhanced affective
expression together with lability of affect .
× Mania causes you to feel abnormally and persistently
happy, angry, hyperactive, impulsive, and irrational at
different times .
× mental illness marked by periods of great excitement
or euphoria, delusions, and overactivity.
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3. 1. Maniac patient feels :
Positive feelings
× Energetic
× Overly happy / optimistic
× Euphoric
× High self esteem
Negative Feelings
× Delusion no of Grandeur
× Pressurized speech
× Racing thoughts
× Poor decision Making
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4. 1. Feelings of special powers and superiority
2. Decreased need for sleep, restlessness
3. Talking excessively
4. Increased activity
5. Racing thoughts
6. Short attention span
7. Inappropriate laughing or joking, or getting into lots of
arguments
8. Inappropriate spending sprees or sexual activity
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5. × high levels of stress
× changes in sleep patterns or lack of sleep
× use of stimulants such as drugs or alcohol
× substance abuse
× violence, trauma or abuse
× Excessive secretion of dopamine
× Mania may be associated with strokes,
especially cerebral lesions in the right
hemisphere
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6. × Mania is treated with a natural Alkali metal By lithium (Lithiun Salt) .
× Lithium is one of the most widely used and studied medications for
treating bipolar disorder .
× It’s ultimate natural medication .
× Lithium also helps prevent future manic and depressive episodes. As a
result, it may be prescribed for long periods of time (even between
episodes) as maintenance therapy .
× Lithium 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 it is thought to help strengthen nerve cell connections
in brain regions that are involved in regulating mood, thinking and
behavior.
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7. 1. Absorption : it’s absorbed completely & Rapidly
in the GIT system
2. Distribution : it’s distributed through out all the
water in your body
3. Metabolism : It’s not metabolised because
ofCourse It’s an element .
4. Excretion : Approxiamately 95% excreted by the
kidney at the cellular level
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8. × Upon ingestion, lithium becomes widely distributed in the central nervous
system and interacts with a number of neurotransmitters and receptors,
decreasing norepinephrine Release and increasing serotonin synthesis .
× The therapeutic mechanism of action of lithium remains uncertain.
× At present it is felt that lithium blocks the enzymeinositol-1phosphatase within
neurons .
× That inhibition results in decreased cellular responses to neurotransmitters
that are linked to the phosphatidylinositol second messenger system .
× Lithium also inhibits glycogen synthase kinase decreasing levels of protein
kinase C isoenzymes .
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9. × Increased thirst.
× Increased urination.
× Diarrhea.
× Vomiting.
× Weight gain.
× Impaired memory.
× Poor concentration.
× Fine tremor .
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10. × Renal failure
× Cardiovascular insufficiency
× Addison’s disease
× Untreated hypothyroidism
× Heart failure
× Psoriasis (Psoriasis is a long-lasting autoimmune disease
characterized by patches of abnormal skin )
× Etiondepletion,
× Electrolyte disturbance
× Hypothyroidism
× Breast feeding.
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11. × Diuretics. Lithium is eliminated primarily through
glomerular filtration. ...
× Angiotensin-converting enzyme (ACE) inhibitors
× NSAIDs
× Calcium channel blockers
× Anticonvulsants
× Muscle relaxant
× Methylxanthines
× Ultram
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12. 1. Diuretics : (Loop diuretics) interacts with Lithium
× Some "water pills" can increase how much sodium the body gets rid of in
the urine. Decreasing sodium in the body can increase lithium levels in
the body and increase the effects and side effects of lithium.
2. Ace-Inhibitor :
× Some medications for high blood pressure can increase lithium levels in
the body. Taking lithium along with some medications for high blood
pressure might cause too much lithium to be in the body
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13. 3. NSAIDs :
× NSAIDs are anti-inflammatory medications used for decreasing pain
and swelling. NSAIDs might increase lithium levels in the body. Taking
lithium along with NSAIDs might increase the risk of lithium side
effects. Avoid taking lithium supplements and NSAIDs at the same
time.
4. Calcium channel blockers :
× Lithium is commonly used to help fix chemical imbalances in the brain.
Some medications for high blood pressure might increase the side
effects of lithium, and decrease the amount of lithium in the body.
5. Anticonvulsant :
× Medications used to prevent seizures affect chemicals in the brain.
Lithium is commonly used to help fix chemical imbalances in the brain.
Taking lithium along with some medications used for seizures might
increase the side effects of lithium. 13

14. 6. Muscle relaxant :
× Lithium might increase how long muscle relaxants work. Taking
lithium along with muscle relaxants might increase the effects and
side effects of muscle relaxants .
7. Methylxanthines :
× Taking methylxanthines can increase how quickly the body gets rid of
lithium. This could decrease how well lithium works .
8. Uthram :
× Tramadol (Ultram) can affect a chemical in the brain called serotonin.
Lithium can also affect serotonin. Taking lithium along with tramadol
(Ultram) might cause too much serotonin in the brain causing
confusion, shivering, stiff muscles and other side effects.
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15. Thanks!
Any questions?
You can find me at InstaGram : @Zuaib_baloc
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