Department of Pharmacology and Toxicology, School of Pharmacy, Benghazi University, Postbox: 5341, Benghazi, Libya.
Department of Pharmacology and Toxicology, School of Pharmacy, Benghazi University, Postbox: 5341, Benghazi, Libya.
Eur J Pharmacol. 2014 Oct 5;740:464-73. doi: 10.1016/j.ejphar.2014.06.042. Epub 2014 Jun 30.
A radical drug treatment for bipolar affective disorder (BD) is currently unavailable. This is attributed to the fact that the precise pathophysiology of this ailment is unclear though a genetic factor is an essential element in etiology. Dissimilar to other serious psychiatric categories such as psychoses and major depression the forecast of this disease is unpredictable. There is a high suicidal risk among BD affected individuals. In this review we will consider lithium, the drug of choice in treatment of this disorder with special emphasis on pharmacology and toxicity. We have also elucidated the alternatives to lithium, since it has a wide spectrum of side-effects. Lithium is known to interact with many types of drugs used to treat different ailments in humans. This could cause either augmentation or minimization of the therapeutic action, causing secondary undesired effects of the agent. This necessitates a search for other alternatives and/or different combinations to lithium in order to decrease the range of unwanted effects for which it has received discredit. These alternatives should be potent mood stabilizers as monotherapy so as to avoid polypharmacy. If not, one should find the best combination of drugs (synergistic agents) such that the lithium dose can be minimized, thereby securing a more potent drug therapy. This study also focuses on the provision of instruction to psychiatric care givers, such as junior doctors in residency, nurses in psychiatric units, psychiatric emergency personnel and, additionally, medical and pharmacy students.
目前，尚无针对双相情感障碍 (BD) 的激进药物治疗方法。这归因于尽管遗传因素是病因学的重要因素，但这种疾病的确切病理生理学尚不清楚。与精神病和重度抑郁症等其他严重精神疾病类别不同，这种疾病的预后难以预测。BD 受影响的个体自杀风险很高。在本次综述中，我们将考虑锂，这是治疗这种疾病的首选药物，特别强调药理学和毒性。我们还阐明了锂的替代方法，因为它具有广泛的副作用。众所周知，锂会与用于治疗人类不同疾病的许多类型的药物相互作用。这可能会导致治疗作用的增强或减弱，从而导致药物的继发不良影响。这需要寻找其他替代方法和/或锂的不同组合，以减少其受到质疑的不良作用范围。这些替代方法应该是有效的单药治疗情绪稳定剂，以避免多药治疗。如果不行，应该找到最佳的药物组合（协同药物），从而使锂的剂量最小化，从而确保更有效的药物治疗。这项研究还侧重于向精神科护理人员（如住院医师、精神科病房护士、精神科急救人员）以及医学生和药剂学生提供指导。
