'MDF The BiPolar Organisation' is the new name for the national charity the Manic Depression Fellowship.

The Manic Depression Fellowship is a registered charity.
Number: 293340

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Observations on MD 5

Observations on manic depression.
Written by Tina and David
Group facilitators, Southend MDF Self-help Group

5. Medication

5.1. Possible inducement of highs by anti-depressants
A number of people have reported that their high came 10 to 14 days after the introduction of, or a change of, an anti-depressant. It may therefore be particularly beneficial to monitor the person with manic depression more carefully at these times.

5.2. Lithium carbonate and blood tests
We still encounter a number of people who have been prescribed lithium carbonate but are not aware of the importance of routine and regular blood tests to establish that they are within the therapeutic range indicated by their own serum lithium levels. Even more frequently people are not aware of the need to have regular thyroid and kidney function checks. We also understand that it is important not to take tablets within the 12 hours prior to a blood test.

5.3. Carbamazepine
Lithium is reputed to work for 80% of people who take it and have it monitored regularly. For the other 20% carbamazepine or other medications can be effective. Blood tests are required for carbamazepine as well.

5.4. Use of lithium and carbamazepine in combination
The use of both medications in combination has been successful for several of the people we know through the national Manic Depression Fellowship.

5.5. Other medications
Lithium carbonate and carbamazepine are mood stabilisers (also referred to as maintenance or prophylactic medications). Another increasingly used mood stabiliser is sodium valproate. The two other major groups of medications used for manic depression are antidepressants and major tranquillisers (also called neuroleptics).

All medications take a time to work and persistence and regular review is required to find the most appropriate medication for an individual. Many people refer to this as 'trial and error' and it seems this process may be necessary for long term well-being.

5.6. Careful monitoring
A key to recovery appears to us to be careful and close monitoring of the individual and their medication in the early stages of an episode of illness (i.e. on a daily basis) in order to assist in obtaining a balance which is acceptable for them. Many people to whom we have spoken appreciate practitioners who explain what they are trying to do and why, and are far less happy with those people who 'treat you' with little explanation.

5.7. Desire to stop medication
Many people wish to stop their medication because of intolerable side effects or concerns about the long term usage. Medication can be so effective that it is easy to persuade yourself that you no longer need it and therefore you stop taking it. In our experience medication is important for many people for long term well being. For people who have had more than one episode of illness, medication can be essential. In any event it is probably wise not to stop taking medication without professional advice but in particular it is very important not to suddenly stop taking lithium.

We are aware of recent research in Cambridge, which indicates that stopping lithium is likely to be the most significant single factor in triggering relapse.

Dr Liz Armstrong, writing in Pendulum, the MDF Journal.

Click here for good comprehensive information on medication for mental health problems from the Norfolk Mental Health Care NHS Trust

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