Drugs Five Years Later

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Abstract
Li ion provides a useful and specific form of chemotherapy for manic and hypomanic episodes, although its antimanic effect may be delayed for as long as 1 wk or more, requiring the use of an antipsychotic agent in the initial period to control the behavior of very disturbed patients. The mechanisms of action of Li remain obscure, but probably involve effects on neuronal and hormone-target cell membranes. Li has interesting antithyroid and anti-antidiuretic hormone effects that are potentially useful medically. The main limitation of the use of Li is its narrow therapeutic index and requirement of close medical supervision. The most promising aspects of the use of Li are its encouragement of better psychiatric diagnosis and its prophylactic effectiveness in at least reducing the frequency and severity of manic and depressive attacks in manic-depressive illness.
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