LITHIUM MEDICATION TO BIPOLAR DISORDER

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Bipolar disorder is one of the many psychiatric disorders that manifest by feeling of depression alternating with hypomania or mania. In many cases, it is an illness which is associated with stigma in society. The knowledge deficit in society is a major cause of stigma, where some of the family members leave the patient at home. Poor compliance with hospital follow-up is among other practices that may affect response to medication such as lithium. It is therefore one of the mental illnesses that need close attention especially in the nursing  field to develop health education and promotion plans through understanding the physiological aspects,  pharmacological and non-pharmacological therapies. It is through such measures that the knowledge deficit will be bridged.  

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The disease burden for the bipolar disorder stands at 2.6 % of the American population. It was also been found that almost a third of the population with the bipolar disorder is most likely to have a close family member with the disease (Richardson & Macaluso, 2017). The most affected demographic is 18 years onwards. It one of the mental disease with gender parity but most survey have shown men to be slightly affected than women. People with bipolar disorder have been shown to have life expectancy less than 9 years compared with the normal one (Richardson & Macaluso, 2017). It is also one of the mental illness that is likely to provoke suicidal tendencies. The pharmacological therapy that is used mostly is lithium. Seventy-five percent of those who use it develop side effects such as tremors, weight gain, increased urination and impaired memory (Richardson & Macaluso, 2017).

In a research article written by Manchia et al. (2013), several aspects of response to lithium as the first line phmacological therapy approach were determined. Lithium is the first line drug of choice that is used in maintenance of bipolar disorder. More so, in their review of literature they found out that lithium is essential since it reduces the suicidal tendencies and the mortality rate associated with bipolar disorder. Statistically, Manchia, Adli & et al. (2013), found out that 1/3 of patients that use lithium have close to complete remission.  

However, Manchia et al. (2013) found a knowledge gap that patients who are on lithium medication have no uniform response to lithium medication. The literature reviewed established that phamacogenetics studies done has varying results. The study conducted by Manchia et al. (2013) was therefore tailored to reduce the effect of clinical heterogeneity of bipolar disorder by prospectively selecting study population among patients on lithium monotherapy with explicit clinical response. In the study, the study population’s response medication was determined by retrospective criteria of long-term treatment.

The finding with response to lithium treatment were two where one continuous in nature while the other one was dichotomous (Manchia et al., 2013). The continuous one had aspect of moderate to enhanced inter-rate agreement and with better consistency of the results. It indicated that there was clinical improvement when lithium treatment was used. The variables taken into consideration were the duration of treatment, full compliance to the lithium medication, same brand of lithium used throughout the treatment. 

The findings are very relevant to the health care worker who manages patients with bipolar disorder. How lithium is administered determines the outcome of the patient. It is from this perspective of the finding that becomes core to psychiatric nurse who takes care of patients under medication such as lithium. One of the variable that was tested is the compliance. A fully complied patient to the lithium medication has the best outcome compared with the other that take with interruption. The research used study populations that used this medication without interruption. The other aspect that has been shown is that long term use of lithium is very good for the outcome as shown by study population that were studied retrospectively. The other aspect is the maintenance of the same brand of drug that an individual was started on since it has better outcome compared with those that keep changing the brands (Manchia et al., 2013). It is imperative to understand the empirical implication and variations that can result in poor response while under the treatment of lithium.  

The research article is important for any health care worker and any other interested person that is ready to perform a research in the same line of study. To a practicing professional, it will enable them to come up with health education to the relatives on how lithium ought to be taken, it will be a resourceful knowledge to their own practice. To researchers, establishment of a knowledge gap will enable them to perfom a research to bring new knowledge in the same line of study. 

In conclusion, bipolar disorder and other psychiatric disorder are more of societal than hospital based. It therefore calls for an informed society. To be informed, the healthcare workers need to get more knowledge on the subjects through research work. It is then that management of psychiatric illness will be easier. 

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  1. Richardson, T., & Macaluso, M. (2017). Clinically relevant treatment considerations regarding lithium use in bipolar disorder. Expert Opinion on Drug Metabolism & Toxicology, 13(11), 1105-1113.
  2. Manchia, M., Adli, M., Akula, N., Ardau, R., Aubry, J-M., Backlund, L., … Alda, M. (2013) Assessment of response to lithium maintenance treatment in bipolar disorder: A consortium on lithium genetics (ConLiGen) report. PLoS ONE, 8(6), e65636.
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