More recently , lamotrigine ( Lamictal ) , a new anticonvulsant , has proved effective in the treatment of bipolar depression and useful for rapid cycling , and could become a widespread treatment. Gabapentin ( Neuroatim MD ) and topiramate ( Topamax ) are newer anticonvulsants have some utility in the treatment of bipolar disorder . However, no major study has yet been published about them.
It is helpful to ask your doctor information on new treatments against bipolar disorder. In some academic medical centers, it is also possible to participate in clinical trials of new treatments .
Remedies "natural" might also be of some use . They include fish oil and inosital , a type of sugar . However, in health food stores , the quality of these products is uneven. We can not recommend them because they have not been precisely formulated . In addition, little research has been done about them. St. John's wort has been extensively studied in the context of unipolar depression studies (without handles ) . However, its effectiveness against bipolar disorder has not been established.
ECT ( Electroconvulsive therapy )
Electroconvulsive therapy (ECT) , formerly known as the " electric shock " is perhaps the most controversial treatment and the least understood of psychiatric treatment , especially because of the sensationalist and misleading portrait that has been in the media. In reality, it is a safe and very effective for depression and manic bipolar disorder treatment. It is sometimes used as maintenance therapy to prevent long-term relapse.
proceedings
ECT involves administering a brief electrical stimulus to the surface of the brain through the scalp. This stimulus produces an epileptic-type convulsion , which usually lasts from 15 seconds to two minutes. A team consisting of a psychiatrist, an anesthesiologist and one or more nurses are present during processing.
The patient receives an injection of anesthetic that briefly asleep for the duration of treatment. It is also a muscle relaxant administered intravenously to reduce the intensity of muscle spasms that accompany seizures and thus prevent injury. The patient is receiving oxygen , and monitors heart rate and blood pressure .
Although anesthesia lasts only a few minutes, the patient experiences drowsiness after treatment, and is resting or sleeping for about an hour .
Generally, treatment is carried out three times a week for three or four weeks , for a total of eight to 12 treatments . If it is a long-term maintenance treatment sessions can be spaced , for example, once a month . Processing continues until the patient and the doctor deem necessary. ECT is generally administered to hospitalized patients, but may also receive outpatient treatment.
side Effects
After ECT , patients may have a headache or jaw . A mild pain reliever such as acetaminophen ( Tylenol ) is sufficient in this case. It is usually a loss of memory for recent events or concentration problems (eg , patients forget what they ate for dinner the night before) , but these symptoms subside after a few weeks of treatment . Some patients report mild memory problems long after the treatment, but they are probably due to their depression .
ECT can be given bilaterally (the electric current is applied to both sides of the brain) or unilateral (on the right side of the brain ) . Although bilateral ECT causes a more severe memory impairment than unilateral ECT , it is relatively more efficient , this technique is usually preferred .
Electroconvulsive therapy in the treatment of bipolar disorder
ECT is the most effective and probably the fastest against severe depression treatment, it is particularly useful for highly agitated or suicidal patients or those with psychotic or catatonic symptoms . Some patients receive treatment at the beginning of an episode because of the urgency of their situation or particular symptoms they feel, while others prefer to use it only if various drugs were ineffective . ECT also helps to treat severe mania .
Although it is very effective to stop episodes of depression and mania, ECT provides benefits for a few weeks or months. Patients should generally start or continue taking mood stabilizers or other drugs after treatment. Maintenance treatment can be administered when medications have failed to prevent relapse or are not tolerated because of side effects.
Transcranial magnetic stimulation
Finally include transcranial magnetic stimulation (TMS ) . It is a treatment that involves subjecting the brain with magnetic pulses . Trials are under way, but the effectiveness of this treatment has not yet been demonstrated.
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