antimanic agent

抗躁薬

WordNet

1. a substance that exerts some force or effect
2. a businessman who buys or sells for another in exchange for a commission (同)factor, broker
3. any agent or representative of a federal agency or bureau (同)federal agent
4. a representative who acts on behalf of other persons or organizations
5. an active and efficient cause; capable of producing a certain effect; "their research uncovered new disease agents"
6. how long something has existed; "it was replaced because of its age"
7. a time of life (usually defined in years) at which some particular qualification or power arises; "she was now of school age"; "tall for his eld" (同)eld
8. begin to seem older; get older; "The death of his wife caused him to age fast"
9. make older; "The death of his child aged him tremendously"

PrepTutorEJDIC

1. 『代理人』;周旋人 / 働き(作用)を起こすもの;作用物,薬剤 / (政府機関,特にFBI,CIAなどの)部員,機関員
2. 〈U〉(一般に)『年齢』,寿命;〈C〉(個々の)『年齢』,年 / 〈U〉成年(おとなとしての資格・権利を得る年齢;通例18または21歳) / 〈U〉『老齢』;《集合的に》老人たち / 〈U〉(人生の)『一時期』;〈C〉世代(generation) / 〈U〉〈C〉《しばしばA-》(歴史上の)『時代』 / 〈C〉《話》長い間 / 年をとる,ふける;〈物が〉古くなる / 〈年〉'を'とらせる;〈物〉'を'古びさせる

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/05/12 13:08:36」(JST)

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A mood stabilizer is a psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts, typically bipolar disorder.

Uses

Used to treat bipolar disorder, mood stabilizers suppress swings between mania and depression. Mood-stabilizing drugs are also used in borderline personality disorder and Schizoaffective disorder.

Examples

The term "mood stabilizer" does not describe a mechanism, but rather an effect. More precise terminology is used to classify these agents.

Drugs commonly classed as mood stabilizers include:

Anticonvulsants

Many agents described as "mood stabilizers" are also categorized as anticonvulsants. The term "anticonvulsant mood stabilizers" is sometimes used to describe these as a class. Although this group is also defined by effect rather than mechanism, there is at least a preliminary understanding of the mechanism of most of the anticonvulsants used in the treatment of mood disorders.

• Valproic acid (Depakene), divalproex sodium (Depakote), and sodium valproate (Depacon, Epilim) – Available in extended release form. This drug can be very irritating to the stomach, especially when taken as valproic acid. Liver function and CBC should be monitored.
• Lamotrigine (Lamictal) – Particularly effective for bipolar depression. Usual dose is 100–200 mg daily, which can be built up by 25 mg every 2 weeks. The patient should be monitored for signs and symptoms of Stevens–Johnson syndrome, a very rare but potentially fatal skin condition.
• Carbamazepine (Tegretol) – CBC should be monitored, as carbamazepine can lower white blood cell count. Therapeutic drug monitoring is required. Carbamazepine was approved by the US Food and Drug Administration as a bipolar disorder treatment in 2005, but had been widely used previously.
• Oxcarbazepine (Trileptal) – Oxcarbazepine is not FDA approved for bipolar disorder. Still, it appears to be effective in about one-half of patients with bipolar disorder and be well tolerated.
• Riluzole -Riluzole is not FDA approved as a treatment for bipolar disorder. This drug is often used for Lou Gehrig’s disease,but also is a potential candidate for bipolar disorder therapy. Riluzole has been shown to have antidepressant properties in a number of recent studies of mood and anxiety disorders. Riluzole was tested for bipolar depression by Dr. Husseini Manji and colleagues. They gave the drug to 14 acutely depressed bipolar patients alongside lithium for eight weeks. A significant improvement was found, with no evidence of a switch into mania. “These results suggest that riluzole might indeed have antidepressant efficacy in subjects with bipolar depression,” say the team.Safety monitoring includes regular liver function tests and people with liver disease such as hepatitis should be monitored especially carefully.
• Gabapentin (Neurontin) is not FDA approved as a treatment for bipolar disorder. Randomized controlled trials suggest that Gabapentin is not an effective treatment, but many psychiatrists continue to prescribe it, it is reported because of positive but "low-quality" literature reviews.
• Topiramate (Topamax) is not FDA approved for bipolar disorder, either; and a 2006 Cochrane review concluded that there is insufficient evidence on which to base any recommendations regarding the use of topiramate in any phase of bipolar illness.

Other

• Lithium – Lithium is the "classic" mood stabilizer, the first to be approved by the US FDA, and still popular in treatment. Therapeutic drug monitoring is required to ensure lithium levels remain in the therapeutic range: 0.6 or 0.8-1.2 mEq/L (or millimolar). Signs and symptoms of toxicity include nausea, vomiting, diarrhea, and ataxia. The less common side-effects of using lithium are blurred vision, slight tremble in the hands, and a feeling of being mildly ill. In general, these side-effects occur in the first few weeks after commencing lithium treatment. These symptoms can often be improved by lowering the dose.
• Some atypical antipsychotics (risperidone, olanzapine, quetiapine, paliperidone, and ziprasidone) also have mood stabilizing effects and are thus commonly prescribed even when psychotic symptoms are absent.
• It is also conjectured that omega-3 fatty acids may have a mood stabilizing effect. Compared with placebo, omega-3 fatty acids appear better able to augment known mood stabilizers in reducing depressive (but perhaps not manic) symptoms of bipolar disorder; additional trials would be needed to establish the effects of omega-3 fatty acids alone.

Sometimes mood stabilizers are used in combination, such as lithium with one of the anticonvulsants.

Relationship to antidepressants

Most mood stabilizers are purely antimanic agents, meaning that they are effective at treating mania and mood cycling and shifting, but are not effective at treating depression. The principal exceptions to that rule, because they treat both manic and depressive symptoms, are lamotrigine and lithium carbonate. While an antimanic agent such as valproic acid or carbamazepine cannot treat depression directly as the former two drugs can, it is widely thought to help ward off depression in bipolar patients by keeping them out of mania and, thus, preventing their moods from cycling.

Nevertheless, an antidepressant is often prescribed in addition to the mood stabilizer during depressive phases. This brings some risks, however, as antidepressants can induce mania, psychosis, and other disturbing problems in bipolar patients — in particular, when taken alone, but sometimes even when used with a mood stabilizer. Antidepressants' utility in treating depression-phase bipolar disorder is unclear.

Use of mood stabilizers and anticonvusants such as lamotrigine, carbamazapine, valproate and others may lead to chronic folate deficiency, potentiating depression. Also, "Folate deficiency may increase the risk of depression and reduce the action of antidepressants." L-methylfolate (also formally known as 5-MTHF or Levofolinic acid), a centrally acting trimonoamine modulator, boosts the synthesis of three CNS neurotransmitters: dopamine, norepinephrine and serotonin. Mood stabilizers and anticonvulsants may interfere with folic acid absorption and L-methylfolate formation. Augmentation with the medical food L-methylfolate may improve antidepressant effects of these medicines, including lithium and antidepressants themselves, by boosting the synthesis of antidepressant neurotransmitters.

Mechanism

Most mood stabilizers are anticonvulsants, with the important exception of lithium, which is the oldest and best-known mood-stabilizing drug.

One possible downstream target of several mood stabilizers such as lithium, valproate, and carbamazepine is the arachidonic acid cascade.

See also

• ATC code N03
• Treatment of bipolar disorder

References

UpToDate Contents

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• 1. 高齢者の双極性障害：急性治療 geriatric bipolar disorder acute treatment
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English Journal

• Microtubule actin crosslinking factor 1 promotes osteoblast differentiation by promoting β-catenin/TCF1/Runx2 signaling axis.

• Hu L1,2,3, Su P1,2,3, Yin C1,2,3, Zhang Y1,2,3, Li R1,2,3, Yan K1,2,3, Chen Z1,2,3, Li D1,2,3, Zhang G2,3, Wang L4, Miao Z1,2,3, Qian A1,2,3, Xian CJ4.
• Journal of cellular physiology.J Cell Physiol.2018 Feb;233(2):1574-1584. doi: 10.1002/jcp.26059. Epub 2017 Aug 3.
• PMID 28621459

• HSF1 phosphorylation by ERK/GSK3 suppresses RNF126 to sustain IGF-IIR expression for hypertension-induced cardiomyocyte hypertrophy.

• Huang CY1, Lee FL2, Peng SF3, Lin KH4, Chen RJ5, Ho TJ6,7, Tsai FJ6, Padma VV8, Kuo WW3, Huang CY2,6,9.
• Journal of cellular physiology.J Cell Physiol.2018 Feb;233(2):979-989. doi: 10.1002/jcp.25945. Epub 2017 Jun 5.
• PMID 28383811

• Integrative omics data analyses of repeated dose toxicity of valproic acid in vitro reveal new mechanisms of steatosis induction.

• van Breda SGJ1, Claessen SMH2, van Herwijnen M2, Theunissen DHJ2, Jennen DGJ2, de Kok TMCM2, Kleinjans JCS2.
• Toxicology.Toxicology.2018 Jan 15;393:160-170. doi: 10.1016/j.tox.2017.11.013. Epub 2017 Nov 14.
• PMID 29154799

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★リンクテーブル★

リンク元	「抗躁薬」
関連記事	「agent」「age」

「抗躁薬」

　　[★]

英

antimanic、antimanic agent、antimanic drug、antimaniacal

同

気分安定薬 mood-stabilizing drug

関

抗躁病

• 炭酸リチウム
• 抗てんかん薬：カルバマゼピン、バルプロ酸
• 抗精神病薬：クロルプロマジン、レボメプロマジン

「agent」

　　[★]

• n.

• 代行者、代理人。代理業者
• 政府職員、官吏
• ある後位をする人、ある作用をするもの。動員、動力因、作用因。(文法)動作主。科学的変化を起こさせるもの、薬品、～剤。病原体

関

agonist、agonistic、attorney、delegate、drug、etiologic agent、fomes、fomites、mediator、pathogen、pathogenic、pharmaceutical preparation、vector、vehicle

　 　 　 　 　 　

「age」

　　[★]

• n.

• 年齢、歳

• v.

• 加齢する、熟成する

関

aged、ageing、aging、year old