First drug to beat manic depression

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A new drug is set to revolutionise the lives of manic depressives who, until now, have had to rely on medication that offers only a temporary solution. For decades, psychiatrists…

A new drug is set to revolutionise the lives of manic depressives who, until now, have had to rely on medication that offers only a temporary solution. For decades, psychiatrists have struggled to control the condition that affects more than half a million people in the UK.

Sufferers experience dramatic mood swings, which in some cases can lead to suicide. Zyprexa is one of the newer anti-psychotic drugs or mood enhancers and works by altering the brain chemistry to adjust imbalances. It is the first drug to have an impact on the symptoms of manic depression since the introduction of lithium more than 50 years ago.


In international trials over the past two years, daily doses of Zyprexa were shown to provide long-term relief from the symptoms of manic depression for 1,500 volunteers. It was twice as successful as lithium in keeping patients stabilised so they could carry on with their everyday lives. Existing drugs for manic depression – such as loxapine, promazine and haloperidol – can cause weight gain and a feeling of tiredness and lethargy. They have also been inconsistent at preventing sufferers from relapsing into a depressed state. Many patients on these drugs find it difficult to get out of bed because of the drugs’ sedating effect. But Zyprexa has been shown to have significantly fewer of these side effects.

Manic depression is thought to be caused by an imbalance of brain chemicals, in particular serotonin, which governs emotions and moods. If the brain’s level of serotonin is too high, sufferers can exhibit eccentric behaviour. They may be extremely verbose, hyperactive and never short of energy. If serotonic levels are too low, they switch back to a more depressive state. ‘In the past, we have had great difficulty stopping sufferers from lapsing back into the manic or depressive phase of the illness,’ says Dr John Cookson, a consultant psychiatrist at the Royal London Hospital.

‘We have been treating patients with several different drugs – one to bring them down from the mania and calm them, and anti- depressants as the manic episode wears off. Lithium has been one of the main stay drugs. We use it to control the manic phase of the condition, and to prevent relapse and the whole cycle starting again. But it has to be used carefully because of its toxicity to the liver and thyroid. It can also cause a jerking of the limbs. For some patients, Zyprexa will help keep them free of symptoms over a long period of time. It is a significant advance, and one that is being welcomed by psychiatrists working with this group of patients.’

The cycle of getting well only to become ill again often leads to breakups in relationships and the loss of employment.

A recent study by the Manic Depression Fellowship (MDF), a patient support group, found that 46 per cent of patients had stopped taking their drugs, with 41 per cent blaming side effects for quitting.

‘Manic depression is difficult to diagnose and treat and the arrival of a new drug offers hope that many patients will find their condition more manageable,’ says Beechy Colclough of the MDF.

‘Zyprexa is good news because, hopefully, it will keep many people from being admitted to hospital when they become manic or depressed. If new treatments can smooth out the extremes of the condition, it will make a significant difference to many patients’ lives.’

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