Manic depressive disorder, also known as affective disorders, is a kind of mental illness with its symptoms being emotional pathological changes. Manic-depressive disorder is characterized by repeated episodes of either manic or depressive episodes (single phase), or alternatively both of episodes (bipolar). The cause may be related to the brain monoamine dysfunction. However, the 5 - HT deficiency is the common biochemical basis. On this basis, upon NA (norepinephrine) hyperactivity, patients exhibits manic performance. Upon pathogenesis, patients are characterized by high mood, quick thinking and increased activities. NA dysfunction is manifested as depression. The patients will exhibit depression with reduced speech, reduced mental activity, bradykinesia and often self-blame and even attempt to suicide. The treatment of this disease is mainly symptomatic treatment with the main drugs being divided into antidepressant and anti-mania drugs. Commonly used antidepressants are tricyclic tetracyclines, including imipramine, desipramine, doxepin, amitriptyline, mianserin and maprotiline, etc. The major difference in the chemical structure of them with phenothiazine drugs is the substitution of the S atom with -CH2-CH2-.
These drugs are mainly used for the treatment of various types of depression. It has better efficacy in the treatment of the endogenous, reactive and menopausal depression, while being less effective in the treatment of the depression of schizophrenia. The most common adverse reactions exhibits atropine-like behavior such as dry mouth, constipation, blurred vision, palpitations and so on. A typical anti-mania agent is a lithium formulation. Lithiuim salt in treatment amount had almost little effect on the mental activity of normal people, but having significant effect on the mania patients, restoring the speech, behavior of patients to normal condition. Experiments have shown that lithium can inhibit the NA and DA release of brain while boosting its reuptake, causing the decrease concentration of NA in the synaptic cleft and resulting in anti-manic effect. There are many adverse reactions of lithium salt and the adverse reactions have individual differences. Other drugs such as chlorpromazine, haloperidol and anti-epileptic drug carbamazepine are also effective against mania.