ABSTRACT
Background: Lithium is considered first line drug effective in treating manic and mixed episodes of bipolar affective disorders throughout the globe. But the chronic and heterogenous nature of disease, along with toxicity of lithium often make patients non-adherent to medication as well as diminished health related quality of life. Present study was done to find out the prospect of regular supervision and follow up with therapeutic drug monitoring in optimization of lithium therapy based on health-related quality of life outcomes.Methods: It was a prospective, non-randomized, observational study of a cohort of subjects who are suffering from bipolar affective disorders and on lithium therapy. Patients were regularly followed up with therapeutic drug monitoring and personalized interview with questionnaires like WHO Quality of Life Score (QOL-Bref), Montgomery-Asberg Depression Scale (MADRS) and Medication Adherence Rating Scale (MARS).Results: Results revealed there was significant improvement in health-related quality of life of patients who were monitored with therapeutic drug monitoring and prescribed lithium therapy.Conclusions: Hence to maintain patients’ quality of life improved throughout the cycle of bipolar disorder spectrum, regular follow-up visits with monitoring of serum levels of lithium is needed, so that adverse effects would be minimal and adherence to medication become optimal. These optimal dosing resulting in optimal benefit to patients can be achieved with the involvement of clinical pharmacological consultation.
ABSTRACT
The rhizomes of Nardostachysjatamansi, the plant commonly known as Jatamansi have been described in Ayurveda for their soothing and sedative action on the central nervous system. In the present study, the anti-stress effect of hydroethanolic extract (70%) of N. jatamansi (NJE) was evaluated in reference to its antioxidant property. Wistar rats were divided into four groups: naive, stressed, and T-200 and T-500 stressed with oral pre-treatment of NJE 200 and 500 mg/kg, respectively. Restraint of rats in metallic chambers for 4 h at 4 degreesC was followed by sacrifice and assessment of stress-induced alterations in biochemical parameters, incidence and severity of ulcers. Lipid peroxidation (LPO) and NO levels in stomach and LPO, NO levels and catalase activity in brain, plasma corticosterone level and adrenal ascorbic acid were measured. In vitro antioxidant activity of NJE was studied by measuring the free radical scavenging activity. NJE showed potent antioxidant activity and significantly reversed the stress-induced elevation of LPO and NO levels and decrease in catalase activity in the brain. It inhibited the incidence of gastric ulcerations and reversed the alterations in biochemical parameters/markers of stress-induced gastric ulceration. NJE also significantly altered stress-induced increase in adrenal and spleen weights and decrease in level of ascorbic acid in adrenal gland. Elevation of plasma corticosterone level was negated dose- dependently. The findings suggest that the NJE possesses significant anti-stress activity, which may be due to its antioxidant activity.