Lithium Lithane Lithonate

Lithium salts are a relatively new treatment for manic-depressive psychosis, a serious mental illness in which people swing back and forth between extremes of mood, from intense elation (mania) to intense depression. Lithium damps out these mood swings and is especially good at preventing manic episodes, although it is also used to treat depression. It has many side effects and can produce serious toxicity in the nervous system, heart, and kidneys. It has no effects on the mind that recommend it for nonmedical use.

...but her other symptoms:

anxiety, loss of interest anorexia, psychomotor retardation strongly suggest an underlying depression.

when the diagnosis is depression

AMITRIPTYLINE HCl

Indications: Mental depression ar<f mild an<iety accompany •ng depression.

Contraindications: C'aicoma and predisposition to urinary retention Not recommended »n pregnancy Precautions and Side Effects Drowsiness may occ<#r within the I rst few days of therapy Patients should ne warned against driving a car or operating n^.aenmery or appliances requiring alert attention When depression is accompanied by an»»*ry or agitation too severe to be controMed by riAVIL HCl atone a phenoth%a/ine tranquilizer may be given concomitantly. Suiode is always a possibility m mental depression and may remain unt«i significant remission occurs Supervise patients closely m case they nay require hospitalization or concomitant eiectroshock therapy Untoward reactions nave t>een reported after the combined use of antidepressant agents having varying modes of activity Accordingly, consider possibility of potentiation >n comb.ned use of antidepressants Mono amine oxidase inhibitor dr>*gs may potentiate other drugs and such potentiation may even cause oeath. pe'mrt at least two weeks to elapse betten admmstration of two agents »n Such patients, .n.tiate therapy with ELAVIL HCl cautiously with gradual increase »n dosage required to obtain a satisfactory response Caution patients abo..t errors of judgment due to change m ^ood and that the response to alcohol may t>e potentiated May provoke mer>»a or hypomania m ma* ic de pressive pat-ents

Side effects include drowsiness dtfMness: nausea excitement; hypotens#on. fme tremor jitter mess. weanness headache, heartburn, anorexia; increased perspiration, incoordination, allergic type reactions manifested by skin rash swelling of face and tongue itching, numbness and tmglmg of limbs, including peripheral neuropathy; activation of schizophren»* which may require phenothia/me tranquilizer therapy epi leptiform seizures in chronic schi/ophren-cs temporary con-fusion, disturbed concentration or rarely, transient visual hallucinations on high doses; evidence of arit>choliner£ic ac tivity such as tachycardia, dryness of the mouth blurring of vision urinary retention. constipation, paralytic ileus. ,aun dree, agranulocytosis

Careful observation of all patents is recomn^nded The anti depressant activity may br evident within 3 or 4 days or may take as ?ong as 30 days to develop adequately. and lack of response sometimes occurs. Response to medication will vary according to sever.-ty as well as type <A ilepression pre\ ent Elderly patients and adolescents car often he o:anaeed on lower dosage »eve's

Supplied: Tabiets f i Avil HCl. containing 10 mg. and 25 mg am.triptyline HCl. bottles of 100 and 1000. tmection ELAVH HCl. m 10 cc vials containing per cc 10 mg. amitnptylme HC». 44 mg dextrose. 1.5 g. metryiparahen. and 0? propylparaben.

Before prescribing or admin»sfenng. read product circular w/th package or avaifafe.'e on request

O MERCK SHARP & OOHME

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