OBJECTIVE: This study was performed to investigate the prescribing patterns of antimanic agents in the treatment of acute bipolar disorder inpatients in Korea from 1990 through 2000. The results will serve as the basic data for the practice guideline for the pharmacotherapy of bipolar disorder patients in Korea. METHOD: Retrospective chart review of bipolar disorder inpatients of Soonchunhyang Medical Center in Seoul and Chun-An was conducted for each of the year 1990, 1995, and 2000. The following data are collected ; 1) demographic data, 2) history of bipolar disorder, 3) length of hospital stay, 4) detailed drug titration records of antimanic agents and antipsychotic agents. RESULTS: During the last decade, the frequency of lithium monotherapy was decreased obviously. Instead, more than half of the patients in 2000 were on combination therapy of lithium and anticonvulsants. Lithiumvalproate combination was the preferred strategy and the use rate of carbamazepine has been decreased. In addition, most of the patients were given antipsychotic agents during the last 10 years. And recently, atypical antipsychotics were increasingly prescribed. These changes in the field of pharmacology of bipolar disorder have resulted neither in shorter hospital stays nor lower dosages of concurrent neuroleptics. CONCLUSIONS: The results indicate the trends in the prescribing of antimanic agents for the treatment of bipolar disorder in Korea across the past 10 years. Mostly, the change seems to correspond to the international practice guideline. More systematic research is needed to find out the clinical benefits of the anticonvulsants in the real practice of treatment of bipolar disorder.
Anticonvulsants ; Antimanic Agents* ; Antipsychotic Agents ; Bipolar Disorder ; Carbamazepine ; Drug Therapy ; Humans ; Inpatients* ; Korea ; Length of Stay ; Lithium ; Pharmacology ; Retrospective Studies ; Seoul

OBJECTIVETo explore the neuroprotection and the impact on brain development of lithium, the effects of lithium salt on the growth and survival of primary cultured cerebrocortical neurons were studied.

METHODSThe technique of primary cultured cerebrocortical neurons of newborn rats with serum-free medium was established, and the growth and survival of neurons treated with different doses of lithium chloride (0.625, 1.250, 2.500, 5.000, 10.000 mmol/L) were observed. The length of neuronal synapse, cell viability by MTT reduction assay were also measured.

RESULTSThe neurons were brighter, germinated rapidly, the neuronal synapse lengthened markedly, and the neurons viability was also better after treated with lithium chloride. Among the five doses, 5.000 mmol/L had the best effect [(53.80 +/- 5.84) micro m, P < 0.01].

CONCLUSIONLithium chloride can promote the growth and survival of neurons.

Animals ; Animals, Newborn ; Cell Division ; drug effects ; Cell Survival ; drug effects ; Cells, Cultured ; Cerebral Cortex ; cytology ; Lithium ; pharmacology ; Neurons ; cytology ; drug effects ; Neuroprotective Agents ; pharmacology ; Rats ; Rats, Wistar

PURPOSE: Lithium-pilocarpine induced status epilepticus (LPSE) causes selective and age-dependent neuronal death, although the mechanism of maturation-related injury has not yet been clarified. The activating transcription factor-2 (ATF-2) protein is essential for the normal development of mammalian brain and is activated by c-Jun N-terminal kinase (JNK). It induces the expression of the c-jun gene and modulates the function of the c-Jun protein, a mediator of neuronal death and survival. Therefore, we investigated the expression of c-Jun and ATF-2 protein in the immature and adult rat hippocampus to understand their roles in LPSE-induced neuronal death. MATERIALS AND METHODS: Lithium chloride was administrated to P10 and adult rats followed by pilocarpine. Neuronal injury was assessed by silver and cresyl violet staining, performed 72 hours after status epilepticus. For evaluation of the expression of ATF-2 and c-Jun by immunohistochemical method and Western blot, animals were sacrificed at 0, 4, 24, and 72 hours after the initiation of seizure. RESULTS: Neuronal injury and expression of c-Jun were maturation-dependently increased by LPSE, whereas ATF-2 immunoreactivity decreased in the mature brain. Since both c-Jun and ATF-2 are activated by JNK, and targets and competitors in the same signal transduction cascade, we could speculate that ATF-2 may compete with c-Jun for JNK phosphorylation. CONCLUSION: The results suggested a neuroprotective role of ATF-2 in this maturation-related evolution of neuronal cell death from status epilepticus.
Activating Transcription Factor 2/*metabolism ; Animals ; Antimanic Agents/pharmacology ; Blotting, Western ; Hippocampus/drug effects/*metabolism ; Immunohistochemistry ; Lithium/pharmacology ; Miotics/pharmacology ; Pilocarpine/pharmacology ; Proto-Oncogene Proteins c-jun/*metabolism ; Rats ; Status Epilepticus/*chemically induced

OBJECTIVETo explore and compare the effects of propofol, ginsenoside Rg-1, protein phosphatae-2A, and lithium on the learning and memory and the concentration of glutamic acid in hippocampus after the electroconvulsive therapy (ECT) in the model of depressed rats induced after the removal of olfactory bulb.

METHODSThe depressed rats were randomized into ECT intervention (two levels:no disposition and a course of electroconvulsive shock) and drug intervention (five levels:microinjection of saline injection, propofol, ginsenoside Rg-1, protein phosphatae-2A, and lithium, 20 g/L). Learning and memory were evaluated using the Morris water maze test within 24 h after the course of ECT. Glutamate contents in the hippocampus of rats were examined using high-performance liquid chromatography.

RESULTSBoth propofol alone and ECT alone induced the impairment of learning and memory in depressed rats, but their combination alleviated the such impairment caused by ECT. Ginsenoside Rg-1, protein phosphatae-2A ,and lithium had no obvious effect on the leaning and improved the learning and memory when in combination with ECT. There was a synergic effect between ECT intervention and drug intervention. ECT remarkably increased the glutamate content in the hippocampus of depressed rats, which could be reduced by both propofol and ginsenoside Rg-1. Protein phosphatae-2A and lithium did not affect glutamate content in the hippocampus of depressed rats before and after ECT.

CONCLUSIONSECT can increase the content of glutamate in hippocampus and thus cause the impairment of learning and memory in depressed rats. Propofol and ginsenoside Rg-1 can ameliorate the impairment by reducing the content of glutamate in hippocampus. Protein phosphatae-2A and lithium may also improve the learning and memory in depressed rats.

Animals ; Electroshock ; Ginsenosides ; pharmacology ; Glutamic Acid ; metabolism ; Hippocampus ; metabolism ; Lithium ; pharmacology ; Male ; Maze Learning ; drug effects ; Memory ; drug effects ; Propofol ; pharmacology ; Protein Phosphatase 2 ; pharmacology ; Rats ; Rats, Sprague-Dawley

To explore the action mechanism of lithium in the brain, the author investigated the effects of lithium on Na-K ATPase and Ca ATPase in rat brain synaptosomes prepared from forebrains by the method of Booth and Clark. The activities of Na-K ATPase and Ca ATPase were assayed by the level of inorganic phosphate liberated from the hydrolysis of ATP. Lithium at the optimum therapeutic concentration of 1 mM decreased the activity of Na-K ATPase from the control value of 19.08 +/- 0.29 to 18.27 +/- 0.10 micromoles Pi/mg protein/h and also reduced the activity of Ca ATPase from 6.38 +/- 0.12 to 5.64 +/- 0.12 micromoles Pi/mg protein/h. The decreased activity of Na-K ATPase will decrease the rate of Ca2+ efflux, probably via an Na-Ca exchange mechanism and will increase the rate of Ca2+ entry by the depolarization of nerve terminals. The reduced activity of Ca ATPase will result in the decreased efflux of Ca2+. As a Conclusion, it can be speculated that lithium elevates the intrasynaptosomal Ca2+ concentration via inhibition of the activities of Na-K ATPase and Ca ATPase, and this increased [Ca2+]i will cause the release of neurotransmitters and neurological effects of lithium.
Animal ; Brain/*enzymology ; Ca(2+)-Transporting ATPase/*antagonists & inhibitors ; Lithium/*pharmacology ; Male ; Na(+)-K(+)-Exchanging ATPase/*antagonists & inhibitors ; Rats ; Rats, Sprague-Dawley ; Synaptosomes/*enzymology

OBJECTIVETo investigate the changes in the functional activity of glycogen synthase kinase-3 (GSK-3) in the hepatic tissue after endotoxin (lipopolysaccharide, LPS) tolerance and explore the effects of LPS-induced GSK-3 inhibition on glycogen metabolism in the liver.

METHODSMale SD rats were randomly divided into normal control, endotoxin pretreatment and GSK-3 inhibitor (lithium chloride) groups with corresponding pretreatments prior to a large dose of LPS challenge (10 mg/kg) to induce liver injury. Glycogen deposition and content in the hepatic tissue was detected using periodic acid-Schiff (PAS) staining and a glycogen quantification kit, respectively. Western blotting was performed for semi-quantitative analysis of protein level and inhibitory phosphorylation of GSK-3, and a Coomassie brilliant blue G-250-based colorimetric assay was used to detect calpain activity in the liver.

RESULTSGlycogen content in the liver decreased significantly after LPS challenge in all the 3 groups (P<0.05) but showed no significant difference among the groups (P>0.05). Both LPS and lithium chloride pretreatments caused a significant increase of liver glycogen content (P<0.05). LPS pretreatment induced inhibitory phosphorylation of GSK-3β (P<0.05) and partial cleavage of GSK-3α but did not affect the expression of GSK-3 protein (P>0.05). Large-dose LPS challenge significantly increased the activity of calpain in the liver tissue (P<0.05) to a comparable level in the 3 groups (P>0.05).

CONCLUSIONEndotoxin pretreatment induces inhibitory phosphorylation of GSK-3β and partial cleavage of GSK-3α and promotes the deposition of liver glycogen but does not affect the activity of calpain, which may contribute to an increased glycogen reserve for energy supply in the event of large-dose LPS challenge.

Animals ; Calpain ; metabolism ; Glycogen ; metabolism ; Glycogen Synthase Kinase 3 ; antagonists & inhibitors ; metabolism ; Lipopolysaccharides ; adverse effects ; Lithium Chloride ; pharmacology ; Liver ; drug effects ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study whether lithium agent produces neuroprotective effect by inhibiting the nerve cell apoptosis of rats after spinal cord injury.

METHODSForty-two male SD rats weighing 200 to 250 g were randomly divided into 3 groups: blank control group(=6) without surgery, normal saline(NS) group(=18) with intraperitoneal injection of NS (40 mg/kg); and Lithium chloride (Licl) group (=18) with intraperitoneal injection of Licl (40 mg/kg). After Allen method modeling, Licl group started intraperitoneal injection of Licl solution (40 mg·kg⁻¹·d⁻¹) within 15 min after operation to the second week. NS group, during the same interval, was injected with a same amount of NS. Postoperative 3, 7, 14 d, BBB scores in each group were measured;the expression of Bcl-2 and Bax protein were observed by immunohistochemisty staining;TUNEL staining was used to observe the nerve cell apoptosis.

RESULTSThe BBB scores in blank control group were 21. Postoperative 7, 14 d, BBB scores of Licl group were higher than that of NS group(<0.05). As for the Bcl-2 protein expression, black control group has a level of 0.081±0.003;7 d and 14 d postoperatively, the level in Licl group was 0.151±0.003, 0.163±0.003 and in NS group, 0.143±0.003, 0.154±0.002, respectively. Licl group showed significantly increased Bcl-2 protein expression(<0.05). As for the Bax protein expression, black control group showed a level of 0.071±0.003; 7 d and 14 d postoperatively, the level in Licl group was 0.121±0.002, 0.106±0.002 and in NS group was 0.126±0.001, 0.120±0.002, respectively. The Bax protein expression is significantly inhibited in the Licl group(<0.05). In nerve cell apoptosis by TUNEL staining, the positive cells were fewer in the black control group with apoptosis index (AI) of 1.98±0.19;while 7d and 14d postoperatively, the AI of Licl group was 13.12±0.69, 4.29±1.00 and of NS group, 18.26±0.87, 5.48±0.70, respectively. Licl group showed significant inhibition of the cell apoptosis(<0.05).

CONCLUSIONSLicl can promote the Bcl-2 protein expression and inhibit the Bax proteins expression in nerve cells of rat after SCI, thereby playing a role in the inhibition of nerve cell apoptosis. This may be one of the mechanisms that Licl can promote the recovery of motor function of rats after SCI.

Animals ; Apoptosis ; Lithium ; pharmacology ; Male ; Neurons ; cytology ; drug effects ; Neuroprotective Agents ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; drug therapy ; bcl-2-Associated X Protein ; metabolism

To investigate the mechanism of proliferation inhibition and apoptosis of K562 leukemia cells by lithium chloride (LiCl), after K562 cells were treated with LiCl (30 mmol/L) cell cycle was examined by flow cytometry (FCM) and the expression of bcr/abl fusion gene mRNA was evaluated by RT-PCR. The intracellular Li(+) concentrations of K562 cells were determined at different time after treated with 30 mmol/L LiCl and the effects of TTX and FSK on intracellular Li(+) concentrations of K562 cells were also detected by atomic absorption spectrometry. The effects of TTX and FSK on LiCl-induced growth inhibition of K562 cells were determined by cell counting in liquid culture. The results showed that LiCl (30 mmol/L) caused a sustained arrest in G(2)/M cell cycle and down-regulated the bcr/abl mRNA expression in K562 cells, the intracellular Li(+) concentration of K562 cells increased at 30 minutes after treated with 30 mmol/L LiCl and reached apex at 2 hours, thereafter, gradually decreased and balanced at 4 hours after the treatment. If either Na(+) channel was pre-blocked with TTX or K(+) channel was pre-blocked with FSK, the intracellular Li(+) concentrations of K562 cells treated with 30 mmol/L LiCl were higher than that in the cells just treated with LiCl without pre-blocking. Furthermore, after pre-blocking either Na(+) channel with TTX or K(+) channel with FSK, the inhibition rate of K562 cell growth by 30 mmol/L LiCl could be increased. It is concluded that the mechanism of proliferation inhibition and apoptosis of K562 leukemia cells induced by LiCl is probably related with the G(2)/M cell cycle arrest, the bcr/abl mRNA expression down-regulation and the status of Na(+), K(+), or Li(+) ion channels on K562 leukemia cells.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Colforsin ; pharmacology ; Flow Cytometry ; Fusion Proteins, bcr-abl ; genetics ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; K562 Cells ; Leukemia ; genetics ; metabolism ; pathology ; Lithium Chloride ; pharmacology ; Potassium Channel Blockers ; pharmacology ; RNA, Messenger ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sodium Channel Blockers ; pharmacology ; Tetrodotoxin ; pharmacology

Akt/protein kinase B is a well-known cell survival factor and activated by many stimuli including mechanical stretching. Therefore, we evaluated the cardioprotective effect of a brief mechanical stretching of rat hearts and determined whether activation of Akt through phosphatidylinositol 3-kinase (PI3K) is involved in stretch-induced cardioprotection (SIC). Stretch preconditioning reduced infarct size and improved post-ischemic cardiac function compared to the control group. Phosphorylation of Akt and its downstream substrate, GSK-3beta, was increased by mechanical stretching and completely blocked by wortmannin, a PI3K inhibitor. Treatment with lithium or SB216763 (GSK-3beta inhibitors) before ischemia induction mimicked the protective effects of SIC on rat heart. Gadolinium (Gd3+), a blocker of stretch-activated ion channels (SACs), inhibited the stretch-induced phosphorylation of Akt and GSK-3beta. Furthermore, SIC was abrogated by wortmannin and Gd3+. In vivo stretching induced by an aorto-caval shunt increased Akt phosphorylation and reduced myocardial infarction; these effects were diminished by wortmannin and Gd3+ pretreatment. Our results showed that mechanical stretching can provide cardioprotection against ischemia-reperfusion injury. Additionally, the activation of Akt, which might be regulated by SACs and the PI3K pathway, plays an important role in SIC.
Androstadienes/pharmacology ; Animals ; Gadolinium/pharmacology ; Glycogen Synthase Kinase 3/*metabolism ; Indoles/pharmacology ; *Ischemic Preconditioning, Myocardial ; Lithium/pharmacology ; Male ; Maleimides/pharmacology ; Myocardial Reperfusion Injury/enzymology/physiopathology/*prevention & control ; Phosphatidylinositol 3-Kinase/*antagonists & inhibitors/metabolism ; Phosphorylation ; Proto-Oncogene Proteins c-akt/*metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Specific Pathogen-Free Organisms

To investigate the effect of lithium on cell cycle progression of airway epithelial cells, primary pig tracheobronchial epithelial cells were incubated with lithium chloride (LiCl) at different concentrations (0, 5 mmol/L, and 10 mmol/L) and time (12 h, 16 h and 24 h). After the treatment, cells were counted, cell cycle profile was measured by BrdU labeling and flow cytometry, and expression of cyclin D1 and cyclin B1 were detected by Western blotting. The results showed that after 24h of 10mmol/L but not 5mmol/L LiCl treatment, proliferation of cells was slowed down as manifested by delayed confluence and cell number accumulation (P<0.05). Lithium did not change the percentage of cells in S phase (P>0.05), but 24 h incubation with 10 mmol/L LiCl induced a G2/M cell cycle arrest. Furthermore, 10mmol/L LiCl elevated cyclin D1 expression after 12h treatment, while expression of cyclin B1 increased more significantly after 24h incubation. These data demonstrate that lithium inhibits proliferation of pig airway epithelial cells by inhibiting cell cycle progression, and suggest that lithium-sensitive molecule(s) such as glycogen synthase kinase 3 may have a role in the regulation of growth of airway epithelial cells.
Animals ; Cell Cycle ; drug effects ; Cell Division ; drug effects ; Cells, Cultured ; Cyclin D1 ; metabolism ; Epithelial Cells ; cytology ; drug effects ; Flow Cytometry ; Glycogen Synthase Kinase 3 ; metabolism ; Lithium Chloride ; pharmacology ; Swine ; Trachea ; cytology