Lithium Lithane Lithonate

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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 ind mild an<iety accompany •ng depression.

Contraindications: C'a^comj and predisposition to urinary retention Not recommended »n pregnancy Precautions and Side Effect* Drowsiness ^ay occur within the I rst few days of therapy Patients should ne warned against driving a car or operating machinery or appliances requiring alert attention When depression is accompanied by annety or agitation too severe to be controMed t>y riAVIL HCl atone a phenoth^a/me 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 eiectroshoch therapy Untoward reactions nave t>een reporied 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. permit at least two weeks to elapse between administration of two agents »n Such patients, .n.tiate therapy wcth ELAVIL HCl cautiously with gradual increase »n dosage required to obtain a satisfactory response Caution patterts abo..t errors of judgment due to change m nood. and tnat the response to alcohol may oe potentiated May provoke men»a or hypomanta m nia* ic de pressive pat-ems

Side effects include drowsiness dtfMness: nausea excitement: hypotens#on. fme tremor jitter mess. weanoess headache, heartburn, anorexia; increased perspiration, incoordination, allergic type reactions manifested by skin ras* swelling of face and tongue itching, numbness and tingling of limbs, including peripheral neuropathy; activation of schizophrenia 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 anticholinergic ac tivity such as tachycardia, dryness of the mouth blurring of vision unnary retention, constipation, paralytic ileus. ¿«sun dice, agranulocytosis

Careful observation of all patients is recomn^nded The anti depressant activity may be 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 «tepression pre\ ent Elderly pat.e^t* and adolescents car often he managed on lower dosage levels

Supplied: Tabiets £i Avil HCl. containing 10 mg. and 25 mg am.triptyline HCl. bottles of 100 and 1000. tmection ELAVIL HCl. in 10 cc vials containing per cc 10 mg. anvtnptylme HCl. 44 mg dext'ose. 1.5 g. metryiparahen. and 0? propylparaben.

Before presenb/ng or admimsfenng. read product circular w/th package or available on request

O MERCK SHARP & OOHME

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