Managing Bipolar Affective Disorder in a Tribal District of Odisha.

ABSTRACT

BACKGROUND: Managing any chronic illness in marginalized communities in resource-poor settings is always a challenge. Lack of facility to monitor lithium and the common morbidity of hypokalemic periodic paralysis and chronic renal failure among tribals of northern part of Odisha pose unique challenges in managing bipolar disorder. METHODOLOGY: This is a cross-sectional study done in a district-level hospital catering to predominantly tribal population. A part of the data was collected by a psychiatrist prospectively and analyzed. Historical data were obtained from medical records. RESULTS: Out of 18 patients who had been diagnosed of bipolar/mania, 12 had received treatment with carbamazepine in the range of 400-600 mg. All but one person showed improvement. One person developed rash and had to stop the treatment. CONCLUSION: Carbamazepine may be used relatively safely in resource-poor settings in high-risk groups.