Bipolar disorder is a brain illness that causes mood, energy, and ability to function variations. Bipolar illness patients have extreme emotional states that often occur over a period of days to weeks, referred to as mood episodes. Manic/hypomanic (abnormally cheerful or angry mood) or depressed (sad mood) mood episodes are classified. People with bipolar disorder frequently have periods of neutral mood. People with bipolar disorder can live long and productive lives if they are treated. The management of BD may be summarized into 2 phases, acute treatment and long-term prevention. Lithium was observed to have a unique therapeutic profile, including mood-stabilizing effects, as well as anti-suicidal and neuroprotective properties.13 It is available in many different salt forms, namely lithium carbonate, lithium citrate, lithium chloride, and lithium sulfate. A meta-analysis discovered that a combination regimen of haloperidol, olanzapine, risperidone, and quetiapine was substantially more effective in treating BD manic episodes than monotherapy with a mood stabiliser, but the combination regimen was less well tolerated than monotherapy. Keywords: Bipolar Disorder, Lithium, Monotherapy, Combination therapy, Adverse effects.

Background: Diabetes mellitus (DM) is chronic hyperglycemia condition affecting multiple organs due to metabolic disorder. Insulin secretion, function, or both are affected for which one of the factors attributed is due to increased free radical activity. Nicotinamide adenine dinucleotide phosphate (NADPH) produced in HMP shunt pathway is regulated by the rate-limiting glucose-6-phosphate dehydrogenase (G6PD). When there is an imbalance between the production of reactive oxygen species and the antioxidant system that detoxifies, then it is called oxidative stress. This pathway is regulated by the reductant concentration of NADPH. Aims and objectives: The current study was taken up to evaluate and correlate oxidative stress and insulin resistance with G6PD activity in type 2 DM (T2DM) patients. Materials and methods: A total of 100 (76 males 24 females) T2DM patients with equal age-and sex-matched healthy controls were selected for the study. Glucose-6-phosphate dehydrogenase was measured by chemical method in semiauto analyzer. Total oxidative stress measured as ferrous oxidation in xylenol orange and total antioxidant capacity estimated as ferric-reducing ability of serum by spectrophotometer. Glucose was measured by glucose oxidase-peroxidase method in an autoanalyzer. SPSS Version 20 software was used for statistical analysis. Results and observations: Increased serum G6PD levels were found in DM patients which significantly correlates with the increase of oxidative stress and high glucose levels (p value < 0.01). Conclusion:Estimation of blood G6PD activity may be used as a test to know the extent of oxidative status in DM patients for its implications in further clinical complications.

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