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Psychiatry Drugs > Mood Stabilisers > Flashcards

Mood Stabilisers Flashcards

1
Q

What is the goal of acute treatment of bipolar?

A
  • Reduce mood in mania

- Raise mood in depression

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2
Q

What is the goal of long term treatment of bipolar?

A

-To stabilise mood and prevent recurrence of depression/mania

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3
Q

What is the most common form of Lithium given to patients?

A

-usually given as lithium carbonate

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4
Q

What are the risks of prescribing lithium?

A

Narrow therapeutic index. 12h post-dose blood levels have to be monitored.

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5
Q

What are the common side effects of lithium?

A
  • dry mouth
  • polydypsia/polyuria
  • hypothyroidism
  • Renal function (long term)-DO NOT PRESCRIBE NSAID simultaneously
  • weight gain
  • Diabetes insipidus
  • sedation (TAKE AT NIGHT)
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6
Q

What are the toxic effects of lithium?

A 
GI upset (nausea, vomiting, diarrhea)
CNS (ataxia, tremor, convulsions, coma)
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7
Q

What other drugs can stabilise mood?

A

Anticonvulsants Antipsychotics

  • lamotrigine (bip. dep.) -Quetiapine
  • carbamazepine -Aripiprazole
  • valproic acid(bip. h/mania) -Olanzapine
    - Lurasidone
    - Haloperidol (old)
    - chlorpromazine (old)
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8
Q

Side effects of these drugs?

A
  • lamotrigine: Steven Johnson’s Syndrome (small risk)
  • Valproic acid: teratogenicity (neural tube defect)
  • carbamazepine: CVS effects, drowsiness, ataxia, induction of liver enzymes
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9
Q

What are the modes of action of antipsychotics?

A

Dopamine and serotonin antagonist

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10
Q

Side effects of antipsychotics?

A
  • Sedation
  • weight gain
  • metabolic syndrome (olanzapine)
  • extrapyramidal symptoms (aripiprazole)-akathisia
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11
Q

What are the uses of lithium carbonate?

A
  • most effective treatment for bipolar
  • used as an adjunct to antidepressants for treatment resistant depression
  • It can be combined with most other psychotropics
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12
Q

What drugs may interact with lithium?

A
  • NSAID
  • ACEI
  • angiotension II receptor antagonist
  • Diuretics (especially thiazide)
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13
Q

What is the protocol for lithium monitoring?

A

prior to initiation: U&E, TFT, ECG
initiation: lithium level 12h after last dose. U&E every 5 days until lithium level stable within therapeutic range
Every 3 months: Lithium level and U &E
Every 6 months: TFT (hypothyroidism treated with levothyroxine instead of stopping lithium)

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14
Q

What is the mechanism of action of sodium valproate?

A

Block sodium channels and increases GABA levels. Effective in bipolar mania/hypomania

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15
Q

what are the side effects of sodium valproate?

A
  • sedation
  • tremor
  • dizziness
  • GI upset
  • Suicidal ideation (Rare)
  • pancreatitis/hepatotoxicity (Rare)
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16
Q

What must be checked prior to initiation of sodium valproate?

A
  • platelet count

- liver function

17
Q

What is lamotrigine?

A

Anti-convulsant. Can be used in treatment and prophylaxis of bipolar depression. Some evidence suggests anti-manic properties

18
Q

What are the uses of atypical antipsychotics in bipolar?

A
  • treatment and prophylaxis of both manic/hypomanic and depressed mood states in bipolar.
  • combine with antidepressant for psychotic unipolar depression
  • combine with antidepressant for unipolar depression wihout psychotic symptoms
19
Q

Which atypical antipsychotics are available in IM depot?

A
  • risperidone

- olanzapine

20
Q

What are the uses of typical antipsychotics in bipolar?

A

Same as atypical antipsychotics

21
Q

What is the mechanism of action of typical antipsychotics?

A

dopamine 2 receptor blockade (mainly

22
Q

What are the side effects of typical antipsychotics?

A
  • extrapyramidal side effects
  • sedation
  • dizziness
  • QTc prolongation
  • hyperprolactinemia
  • neuroleptic malignant syndrome (fever, muscle rigidity, altered mental status, autonomic dysfunction(
23
Q

Which class of antipsychotics are usually used in mood disorders?

A

atypical antipsychotics

Psychiatry Drugs (6 decks)

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